Pain Relief Chiropractic

Cubital tunnel syndrome occurs when the ulnar nerve becomes compressed or
irritated as it passes through a narrow space on the inside of the elbow called the cubital
tunnel. This can result in numbness or tingling in the ring and little fingers, hand weakness,
reduced grip strength, and aching pain along the inside of the elbow. Symptoms are often
more noticeable when the elbow remains bent for prolonged periods, such as while sleeping
or talking on the phone. While repetitive elbow bending and prolonged pressure on the elbow
are well-known contributors, several health conditions may also increase one’s risk:

• Smoking – Smoking can reduce blood flow to nerves, increase inflammation, and
  impair healing, making nerves more vulnerable to compression.
• Diabetes – High blood sugar may damage nerves and the small blood vessels that
  supply them. Nerves of diabetic patients may become symptomatic under lower levels
  of compression and often recover more slowly.
• Hypertension – High blood pressure may affect the small blood vessels that nourish
  nerves and is frequently associated with other metabolic conditions that influence
  nerve health.
• Excess Body Weight – Obesity may increase pressure around the elbow, contribute to
  inflammation, and is strongly associated with diabetes and metabolic syndrome.
• Carpal Tunnel Syndrome – Carpal tunnel syndrome and cubital tunnel syndrome
  share many of the same risk factors, including diabetes, obesity, smoking, and
  inflammatory conditions. In some cases, irritation of nerve roots in the neck or the
  brachial plexus from which these nerves arise may reduce the nervous system’s
  tolerance to compression, making symptoms more likely to develop at multiple
  locations in the arm.
• Osteoarthritis – Bone spurs, joint enlargement, and changes in elbow structure may
  reduce the space available for the ulnar nerve.
• Rheumatoid Arthritis – Chronic inflammation, tissue swelling, and joint deformity
  may increase pressure on nerves and raise the likelihood of nerve entrapment.
  As with other nerve entrapment disorders, seeking care early when symptoms are
  mild and less frequent is often associated with better outcomes. If these factors are suspected
  to contribute to a patient’s symptoms, a chiropractor may coordinate care with other
  healthcare providers while providing conservative treatment aimed at improving the mobility
  of the ulnar nerve along its course, including through the cubital tunnel.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

Tags: pain relief, carpal tunnel syndrome, mechanicsburg pa chiropractor

Carpal tunnel syndrome (CTS) occurs when the median nerve becomes compressed as it
passes through the wrist, resulting in symptoms such as numbness, tingling, weakness, burning
sensations, or pain in parts of the hand. Workplace factors such as forceful gripping, repetitive
movements, awkward wrist positions, and vibrating tools are well-known contributors to CTS;
however, researchers are increasingly identifying additional workplace exposures that may play a
role in CTS risk over time, especially in combination with the following factors:

• Non-traditional shift work: Shift work can disrupt normal sleep cycles and circadian
  rhythms, potentially increasing systemic inflammation, impairing tissue recovery, and
  altering pain sensitivity. Fatigue may also contribute to poorer posture, reduced
  coordination, or increased muscle tension during repetitive tasks.
• Toxic substances: Certain industrial chemicals and solvents are known to contribute to
  peripheral nerve irritation or neuropathy. Repeated exposure may make nerves more
  vulnerable to compression injuries, including irritation of the median nerve within the
  carpal tunnel.
• Secondhand smoke: Tobacco smoke exposure may impair circulation and reduce oxygen
  delivery to tissues. Nicotine-related vascular changes and chronic inflammation may
  negatively affect nerve health and slow healing of irritated tissues surrounding the wrist.
• Extreme temperatures: Cold environments can reduce blood flow, increase tissue
  stiffness, and slow nerve conduction. Workers exposed to cold conditions often
  experience increased muscle tension and reduced hand dexterity, potentially increasing
  strain on tendons and surrounding soft tissues. Repeated heat exposure may also
  contribute to tissue swelling.
• Loud noise: Chronic noise exposure has been associated with increased physiologic stress
  responses, elevated stress hormone levels, and greater muscle tension. Some researchers
  suggest these stress-related changes may indirectly contribute to musculoskeletal
  disorders, particularly when combined with repetitive or physically demanding work
  activities.
  While reducing exposure to these risk factors may not always be possible in certain
  occupations, chiropractic care aimed at improving biomechanics, reducing mechanical stress on
  the median nerve, and addressing muscle and joint dysfunction in the upper extremity may play a
  role in managing the condition and helping workers perform daily job tasks more comfortably.

Brent Binder, D.C.

