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Carpal Tunnel Syndrome and Body Type

5 Oct

Is there a relationship between carpal tunnel syndrome (CTS) and body mass index (BMI)? A 1994 study focused on 949 patients who presented with right arm numbness and tingling. In the study, the patients underwent electromyography and nerve conduction velocity (EMG/NCV)—the “gold standard” of tests to diagnose nerve injuries in conditions such as CTS.

Researchers then sub-divided the group by age (three groups: younger than 45; between 45 and 64; and 65 or older), body size (defined by BMI), and gender. Investigators compared those who were obese (BMI more than 29) to the other groups: slender – BMI less than 20; normal – BMI 20-The findings revealed that of the 261 patients diagnosed with CTS, only 16% were slender compared with 39% who were obese. This indicates that those with obese body types are 2.5 times more likely to develop CTS than slender individuals. Regarding gender, 43% of obese women had CTS compared to 32% of obese males, and 21% of slender women had CTS compared to 0% of slender males. The mean age for the CTS patients was higher at 48.1 years of age (vs. 44.7 years), with the peak occurrences in the 45-65 year old group (41%), followed by those 65 years or older (26%), with the rate in those younger than 45 years old group at  21%.

This study is consistent with previously identified risk factors for developing CTS: obesity, older age, and being female. But are there additional “body type” risk factors?

It turns out that other studies have found that people with square-shaped wrists, short/wider palms (with shorter third fingers), and those with poor upper back strength all have a higher risk for developing CTS.

We’ve looked at other well-known risk factors previously such as diabetes, arthritis, pregnancy, birth control pill use, occupation type, smoking, alcohol abuse, poor nutrition, high LDLs (“bad” cholesterol), and genetic factors. Doctors of chiropractic are trained to diagnose and treat CTS, and ALL studies recommend EARLY treatment, so DON’T WAIT!

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

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Carpal Tunnel Syndrome Splints

7 Sep

Wrist splints are often a beneficial form of CTS self-care, as they can assist in relieving the pressure within the carpal tunnel by restricting wrist flexion and extension.  Because we cannot control the position of our wrist during sleep and the pressure on the nerve worsens the more it bends forwards or backward, splints are most commonly used during sleep.

There are literally hundreds of options of splints available online that range from simple glove-like splints (some with and without the fingers covered) to full arm splints. The majority block wrist motion and use Velcro closures with metal bars on the bottom and/or top of the splint. Your doctor of chiropractic can help you choose the best splint for your particular case.

There are studies that have attempted to isolate one form of treatment from others for conditions like CTS, but as noted in a 2012 Cochrane report, many of these studies involve small sample sizes, making it difficult to draw firm or hard conclusions. Moreover, healthcare providers typically utilize MANY approaches simultaneously to achieve the best, most prompt results, keeping surgery as the last resort.

Typically, the non-surgical management of carpal tunnel syndrome (CTS) includes several approaches such as splints; rest; job modifications; anti-inflammatory measures like ice, drugs, vitamins, and herbs; physical modalities, such as ultrasound and laser; and manual therapies, such as manipulation and mobilization.

Care may also focus on relieving pressure on the median nerve in other anatomical locations (the neck or shoulder, for example) as dysfunction elsewhere on the course of the nerve can contribute to a patient’s CTS symptoms. Furthermore, a treatment plan may also address other conditions that can contribute to the build-up of pressure in the carpal tunnel such as diabetes or hypothyroidism. Generally, it’s more challenging to manage the condition when a patient has waiting years or even decades to seek care. Thus, for the best possible outcome, please have a doctor of chiropractic evaluate your wrist and hand symptoms sooner rather than later.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055
Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Carpal Tunnel Syndrome Exercises

7 Aug

There are nine tendons that pass through the carpal tunnel at the wrist that connect the forearm muscles to the palm-side of the fingers. These tendons are encased in sheaths, and friction and heat can build-up inside these sheaths, leading to swelling, pressure, and pain (especially during fast, repetitive tasks). As the swelling increases and pressure builds up inside the tight space of the tunnel, the median nerve is pushed into the transverse carpal ligament, which serves as the floor of the tunnel, resulting in the symptoms we commonly associate with CTS. Stretching helps reduce this tightness and friction.

