Not Just Back Doctors: Chiropractors and Carpal Tunnel Syndrome

Chiropractor in Burke, VAWhile doctors of chiropractic have a well-deserved reputation for helping patients overcome back problems, they are actually experts in diagnosing and treating a wide range of health conditions that affect the musculoskeletal and nervous systems. Many of these conditions involve the extremities—arms, legs, hands and feet—rather than the back, neck or hips. Carpal Tunnel Syndrome (CTS) is one example.

What causes CTS?

CTS affects about one in a thousand people each year, mostly women. It is essentially a mechanical problem caused by the median nerve being compressed as it runs through the carpal tunnel, a passageway made up of tendons, ligaments and bones that runs from the wrist to the hand.

In many cases, the precise cause of carpal tunnel syndrome isn’t clear. An injury to the wrist (sprains, strains or broken bones, for instance) may sometimes trigger CTS. So might strong vibrations from power tools or heavy machinery. Repetitive movements that place stress on this area of the body can also play a role. The tendons that control finger movement all run through the carpal tunnel, so when they become inflamed and swollen the amount of space is reduced, putting increased pressure on the median nerve.

Who’s most at risk?

Women. As mentioned earlier, women are at greater risk of CTS than men. There are a number of theories as to why women tend to suffer from CTS more frequently than men. One is that they have smaller wrist bones, and thus a smaller space through which tendons can pass. Another is that hormonal shifts may play a role, particularly during pregnancy and around menopause.

People with a genetic predisposition. Some people may have a genetic predisposition for CTS. Approximately one out of four people has a close family member who has also has the disorder.

Workers who perform repetitive, forceful movements that place localized stress on the wrist. Those who have jobs that involve repetitive movements of the arm are more likely to develop carpal tunnel syndrome. Assembly line workers, carpenters and violinists would all be in relatively high-risk occupations. But what about heavy computer users? Interestingly, although long-term computer use was previously thought to contribute to CTS, there is now conflicting information about the relationship between keyboarding and CTS. Some studies, such as one from 2007 published in the journal Arthritis and Rheumatism, have found that those who use a keyboard intensively at work actually have a significantly lower risk of developing CTS. It’s worth mentioning that some leisure activities can also contribute to the risk of CTS. Knitting, golfing and anything else that requires you to grip items in your hands for long periods of time could raise your risk.

Why chiropractic care?

CTS treatment has been evolving rapidly across the last few years, so it’s important to visit a healthcare provider who keeps current on the latest research and works with carpal tunnel patients on a regular basis. Among the most commonly recommended treatments for carpal tunnel syndrome are using a wrist splint, resting the wrist and taking pain relievers. Surgery is usually viewed as a last resort that should be considered only after more conservative treatment options have been exhausted.

Recent research has focused on the role of manual therapies—particularly specialized manipulation and mobilization techniques—as well as exercise in relieving pain and restoring range of motion. Chiropractic treatment for CTS (specifically soft tissue mobilization) has been shown to be both safe and effective compared to conventional non-surgical medical treatment, helping to improve nerve conduction latencies, wrist strength and mobility.

Chiropractors (and physical therapists) may also prescribe at-home strengthening and stretching exercises to help relieve pain and improve function in the affected hand and wrist. These approaches offer natural alternatives to sufferers who can’t tolerate common over-the-counter anti-inflammatories or painkillers, or who simply wish to avoid medication altogether.

When it comes to carpal tunnel syndrome, early diagnosis and treatment are the keys to success. The sooner this condition is addressed, the more non-invasive therapeutic choices exist for the patient. So if you suspect that you or someone you care about is suffering from CTS, please give us a call at (703) 912-7822 or visit us at Chiropractor in Burke, VA.

NOVA Chiropractic & Wellness Center
8992 Fern Park Drive BurkeVA22015 USA 
 • (703) 912-7822

Carpal Tunnel Syndrome – WHAT YOU NEED TO KNOW!

Chiropractor in Burke, VACarpal Tunnel Syndrome (CTS) develops from a nerve problem in the wrist (the median nerve) and is NOT a “muscle problem” like some people believe. That is not to say the median nerve cannot be trapped and pinched by muscles. When this occurs, the condition is labeled with a different name, depending on which muscle(s) are pinching the nerve or where the entrapment is located. Here are some more FACTS about CTS that you need to know:

SYMPTOMS: CTS complaints include numbness, pain, tingling, and/or weakness of the hand (especially fingers two, three, and four), and while this can be constant, it usually comes and goes.

ONSET: CTS usually comes on gradually. However, the length of time over which it progresses can be HIGHLY VARIABLE. It can take weeks, months, or even years before the patient consults with their chiropractor or family doctor.

CAUSE: There are MANY reported causes of CTS, but it is not completely known how the process starts out or how it evolves for different people. Risk factors include age greater than 50, obesity, genetics (family history of CTS), gender (as it favors females over males), work type (highly-repetitive, hand-intensive work), pregnancy, birth control pill usage, thyroid disease, diabetes, rheumatoid arthritis, and more. In general, swelling is the culprit that results in pressure on the median nerve. This most commonly occurs from overuse of the hands and fingers. Playing musical instruments, sewing, crocheting, basket weaving, assembly/line work, meat processing work, typing/computer work, and waitressing are common over-use activities.

