Pain Relief Chiropractic

Carpal Tunnel Syndrome (CTS) is a very common problem that affects many people. In fact, the US Bureau of Labor Statistics reports about 28,000 CTS cases per year and because so many sufferers jump to a surgical option, it’s become THE LEADING CAUSE of lost workdays in the United States. Women are 71% more likely more likely to develop CTS than men!

In a review of over 31,000 cases, women spent an average of 30 days off work because of CTS. Jobs most commonly affected include: production workers in food processing and clothing manufacturing, typists who work at keyboards for hours on end, and construction workers who use tools that vibrate, such as jackhammers or tools that have poorly designed handles. The Journal of the American Medical Association recently estimated that almost 3 percent of adults in the United States may suffer from Carpal Tunnel Syndrome at some point in their lives.

Now that we’ve learned how susceptible we are to CTS, what are some things you can do to decrease your chances of acquiring Carpal Tunnel Syndrome? For starters, keep your weight reasonable (Body Mass Index between 19 and 25), take “mini-breaks” during the repetitive work day, and receive chiropractic treatments aimed at releasing the tight muscles in the neck, shoulders, upper arms, forearms, hand and adjusting the associated joints.

You can also stretch! There are many different types of stretches that should be considered. Feel free to watch the entire 37-minute YouTube video at the link below that addresses many exercises that may help:

http://tinyurl.com/CTSYOGA

(CTSYOGA is ALL CAPS)

As you perform these various stretches, take deep breaths, “feel” the different fibers of muscles stretch and keep the intensity, “…within reasonable pain boundaries.” That is, a “good hurt” is what you’re striving for here, no sharp pain is allowed!

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

Carpal Tunnel Syndrome (CTS) is a very common problem that is often associated with work related activities. Our focus this month is on how to prevent CTS. Of course, if you already have CTS, read this Health Update to learn preventative measures that also work while you receive treatment for CTS.

The concept is to think about prevention as a matter of economics; as you lose time from work because of CTS, if affects your bottom line, and I’m sure you have bills to pay and mouths to feed (…or, at least one)! So please take the advice offered here seriously, as we are genuine about our concern for your well-being and not losing work time is a huge component of all of our “well-being!”

If you’ve experienced sore wrists, hands, sudden sharp jabs of pain up the forearm, noted numbness and/or burning in your fingers (especially the index through 4th / ring finger), wake up at night needing to shake and flick your fingers to “wake them up,” have weakness in your grip strength, are slowing down at work (whether it’s typing/computer work, assembly line work, cooking, waitressing, and so on), you NEED to do the following NOW! The goal here is prevent work loss and surgery (as up to 6 weeks lost work time will be required if surgery is needed).

Anti-inflammatory measures: This starts with a healthy diet. STOP eating foods that inflame such as omega 6 rich foods (“GOOGLE” omega 6 and print out the list of food). Emphasize fruits, vegetables, lean meats, nuts and AVOID grains because of glutens, which many of us have a sensitivity against. Vitamins such as a multiple, magnesium, fish oil (omega 3’s), Vitamin D3, and CoQ10 are GREAT! Freeze water in a small cup and rub it on the wrist/carpal tunnel until it gets numb (takes 3-5 minutes) and do that 2-3 times a day. Consider natural anti-inflammatories such as ginger, turmeric, cercumen, bioflavinoides and others.

Stretch: Bear-claw, fist, “High-5” (opened hand with the fingers fanned out) reps, wrist extensions on the wall/table stretches (elbows straight).

Rest: Cock-up splint, take mini-breaks, and get sound/restoring sleep. IT REALLY HELPS!

Ergonomic modifications: Position your computer keyboard, mouse and monitor so that you are looking straight ahead at a slight downward angle and your elbows are at a 90° or slightly less of an angle when typing. Set an alarm on your computer to go off every 15 minutes as a reminder to “shake and flick” your hands, wiggle your fingers, do your stretches, and/or squeeze a soft ball. Write with a fat pen vs. a skinny one – this helps a lot!

Weight management: Obesity is a common risk factor for developing CTS.

Manage other health issues: Diabetes, thyroid disease, inflammatory arthritis, neck/shoulder or elbow problems can all contribute to or, even cause CTS.