The stretching exercises listed below can BOTH help CTS as well as prevent it from occurring or re-occurring. As a warm-up:

  • Rotate the wrist in multiple directions—up, down, side-to-side, and figure 8s.
  • Spread your fingers as wide as you can and pull the fingers back using your other hand (or a wall) keeping the elbow straight.
  • Repeat step two, but this time, stretch the thumb back.

Repeat these steps five to ten times—enough to feel the forearms and hands loosen up.

The Prayer: Place your palms completely together like you are praying (keep the heels of the hands together) next to your chest and slowly lower the hands toward the floor while keeping the hands close to your body. Hold for 15-20 seconds.

Forearm Flexors: Arm straight, palm against the wall, fingers point downward, reach across and gently pull the thumb back. Hold for 15-20 seconds.

Forearm Extensors: Arm straight, back of the hand against the wall, fingers pointing downward. Hold for 15-20 seconds.

Repeat the above exercises three to four times and focus on feeling the muscles “release.” Try to do this three to five times a day, ESPECIALLY during the busy work day to “break-up” the monotony of fast, repetitive work tasks that can increase heat and friction in the sheaths surrounding the tendons that pass through your wrist.

Your doctor of chiropractic may recommend ice cupping over the wrist/s (palm side) and using a night splint on the affected wrist/s, in addition to exercises (like those above) and job modifications aimed at reducing CTS risk. Treatment may also include the use of manual therapies applied to the forearm, wrist, and hand, as well as the elbow, shoulder, and neck as these areas are frequently involved and must also be addressed to optimize the patient’s outcome.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 103
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Important Carpal Tunnel Syndrome Facts

6 Jul

Carpal tunnel syndrome (CTS) occurs as the result of the median nerve being trapped or squeezed as it passes through the carpal tunnel, which is located in the wrist. Nine flexor tendons with their covering or sheathes, blood vessels, and connective tissue also pass through the carpal tunnel, creating a tight passageway between the forearm and hand. Therefore, swelling of tendons and/or their sheathes, leaking of synovial or joint fluid from the many carpal joints, or bone spurs, cysts, and/or systemic swelling can each impinge on the median nerve. Basically, ANYTHING that increases the pressure inside the tunnel can cause the symptoms associated with CTS.

Symptoms associated with CTS include pain, numbness, tingling, a “half-asleep” feeling, swelling, and a weak grip (such as difficulty unscrewing the lid from a jar). Sleep interruptions are common as we often sleep with a bent wrist, which further increases the pressure on the various soft tissues in the area.

Some people have a greater risk of developing CTS. For example, women are three times more likely than men to develop the condition due to a smaller tunnel and wrist as well as a slightly different tunnel shape. The following can increase the risk of developing or worsening CTS: diabetes, hypothyroidism, birth control pills and/or other hormonal replacement therapies, pregnancy, and some types of inflammatory arthritis.

Jobs that require fast, repetitive work without enough rest time and those that require forceful gripping also carry an increased risk for CTS. Ergonomic factors such as certain job tasks, tool handle shape, body position on a line or machine, prolonged sitting (especially when the head/neck is not in a neutral position), and work that requires telephone use (especially without headsets), must be addressed to gain proper control of the condition.

The diagnosis of CTS is made from a combination of a careful history and physical examination of the hands, arms, shoulders, and neck, as it is VERY IMPORTANT to make sure it is truly CTS and not a group of conditions or something totally different. Hence, your doctor may run a series of tests to differentiate between the many possible causes of CTS. Typically, a careful evaluation can lead to a successful diagnosis of CTS but occasionally, further tests are necessary.

The chiropractic treatment approach for CTS includes the typical rest, ice, night splints, exercises, and job modifications that most healthcare providers utilize. The unique feature that separates chiropractic from medical-based, non-surgical care is the use of manual therapies applied to not only the forearm, wrist, and hand, but also frequently the elbow, shoulder, and neck, as these areas frequently contribute to the patient’s symptoms and must also be managed for a successful outcome.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Carpal Tunnel Syndrome, Inflammation, & Treatment Options

5 Jun

Carpal tunnel syndrome (CTS) belongs to a group of disorders called “entrapment neuropathies” and as the name implies, it is caused by the trapping of the median nerve in the carpal tunnel of the wrist. There are MANY ways to treat CTS, with some of the most effective focused on reducing inflammation.

