Archive | Carpal Tunnel Syndrome RSS feed for this section

How Does Chiropractic Help Carpal Tunnel Syndrome?

11 Mar

Carpal tunnel syndrome (CTS) occurs when pressure is placed on the median nerve as it passes through bones and ligaments of the wrist in order to innervate a portion of the hand. This pressure can be cause by compression of the carpal tunnel due to mechanical injury or when other tissues near the median nerve become inflamed, either from disease or overuse.

When it comes to treating a patient with carpal tunnel syndrome (CTS), what separates chiropractic care from standard medical care? Both options recommend night wrist splints, anti-inflammatory measures, rest, and the “tincture of time.” Doctors of chiropractic are trained to provide manual therapies like manipulation and mobilization. Two studies show that these therapies can relieve pressure on the median nerve by improving the shape of the carpal tunnel itself.

In a study published in December 2018 in The Journal of Hand Surgery, researchers used dynamic ultrasound to capture images of longitudinal median nerve motion inside the tunnel as compressive forces were applied to the two sides of the wrist and distal forearm in both healthy and CTS patients. The researchers observed that the median nerve moved more within the carpal tunnel in patients with CTS compared to those without the condition.

In an anatomical study published in the journal Clinical Biomechanics (November 2018), lead author Dr. Elena Bueno-Gracia and colleagues measured the cross-sectional area of the carpal tunnel before and after manual manipulation and mobilization of the carpal bones. They observed both an increase in the front-to-back diameter of the tunnel AND a reduction in pressure on the median nerve. Additionally, the researchers noted that the shape of the carpal tunnel itself becomes more round following manipulative therapy. The research team reported that their findings are consistent with prior studies.

These studies demonstrate that the carpal tunnel is indeed dynamic/flexible and that manual techniques can alter its shape, providing more “breathing room” and allowing the contents within (i.e., the tendons and the median nerve) increased mobility with less friction.

Doctors of chiropractic are trained to provide manual therapies, which include mobilization and manipulation, of the spine and extremities of individuals with musculoskeletal conditions, including carpal tunnel syndrome.  Together with the “standard” therapies previously mentioned, proper exercises, and patient education, chiropractic is the perfect choice for non-surgical CTS care!

 

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.
Advertisements

Do Splints Help Carpal Tunnel Syndrome?

11 Feb

Carpal tunnel syndrome (CTS) is a very common condition caused by inflammation of the median nerve that runs through the palm side of the wrist. When the median nerve is pinched and irritated, numbness, tingling, and/or weakness in the hand can result.

Wrist splinting is a common recommendation given to CTS patients by all healthcare providers, including chiropractors, based on the theory that pressure increases dramatically inside the tunnel at the extremes of wrist bending, so restricting motion may allow the associated soft tissues to become less inflamed. But, does splinting actually work?

One study that included 36 participants looked at the outcomes of night-time splinting only, using a common thermoplastic neutral wrist splint. The researchers observed that the patients in the study reported improvements related to their hand/wrist symptoms at the three-month point, while after six months, the participants had also experienced improvements related to wrist function.

To determine if all splints and braces for CTS were the same or if some were better than others, a 2018 study compared the efficacy of a neutral wrist splint vs. one the incorporated a “lumbrical unit” that extended further into the hand. After six weeks, patients in both groups reported improvements related to pinch and grip strength, but the patients given the longer splint also experience statistically significant improvements related to pain and function.

What about combining nerve and tendon stretching exercises WITH wrist splinting? One study that included 51 mild-moderate CTS patients found that those who performed nerve/tendon gliding exercises (three times a day for four weeks) reported better outcomes regardless of which splint they used. A similar study found that patients who engaged in a home stretching program and who wore the longer splint were less likely to require surgical intervention.

These studies support the use of a longer splint and stretching exercises in the management of CTS. When treating patients with CTS, doctors of chiropractic typically take a multimodal approach that includes wrist splinting, specific exercises/stretches, and manual therapies in order to reduce pain and improve function in the wrist and surrounding tissues.

 

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.

Can a Job Cause Carpal Tunnel Syndrome?

7 Jan

Every career has its pros and cons when it comes to physical exertion, stress, work hours, the physical environment (temperature, cleanliness, etc.), and more. But when a worker develops carpal tunnel syndrome (CTS), is it the job that’s the culprit or is there something else responsible for the patient’s symptoms?

Since we spend about a third of our time each week at work, it only makes sense that certain jobs are more likely to cause or exacerbate CTS. The current research shows that jobs that include the following factors have an elevated risk for repetitive stress injuries, like CTS: highly repetitive tasks; exposure to vibratory/percussive forces; and little-to-no down time or rest breaks.

Examples of careers associated with such factors include auto repair, landscaping, garment work, computer work, dental hygiene, hair dressing, music, retail, radiology, meatpacking, massage therapy, and carpentry, just to name a few.

One’s risk for developing the symptoms associated with CTS can also be raised by factors outside of work such as having conditions like diabetes, hypothyroid, obesity, and arthritis (rheumatoid and osteoarthritis, most commonly); hormonal changes associated with birth control pills and pregnancy; and musculoskeletal dysfunction elsewhere along the course of the carpal tunnel. If someone who may already have an increased risk for CTS takes on a vocation that requires repetitive and forceful movements with few breaks, then the chances they develop pain, tingling, and numbness in their hands and wrists may be even higher.

The good news is that in many cases, a worker can recover from CTS and return to their job of choice (that is, not have to change careers) with reasonable work modifications (better ergonomics, more breaks, changes to the tools used), better management of health conditions associated with increased CTS risk, night splinting, dietary modifications to reduce inflammation and promote healing, and conservative care to address any musculoskeletal issues that are present (of which chiropractic care is a fantastic choice).