Think of the above measures as minimums and obtain professional care to help you. You have choices between the traditional medical model of cortisone shots, anti-inflammatory medication, and surgery vs. chiropractic: manipulation and mobilization of the fingers, hand, wrist, elbow, shoulder and neck as needed, splinting at night, anti-inflammatory diet and nutrients, ergonomic modification and exercise training, which ALL will help to treat as well as prevent future CTS problems, EVEN IF you’ve had surgery already!

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

Carpal Tunnel Syndrome (CTS) is a condition characterized by pain, numbness and/or tingling in the hand. This includes the palm and the 2nd, 3rd, and half of the 4th finger, usually sparing the thumb. Another indication of CTS is weakness in grip strength such as difficulty opening a jar to even holding a coffee cup. CTS can occur from many different causes, the most common being repetitive motion injuries such as assembly line or typing/computing work. Here is a PARTIAL list of potential causes of CTS: heredity (a small sized tunnel), aging (>50 years old), rheumatoid arthritis, pregnancy, hypothyroid, birth control pill use, trauma to the wrist (especially colles fractures), diabetes mellitus, acromegaly, the use of corticosteroids, tumors (benign or malignant), obesity (BMI>29 are 2.5 more likely), double crush (pinching of the nerve in more than 1 place such as the neck and the carpal tunnel), heterozygous mutations in a gene (associated with Charcot-Marie-Tooth), Parvovirus b19, and others. Again, repetitive trauma is still the most common cause. It becomes quite clear that a COMPLETE physical examination must be conducted, not just evaluation of the wrist! Once the cause(s) of CTS has been nailed down, then treatment options can be considered.

From a treatment perspective, we’ve previously discussed what chiropractors typically do for CTS (spinal and extremity joint manipulation, muscle/soft tissue mobilization, physical therapy modalities such as laser, the use of a wrist splint – especially at night, work task modifications, wrist/hand/arm/neck exercises, vitamin B6, and more). But, what about using other “alternative” or non-medical approaches, especially those that can be done with chiropractic treatment? Here is a list of four alternative or complementary treatment options:

Anti-inflammatory Goals: Reducing systemic inflammation reduces overall pressure on the median nerve that travels through the limited space within the carpal tunnel at the wrist. An “anti-inflammatory diet” such a Mediterranean diet, gluten-free diet, paleo-diet (also referred to as the caveman diet) can also help. Herbs that can helps include arnica, bromelain, white willow bark, curcumen, ginger, turmeric, boswellia, and vitamins such as bioflavinoids, Vitamin B6 (and other B vitamins such as B1 and B12), vitamin C, and also omega 3 fatty acids.

Acupuncture: Inserting very thin needles into specific acupuncture points both near the wrist and further away can unblock energy channels (called meridians), improve energy flow, release natural pain reducing chemicals (endorphins and enkephlins), promote circulation and balance the nervous system. For CTS, the acupuncture points are located on the wrist, arm, thumb, hand, neck, upper back and leg. The number of sessions varies, dependant on how long the CTS has been present, the person’s overall health, and the severity of CTS.

Laser acupuncture: The use of a low level (or “cold” laser) or a class IV pulsed laser over the same acupuncture points as mentioned above can have very similar beneficial effects (without needles)! One particular study of 36 subjects with CTS for an average of 24 months included 14 patients who had 1-2 prior surgeries for CTS with poor post-surgical results. Even in that group, improvement was reported after 3 laser treatments per week for 4-5 weeks! In total, 33 of the 36 subjects reported 50-100% relief. These benefits were reportedly long-term as follow-up at 1-2 years later showed only 2 out of 23 subjects had pain that returned and subsequent laser treatment was again successful within several weeks.

Acupressure: Acupuncture point stimulation with manual pressure. These points can be self-stimulated by the CTS sufferer multiple times a day via deep rubbing techniques.

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

Carpal Tunnel Syndrome (CTS) is the most investigated, researched, and talked about disorder when it comes to work related injuries to the upper extremity because it is often the cause of so much lost work time, disability costs, and the source of financial hardship for many of its sufferers. So, the questions are: Is there a way to detect it early? What can be done to prevent CTS? And, what can you do to facilitate in the treatment process of CTS?

1. EARLY DETECTION: Because CTS symptoms usually start out mildly, maybe a little numbness or tingling in the hand or fingers that can be easily “shaken off,” people usually do not identify these early symptoms as, “…a big deal” and consequently, do nothing about it. After a while, and the time depends on how severely the median nerve is pinched, you may start waking up at night needing to shake out your hands in order to return to sleep. Similarly, when driving, you may need to change your hand position on the steering wheel due to the same symptoms. If you are really stubborn (and many people are) and you STILL don’t give in and come to us for treatment, then buttoning shirts, writing, crocheting, knitting, playing piano, typing, etc., may all soon become affected. The KEY in early detection is to NOT ignore the early symptoms. Come in right away!