Inflammation (from the Latin inflammatio) is commonly referred to as “swelling” and is a sequence of biological responses to harmful stimuli that include pathogens such as bacteria and viruses, damaged cells, and other irritants. It is a protective response to something abnormal that has occurred and involves our immune cells, blood supply, and more. Inflammation helps to eliminate the cause of cell injury, clean up necrotic or dead cells from area, and initiate the tissue repair process.

The hallmarks of inflammation include heat, redness, swelling, pain, and loss of function. With CTS, inflammation can arise from multiple causes. One common cause is from the rapid, repetitive rubbing together of the nine tendons that travel through the already tight carpal tunnel. This “mechanical” cause can be managed by modifying the activity by slowing down, taking breaks to allow the tissues to rest, and decreasing the force required by the job or task.

The inflammation associated with CTS can also arise from other causes that are less obvious and common than trauma or overuse. Some of these include (but are not limited to) rheumatoid arthritis (and other autoimmune forms of arthritis) and hormonal changes such as an overactive pituitary gland, an underactive thyroid, diabetes, taking birth control pills, or pregnancy.

Women are three times more likely to develop CTS than men. While hormones may play a role, women also have different shaped carpal tunnels and smaller wrists. Either way, the underlying cause must be dwelt with AS SOON AS POSSIBLE to reduce the pain, numbness, tingling, and loss of function. So how can we reduce inflammation?

An ice massage applied directly over the carpal tunnel/wrist is both easy to perform and very effective. Modifying activities that may be causing or irritating CTS is important but not always available. Night splints help to prevent extreme flexion or extension of the wrist and reduces sleep interruptions common with CTS. Chiropractic utilizes all the above plus manual therapies, like joint mobilization, and exercises/stretches that can be done at home.

As the Western diet may promote inflammation, your doctor may also recommend the Paleo diet, Mediterranean diet, or a gluten-free diet to aid in the recovery process.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Why Carpal Tunnel Syndrome May Be More Dangerous Than You Think

4 May

Carpal tunnel syndrome (CTS) is a very common condition. According to a report by the Bureau of Labor Statistics (BLS), CTS ranks SECOND among the major disabling diseases and illnesses in ALL private industries. The BLS states that workers with CTS may eventually have to give up their livelihood. They cite one study in which almost half of all CTS patients changed their jobs within 30 months following their diagnosis. Due to the controversy surrounding the issue of CTS and worker’s compensation, workers do not always receive compensation benefits.

The KEY to long-term cost containment associated with CTS is EARLY DIAGNOSIS and PREVENTION! The challenge is getting the worker to identify early symptoms and NOT feel intimidated to report them, which could then lead to prompt care and possibly job modifications, resulting in the best chance of preventing a more complicated and far more costly problem.

Because of the many factors that contribute to and/or cause CTS, there is similarly no one way to prevent it from happening. Treating any/all underlying medical condition(s) is important. Using simple common sense can go a long way to help minimize some of the risk factors that predispose a person to work-related CTS and other cumulative trauma disorders (CTDs).

For example, watching and mimicking veteran workers can be a great guide as to how to maximize efficient work methods while minimizing unnecessary stresses and strains. Other preventative “tricks” include learning how to adjust the work area, handle tools, or perform tasks that minimize hand/wrist strain. Maintaining proper posture and exercise programs to strengthen the fingers, hands, wrists, forearms, shoulders, and neck may also help prevent CTS.

Many companies have taken action to help prevent repetitive stress injuries. In one study, 84% of the companies surveyed reported that they were modifying equipment, tasks, and processes as part of a prevention effort; nearly 85% analyzed their workstations and jobs; and 79% purchased more ergonomic equipment. Unfortunately, there is NO EVIDENCE that any of these methods can completely protect a worker against CTS. Often, the best approach is to relocate the worker to a less repetitive job, but this is not always an option.

Doctors of chiropractic can observe the worker through a video or during a factory tour/visit and often identify ergonomic problems that can result in a low-cost, easy modification. Simple modifications coupled with quality care, patient education, and cooperation from BOTH the worker and the employer can typically help yield the best outcome for the CTS patient.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.