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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
856 Century Drive, Suite C
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
856 Century Drive, Suite C
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… In a Nutshell

6 Apr

Here it is: carpal tunnel syndrome (CTS) in a nutshell!

WHAT: CTS is caused by an injury to the median nerve (MN) as it travels through the wrist.

WHERE: The eight small carpal bones and a ligament form a tunnel in which tendons and nerves pass through to reach the hand.

HOW: The MN gets pinched/irritated from repetitive stress.

WHY: The tunnel is tight as it includes the MN and nine rapidly moving muscle tendons!

PROGRESS: CTS usually starts slow and often progresses over weeks, months, even years.

SYMPTOMS: Pain, numbness, tingling, and/or weakness of the hand, sparing the little finger.

PROGNOSIS: CTS is easier to treat shortly after it starts, and waiting too long to seek care may lead to worse outcomes.

RISK FACTORS: 1) family history (genetics); 2) women are more likely to suffer from CTS than men; 3) age over 50; 4) manual jobs; 5) pregnancy; 6) conditions like diabetes, hypothyroid, rheumatoid arthritis (RA), osteoarthritis, autoimmune diseases (includes RA, certain types of thyroid disease), gout, kidney disease (especially dialysis patients), Down syndrome, amyloidosis, acromegaly, tumors on the median nerve; 7) medications (those that affect the immune system such as interleukin-2, possibly corticosteroids), anti-clotting drugs such as warfarin, hormone replacement, BCPs; 8) obesity; 9) smoking; 10) alcohol abuse; and 11) trauma/injuries (fractures, tendonitis).

TREATMENT: Ideally, treatment should begin as soon as possible after symptoms first start, but this RARELY occurs due its slow and gradual onset. Non-surgical care includes anti-inflammatory care (ice, anti-inflammatory nutrients—ginger, turmeric, bioflavonoids; NSAIDs like ibuprofen), wrist splinting (primarily at night), corticosteroid injections, job/ergonomic modifications, exercises (yoga, stretching, strengthening, and aerobic fitness), low level laser therapy, ice, acupuncture, and chiropractic care. Chiropractic care includes MANY of the above PLUS manual therapies applied to the neck, shoulder, arm, wrist, and hand.

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

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055
Member of Chiro-Trust.org

Should Playing Music Create Tingling Wrists?

6 Mar

Carpal tunnel syndrome (CTS) is a condition caused when pressure is applied to the median nerve as it passes through the wrist. When playing a musical instrument, especially for hours at a time for several days in a row, the fast repetitive movements of the fingers can cause the tendons—all nine of them—that travel through the carpal tunnel to rub together, creating friction. This leads to heat and eventually swelling or inflammation, which manifests as pain, numbness, and tingling. Without treatment or modifications to your practice schedule, it is likely the numbness/tingling in your hands and fingers will gradually worsen and may even completely prohibit you from playing your instrument.

We must accept that every tissue in our body has a certain capacity or threshold, and if it is exceeded, problems will surface, and there are factors that can make some of us MORE SUSEPTIBLE to CTS. Some of these differences include: female gender, age over 50, hormone imbalances (low thyroid function, diabetes, and others), birth control pill (BCP) usage, pregnancy, obesity, and manually intensive jobs. Personality can even play a role—if you’re someone who will push yourself to play through the pain, then your risk for CTS is greater.

Because both hands are typically required to play an instrument, it is more common than not that BOTH hands may eventually become symptomatic if you don’t practice some VERY SIMPLE preventative “tricks of the trade.” So what are those tricks?

Take 30-60 second mini-breaks every hour during your practice sessions to stretch. Simply BEND your wrist and fingers back as far as you can with your other hand or against  a wall (fingers pointing downward) and try to touch your palm to the wall. Hold the maximum stretch for five to ten seconds and repeat until the forearm feels looser (usually three to four times).

Another “trick” is to wear a cock-up wrist splint at night, since we cannot control our wrist/hand position when sleeping. When the wrist is bent to its maximum, the normal pressure inside the carpal tunnel increases six times or more, which can REALLY irritate the median nerve.

Doctors of chiropractic can teach you proper exercises, fit you with a wrist splint, AND check to make sure pressure on the median nerve isn’t the result of dysfunction in other anatomical areas along the course of the nerve, such as the neck.