 

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.

These Foods Can Help Fight Carpal Tunnel Syndrome…

6 Dec

Because inflammation along the course of the median nerve can contribute to carpal tunnel syndrome (CTS), consuming these inflammation-reducing foods may help the patient achieve their desired outcome.

Salmon and other fatty fish, including tuna and sardines, are rich in omega-3 fats called EPA and DHA, which help reduce inflammation. Supplements are commonly used as well with the recommended dose of 1000 mg of combined EPA and DHA per day, which often requires 2000-4000 mg of fish oil to get EPA and DHA to the proper 1000 mg/day level. If you take a blood thinner or are preparing for surgery, discuss this with your physician!

Walnuts are an excellent source of alpha-lipoic acid, or ALA, another omega-3 fatty acid that also reduces inflammation, though to a lesser extent compared to EPA and DHA. Other foods rich in ALA include flaxseed and chia seed.

Pineapple is rich in an enzyme called bromelain, which also reduces inflammation and aids in digestion! But again, it can thin the blood if taken in a higher concentration (from a supplement) so be aware of this.

Turmeric is another great anti-inflammatory that’s found in mustards and curry sauces. Its anti-inflammatory properties are further enhanced when combined with black pepper and ginger!

Spinach is rich in vitamin B6 (pyridoxine), which can help reduce pain.

The “good news” about getting these important benefits from whole foods rather than from supplements is that it’s virtually impossible to consume toxic levels of these nutrients. Your doctor of chiropractic can help guide you in both the nutritional management of CTS as well as the many benefits derived from manual therapies, modalities, night splints, specific exercises for CTS, ergonomic/work station modifications, and more. If diabetes, inflammatory arthritis, or other complicating conditions are present, your chiropractor can work with your medical physician to coordinate care to obtain the best results for you!

 

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.

Great Exercises for Carpal Tunnel Syndrome

8 Nov

Carpal tunnel syndrome (CTS) is caused when the median nerve is compressed as it passes through the tight bony carpal tunnel at the wrist. The condition can result in pain, numbness, tingling, and weakness in the hand, and it can affect one’s ability to carry out everyday life and work tasks. Here are a few GREAT exercises for CTS that require no equipment and can be done anytime and anywhere:

PRAYER: Place your hands in a “prayer” position. Touch the palm-side finger pads together and slowly push the palms into one another while keeping the elbows up as much as possible as you feel a strong stretch in the hands, fingers, and palm-side of the forearms.

SHAKE: Shake your hands for 10-15 seconds as if you just washed them and you’re trying to air dry them off.

WRIST FLEXION STRETCH: Hold your arm out in front of you with the elbow straight, palm facing down. With the opposite hand, bend the wrist as far downward as possible so the fingers point to the ground. This will produce a strong stretch in the muscles located in the back or top of the forearm. Repeat five to ten times holding each stretch for 15–20 seconds (as tolerated).

These exercises can be repeated multiple times a day, as often as once per hour.  It is often very helpful to set a timer on your cell phone to remind you to take a stretch break. A “good pain” (stretch) is considered safe while sharp or radiating pain may be potentially harmful. However, if you experience sharp, lancinating, or radiating pain, then stop or modify the exercise.

Frequently, CTS involves more than just the wrist, and exercises that target the neck, shoulder, and elbow can often hasten recovery. This is especially true when there is “double crush syndrome” where the median nerve is entrapped in more than one location such as the neck, shoulder, elbow, or forearm (as well as the wrist).

Chiropractic management of CTS can include manipulation and mobilization of the hand, wrist, forearm, elbow, shoulder, and neck. Muscle release techniques are often employed as well as the use of physical therapy modalities such as laser, electric stimulation, ultrasound, and others. The use of night splints to keep the wrist straight when sleeping is a “standard” used by most healthcare providers. Co-management with primary care may be appropriate if diabetes, inflammatory arthritis, or other complicating conditions are present.

 

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: A Brief Overview

16 Oct

Carpal tunnel syndrome (CTS) is a condition that arises when the median nerve is compressed as it passes through the narrow, rigid carpal tunnel, resulting in numbness, tingling, pain, and/or weakness in the hand and wrist.

The underlying cause of CTS can be obvious and easy to trace, such as an injury to the wrist, or the cause of the condition can be the result of cumulative trauma from months or years or repetitive strain caused by working with vibrating tools or poor ergonomics. Another cause can be the result of swelling/inflammation from conditions like arthritis, thyroid disease, pregnancy, or diabetes. In many patients, there are several factors at play, which all must be treated in order to obtain a successful outcome.

Women are three times more likely to develop CTS than men, mostly due to differences in the shape of the wrist.  This disorder usually occurs in adults (especially over the age of 50), but it can occur at younger ages, such as college music majors who practice their instrument for several hours each day with little time allotted to rest the tissues in the wrist.

After a thorough examination to identify all contributing factors for a patient’s CTS-related symptoms, a doctor of chiropractic may employ the following conservative treatments: a wrist splint to maintain proper posture at night when sleeping; anti-inflammatory measures such as ice; anti-inflammatory nutritional products such as ginger, turmeric, bioflavonoids, and others; work and/or leisure activity modifications that reduce strain on the wrist; manipulation of the small joints of the wrist as well as to joints proximal to the wrist including the elbow, shoulder, and cervical spine;  muscle release techniques to the upper extremity, especially the forearm and hand; stretching exercises;  and the use of some physio-therapeutic modalities can also facilitate in reducing inflammation.

According to the National Institute of Neurological Disorders and Stroke, CTS usually responds well to conservative treatment, especially early in the course of the condition. However, in some cases, surgical intervention may be necessary.

 

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.