2. PREVENTION: There are many highly effective preventative tactics. For example, recognize that certain conditions predispose us to CTS and anything to avoid and/or properly manage these conditions will help. Some of these conditions include diabetes mellitus, pregnancy, the use of birth control pills, inflammatory arthritis (such as rheumatoid or lupus), hypothyroidism, and obesity. From an ergonomic approach, make sure your work station is set up properly including (but not limited to) the position of the monitor, the keyboard, the mouse, and your chair. Set up the area so the extremes of wrist bending can be avoided. If a wrist brace doesn’t get in the way, it may help, especially when there is a high incidence rate of CTS with your co-workers. Most importantly, small mini-breaks and stretching can be highly effective during the day. If you develop any symptoms, come in and see us RIGHT AWAY (see #1 above).

3.  SELF-MANAGEMENT: Certainly consider and implement the “prevention” approaches described above in #2. Specific exercises for stretching, strengthening, and dexterity REALLY HELP! We will teach you these, as it is important that you perform the correct exercises accurately. Improper exercising will only add to the problems that lead to CTS or, worsen it. Control your diet to avoid obesity, to control diabetes and the other sometimes preventable conditions described above. Wearing a wrist splint, especially at night can also really help. There are many types from Velcro wrist wraps with or without thumb loops to cock-up splints, carpal lock splints, and many more. The key as to whether to use a wrist splint or not during work is largely dependent on the comfort of the splint during the work day. Many occupations simply require too much wrist bending or movement for the splint to be comfortably worn during the work day which ends up bruising the forearm and/or hand due to the repetitive motion into the edges of the splint. If or when daytime use of the splint isn’t tolerated, use it only at night to prevent extreme wrist bending while sleeping. This usually REALLY helps. Bottom line, remember the saying, “…an ounce of prevention is worth a pound of cure!”

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

Carpal Tunnel Syndrome (CTS) is a very common problem affecting a large population (1 out of 20 in the general population) including typists, assembly line workers, postal employees, secretaries, servers/waiters, musicians, carpenters, and many others. CTS drives a high level of cost to the health care system between time lost from work, treatment costs, and short and long term disability payments (on average $30,000 per claim, and this is an old stat!). Continued CTS signs and symptoms can persist long after surgical treatment and the question that typically arises when this happens is “…why?” Let’s take a look at reasons for failed treatment of CTS…

The classic non-surgical medical management model for treating CTS includes non-steroidal, anti-inflammatory medication (like ibuprofen), rest, and the use of nocturnal (night time) wrist splints. This approach works in some cases, but in the majority, it is unsuccessful and leads to the next medical management step: surgery.

The classic chiropractic management model for treating CTS includes similar initial treatment approaches including anti-inflammatory measures, rest, and night wrist splints. One anti-inflammatory measure is ice massage or cupping, where the ice is rubbed directly on the skin until numbness is achieved (this usually takes about 4 minutes). Prior to numbness, there will be a burning and aching often described as intense, “…like a brain-freeze when I drink a slushy too fast.” The ice cup approach can be repeated several times a day. Other anti-inflammatory measures may include the use of herbal anti-inflammatory nutrients such as ginger, tumeric, boswellia, bioflavinoids, and/or the use of digestive enzymes taken between meals to help reduce the inflammation. The “rest” component is also shared by both models as is the use of the night wrist splint. So, what makes the chiropractic model different?

The nerve affected in CTS is called the median nerve. It arises initially from the nerves in the neck, specifically, C6-8 and T1 nerve roots which are part of the brachial plexus. These form into one nerve (the median nerve) which travels through small openings, first at the neck followed by the shoulder (called the thoracic outlet), then into the arm through a muscle at the elbow (pronator tunnel), and finally through the carpal tunnel at the wrist to innervate the hand including the palm and the 2nd, 3rd digits and thumb side of the 4th finger. The median nerve can get “crushed” in more than one tunnel and treatment must address the WHOLE nerve, not just at the carpal tunnel / wrist. This chiropractic management of CTS helps many patients because the nerve along its entire course including the neck, shoulder, and elbow is treated, not just the wrist!

We realize you have a choice in who you consider for your health care provision and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.