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

Dr. Brent Binder
856 Century Drive, Suite C
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

How Do I Know if I Have Carpal Tunnel Syndrome?

6 Feb

Carpal tunnel syndrome (CTS) can be an extremely painful and activity-limiting condition. It affects many people of all ages and genders, though women are affected more often than men. But how do you know if what you are suffering from is truly CTS or if it’s another condition that’s producing the symptoms in your hand or wrist?

Carpal tunnel syndrome occurs when the median nerve is compressed as it passes through the wrist. However, the median nerve travels out of the neck, through the shoulder, elbow, and forearm before it passes through the wrist and into the hand. Pinching of the median nerve ANYWHERE along its course can give rise to the signs and symptoms of CTS including numbness, tingling, and/or pain into the hand and index, third, and thumb-side half of the fourth digits, and sometimes the thumb. If the pinch is significant enough, weakness can also occur. Sometimes the median nerve can become compressed at both the wrist and other body sites as it travels from the spinal cord to your hand, that’s why it’s important for a doctor to check for impingements along the entire course of the nerve.

But compression of the median nerve isn’t the only thing that can produce symptoms in the hand. Here are a couple of the more common conditions that are often confused with CTS:

  • Ulnar neuropathy: This is pinching of the ulnar nerve (at the neck, shoulder, elbow, or wrist) but this gives rise to a similar numbness/tingling BUT into the pinky-side of the fourth and the fifth fingers (not the thumb-side of the hand). The most common pinch location is either at the neck or the inner elbow, the latter of which is called “cubital tunnel syndrome” or CuTS.
  • Tendonitis: There are a total of nine tendons that pass through the carpal tunnel that help us grip or make a fist. Similarly, there are five main tendons on the back side of the hand that allow us to open our hands and spread our fingers. ANY of these tendons can get strained or torn, which results in swelling and pain as well as limited function BUT there is usually NO NUMBNESS/TINGLING!
  • DeQuervain’s disease: This is really a tendonitis of an extensor tendon of the thumb and its synovial sheath that lubricates it resulting in a “tenosynovitis.” This creates pain with thumb movements, especially if you grasp your thumb in the palm of your hand and then bend your wrist sideways towards the pinky-side of the hand.

Chiropractors are well-trained to diagnose and treat patients with CTS. And if you don’t have CTS but another condition listed above, they can offer treatment (or a referral, if necessary) to help resolve it so you can return to your normal activities as soon as possible.

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

Dr. Brent Binder
856 Century Drive, Suite C
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.

WHEN Is Surgery Needed for Carpal Tunnel Syndrome?

5 Jan

Carpal tunnel syndrome (CTS) often responds well to non-surgical care and there is good evidence supporting chiropractic treatment for CTS. But the question frequently arises, “When should I consider surgery for my CTS?” Let’s take a look…

CTS is basically the pinching of the median nerve as it travels through a tight tunnel at the wrist. The causes of CTS are many and include mechanical (trauma like fractures, sprains or strains, ganglion cysts, spurs from arthritis, tendonitis from overuse), metabolic (obesity, pregnancy, hormone replacement and birth control pills, diabetes, hypothyroid), inflammatory (overuse, work, playing an instrument, hobbies), and more.

When it comes to surgery, each case MUST BE individually assessed. The factors that increase one’s risk for needing surgery to resolve their CTS include: 1) EMG/NCV evidence of axonal degeneration (nerve damage); 2) muscle atrophy or shrinkage of the thumb pad; 3) acute onset after trauma (especially in fracture or dislocation of the wrist); and 4) after ALL non-surgical attempts have been tried.

Many reading this article may be surprised that CTS can actually be treated without surgery, given the popularity of surgery for this condition. Further, many may also be surprised that chiropractic can be VERY effective in managing CTS and studies have often demonstrated such care performs as well as or better than standard medical care, without the potentially serious side effects associated with some medications that may be prescribed for the CTS patient.

Non-surgical treatment offered by chiropractors may include manipulation and mobilization to the wrist (and the neck, shoulder, and elbow if nerve impingement in these areas contributes the CTS symptoms), as well as stretching exercises multiple times during the work day, taking mini-breaks,  workstation modifications, an anti-inflammatory diet with supplementation,

The BOTTOM LINE is you can always have surgery, so make sure you’ve exhausted ALL your non-surgical options before resorting to surgery!

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

Dr. Brent Binder
856 Century Drive, Suite C
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.