CLINICAL COURSE: Early into the disorder, CTS is usually easily managed and reversible. However, if the amount of pressure on the nerve is too much, the symptoms can become permanent. Think of a wire and how wearing away the plastic coating will “short” the wire. There are multiple layers to our nerves and the wearing away of the outer layers over time can become a problem resulting in permanent numbness and/or weakness.

BIGGEST MISTAKE: Don’t wait until your symptoms are terrible! If you feel periodic numbness and tingling and you find yourself shaking your hand and “flicking” your fingers in attempt to “wake them up,” NOW IS THE TIME TO COME VISIT YOUR CHIROPRACTOR before nerve damage occurs and the risk of permanency increases.

HOW CHIROPRACTIC HELPS: Treatment guidelines for CTS recommend a non-surgical approach, and this is where chiropractic comes in! A wrist night splint is typically recommended since sleep interruption due to numbness is VERY common as we cannot control our wrist position when we sleep. Ice (not heat) is best as it reduces swelling (see #3 above). Rubbing an ice cube (or Dixie cup of ice) over the palm-side of the wrist works well. First, you will feel COLD followed by BURNING, then ACHING, and finally NUMBNESS (“C-BAN”). At this point STOP, as the next stage of cooling is frost bite! Do this three times a day or as directed. Your doctor of chiropractic will also talk to you about taking “mini-breaks” at home and/or at work and teach you exercises or stretches that can be performed during these breaks! A work station assessment is often very helpful as sometimes a simple change in work position or method can reduce wrist strain considerably. Your doctor of chiropractic may also perform manipulation to the small joints of the hand, wrist, elbow, shoulder, and neck as indicated in each specific case. He or she may also perform soft tissue release techniques to the muscles and soft tissues of the forearm, shoulder, and neck regions as needed. Surgery should be the LAST step in the treatment process, used only if all other non-surgical options have been tried without success.

We realize you have a choice in whom 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 requires care for Carpal Tunnel Syndrome, give our office a call at (703) 912-7822 or visit us at Chiropractor in Burke, VA.

Carpal Tunnel Syndrome vs. Cubital Tunnel Syndrome

Carpal Tunnel Syndrome Relief in Burke, VACarpal Tunnel Syndrome (CTS) belongs to a group of disorders referred to as “cumulative trauma disorders,” or CTDs. The word “cumulative” refers to the cause being repetitive motion, usually fast and prolonged. Over time, the wear and tear on the upper extremities accumulates and symptoms begin to occur and possibly worsen. This can result in changes in movement intended to avoid further injury that then overstress another part of the arm, which can lead to a second injury. Like dominos, injury after injury can eventually result in multiple conditions between the neck and hand. Let’s take a look at two of the more common CTDs…

Carpal Tunnel Syndrome (CTS) is the most well known of the CTDs because the thumb, index, third, and fourth ring finger comprise 90% of the hand’s function. This part of the hand is innervated by the median nerve that travels through the carpal tunnel at the wrist. When injured, it can make fine motor movements, like tying your shoe, difficult-to-impossible! Our grip strength is also greatly affected by a pinch of the median nerve, so dropping coffee cups, difficulty removing a gallon milk jug from the refrigerator, and the ability to lift and carry are all compromised. Some risk factors for CTS include: 1) Age over 50; 2) Female gender; 3) Obesity; 4) Working in a highly repetitive motion type of job (assembly line work, meat/poultry plants, typing); 5) The presence of other CTDs such as forearm, wrist, or hand tendonitis; and 6) Metabolic conditions such as thyroid disease (hypothyroidism), diabetes, rheumatoid arthritis, and more. Management strategies include: 1) Night use of a wrist splint (i.e., rest); 2) chiropractic manipulation of the small joints of the wrist and hand, and often, the elbow, shoulder, and neck; 3) Muscle and tendon myofascial release / mobilization techniques; 4) Management of any underlying metabolic condition (like hypothyroid disease and diabetes); and 5) Anti-inflammatory measures (ginger, turmeric, boswellia, bioflavinoids, vitamin B6, ice massage over the palm side of the wrist). NOTE: Recent studies have reported the use of NSAIDs — non-steroidal anti-inflammatory drugs like Advil (ibuprofen), Aleve (Naproxen), and aspirin — can interfere with and prolong the healing process. Chiropractic care may also include the use of modalities such as low level laser therapy, pulsed magnetic field, ultrasound, and/or electrical stimulation. Your doctor may order an EMG/NCV (electromyogram/nerve conduction velocity) if the case is not responding appropriately. Surgical intervention is the LAST RESORT but frequently, conservative chiropractic care yields satisfying results!

Cubital Tunnel Syndrome (Ulnar Nerve Entrapment – UNE): This is similar to CTS but it involves the ulnar nerve being pinched at the inner elbow (near where the “funny” bone is located). The big difference here is that the numbness/tingling involves the pinky side of the fourth and fifth fingers (NOT the thumb, index, third, or thumb-side of the fourth finger). Remember, you can have BOTH CTS and ulnar nerve entrapment (UNE) at the same time, in which case all five fingers may be involved. Causes are similar as CTS, but a more recently identified cause is called “cell phone elbow” due to the prolonged elbow flexed/bent position while using a phone. An overnight splint keeping the elbow straight as well as a wrist splint can be very effective. Otherwise, the treatment is similar to that described for CTS and it is frequently easily managed with non-surgical chiropractic care!  If you are suffering from carpal tunnel syndrome or cubital tunnel syndrome give our office a call at (703) 912-7822 or visit us at Chiropractor in Burke, VA.