4909 Louise Dr.

Suite 102 Mechanicsburg, PA 17055

Tags: carpal tunnel syndrome, mechanicsburg pa chiropractor, pain relief

Carpal tunnel syndrome (CTS) is a condition characterized by symptoms in parts of the hand
supplied by the median nerve, typically caused by compression of the nerve as it passes through the
wrist. However, the constellation of symptoms associated with CTS is not unique to this peripheral
neuropathy, and without a thorough history and examination, it’s possible for a healthcare provider to
make an incorrect or incomplete diagnosis. In such cases, patients may achieve only temporary relief
at best.
Let’s look at how a doctor of chiropractic may map a patient’s symptoms to develop a clearer
picture of the chief complaint:

• Location: The chiropractor will work with the patient to identify the precise areas in the hand
  where symptoms are experienced. In CTS, symptoms are most often reported in the thumb,
  index finger, middle finger, and the thumb-side of the ring finger as well as the
  corresponding portion of the palm. Symptoms affecting the pinky, the pinky-side of the ring
  finger, or the back of the hand may suggest involvement of a different nerve.
• Timing and movement: Uncovering when symptoms occur can provide important clues. In
  CTS, symptoms may worsen at night, during repetitive or forceful hand activity, or at the
  extremes of wrist motion. If symptoms are provoked by changes in neck position or certain
  arm movements, this may indicate involvement beyond the wrist.
• Path: If symptoms travel from the hand up the arm—or from the neck or shoulder down into
  the hand—this may suggest nerve irritation somewhere along its course.
• Associated symptoms: While hand symptoms often drive patients to seek care, it’s important
  to check for additional complaints such as neck pain or stiffness, shoulder discomfort,
  headaches, or weakness in the arm or hand. These findings may be related and can influence
  the diagnosis.
  Assessing symptoms in this way helps determine whether the patient likely has CTS, whether
  there is median nerve involvement at other points along its path, whether a different nerve is
  involved, or some combination of these factors. It’s not uncommon for median nerve compression at
  the wrist to coexist with irritation at other sites (often referred to as double crush syndrome), or for
  the ulnar or radial nerves to also be involved—especially in cases that do not respond as expected to
  typical CTS care.
  With a more complete clinical picture, the chiropractor can develop a treatment plan aimed at
  reducing pressure on the affected nerves. This may include manual therapies, targeted exercises,
  physiotherapy modalities, nighttime wrist splinting, and nutritional recommendations to help manage
  inflammation. If underlying health conditions are suspected to contribute to nerve irritation, care may
  also involve collaboration with other healthcare providers, such as a medical physician or specialist.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

Tags: carpal tunnel syndrome, mechanicsburg pa chiropractor, pain relief

Fast and repetitive hand and finger movements with little rest time can cause the sheaths that cover the
tendons passing through the carpal tunnel to become inflamed, placing increased pressure within the tunnel,
compressing the median nerve, and stimulating the symptoms associated with carpal tunnel syndrome. Injury
or overuse of the tendons themselves can also cause symptoms that may be thought of as carpal tunnel
syndrome. How does a doctor of chiropractic determine which condition a patient has, carpal tunnel syndrome
or wrist tendonitis?
The first step involves the patient’s history and initial consultation. In addition to providing
information on their past and current health issues, the patient may be asked specific questions about their
presenting complaint, such as whether they recall what caused their symptoms, when the symptoms first
became noticeable, what makes the symptoms feel better or worse, what their exact symptoms are, and what
time of day the symptoms are best or worst, for example.
Based on the information provided, the chiropractor will conduct a physical examination. The exam
will include observation; palpation (touching and pressing); range of motion assessments of the arm, wrist,
hand, and fingers; and neurological tests of the upper extremity, including reflexes, muscle strength (such as
grip and/or pinch), and sensation testing (for example, light touch or distinguishing between sharp and dull).
To rule out red-flag issues—such as fracture or advanced joint disease—an X-ray may be ordered. Other
diagnostic studies, such as ultrasound or nerve conduction velocity testing, may be of use to help confirm a
suspected diagnosis.
If carpal tunnel syndrome is suspected, symptoms such as pain, numbness, tingling, and reduced
sensation will follow the course of the median nerve into the thumb, index finger, middle finger, and the
thumb-side of the ring finger, though symptoms may also travel up the forearm. Symptoms may worsen at
night and during the day when the wrist is bent up or down or held in one position for prolonged periods.
Orthopedic tests that involve flexing the wrists for 60–90 seconds, tapping over the carpal tunnel, and
manually compressing the carpal tunnel will also be positive in carpal tunnel syndrome. When performed, a
nerve conduction study will typically show slowed median nerve function across the wrist.
In cases of wrist tendonitis, pain will be localized to a specific tendon with tenderness at one precise
point, and symptoms will mostly be felt in the wrist or forearm rather than the fingers. Symptoms may be
described as achy, sharp, or pulling pain, without numbness or tingling, that worsens with gripping, lifting,
twisting, or resisted motion. With rest, symptoms will usually improve. Diagnostic imaging may show tendon
thickening or inflammatory changes.
Treatment will depend on examination findings, but in general, with carpal tunnel syndrome, the
approach used will be intended to reduce compression on the median nerve, potentially with activity
modifications and ergonomic changes to reduce inflammation while tissues heal. With wrist tendonitis, heavier
activity will be reduced initially to allow the tendon to recover, followed by specific exercises to increase
tendon strength and load tolerance. The good news is that doctors of chiropractic are well-equipped to
distinguish between these conditions and manage them using an effective, non-surgical, conservative approach.

Brent Binder M.S., D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055

(717) 697-1888

Tags: carpal tunnel syndrome, mechanicsburg pa chiropractor, pain relief