Category Archives: Carpal Tunnel Treatment

Chiropractic Treatment of Carpal Tunnel Syndrome

Hand Numbness and Tingling?

carpal tunnel treatment san franciscoWe have been providing treatment for the neck, shoulders and hands in downtown San Francisco for over 23 years now.

Most of the patients we treat in the SF Financial District spend the majority of their day sitting in front of a computer doing repetitive motions. This activity can put a lot of stress on the bones of the spine in the neck and well as the muscles, ligaments and tendons of the shoulders, arms and hands.

The nerves that control the arms and hands exit from in between the bones of the spine in the neck. These nerves can become compromised with abnormal wear and tear leading to numbness and tingling in the hands. The problem can be in the neck, shoulders, elbows, or wrists.  All must be checked.

In most cases there is joint dysfunction and muscle imbalances, and even nerve pressure in multiple locations. The good news is that these sorts of problems tend to respond favorably to chiropractic and favorable outcomes are the norm.

The standard treatment for hand pain and numbness at our clinic is chiropractic adjustments to the neck, shoulder, elbow, wrists and fingers, massage or ART, low tech exercises in office and at home, deep tissue laser if needed, and ice or heat. Most cases respond in short order. Chronic long standing cases can take longer to treat.

We also have a team of medical doctors and physical therapists that specialize in sports medicine at our primary clinic, Chiro-Medical Group, Inc. which is a few blocks away from our Embarcadero Center walk-in clinic.

To find out if you are a candidate for hand pain treatment in San Francisco please call 415-392-2225. We validate parking at the Embarcadero Center. 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Carpal Tunnel Syndrome? Maybe, Maybe Not!

carpal tunnel san franciscoWe have been providing treatment for Carpal Tunnel Syndrome in Downtown San Francisco for over 23 years. 

Most of the patients we treat spend the majority of their day sitting in front of a computer doing repetitive motions Many go on to do more computer work at home. Some are even on the computer or smart phone as they commute to and from work. OUCH!

We are simply not designed to be sitting for long periods doing the same thing over and over.  In fact, we are designed to be doing just the opposite…running and hunting for food. Our bodies need constant motion in order to function properly.

When we sit all day the muscles in the neck and back are in a constant state of tension. Plus, our posture tends to take on hunched-over position we are in. This can cause pressure on the nerves in the neck that travel down the arms and control the hands. Pressure on the nerves can cause the same symptoms you experience when you have carpal tunnel syndrome (CTS).

The classic signs and symptoms of CTS are as follows:

  • Hand pain
  • Numbness and Tingling in the hand
  • Night pain
  • Neck pain
  • Pain that radiates from the hand to the elbow or neck
  • Weakness of grip

Again, pressure on the nerves in the neck cause the same symptoms This is why so many carpal tunnel surgeries fail. It was not the true problem. The nerve involved in true CTS is the Median Nerve. It is actually formed by branches of the cervical nerves (neck). This is why the symptoms are the same. True CTS is when there is compression of the median nerve in the wrist. This is a far less likely scenario than compression on the nerves in the neck. It is also easier to treat the neck. Results can typically be seen right away.

Some of the conditions in the neck area that can pinch the nerves that innervate the arm and hand are as follows:

  • Bulging and herniated discs
  • Vertebral Subluxation
  • Degenerative Disc Disease
  • Facet Syndrome
  • Spinal Degeneration
  • Thoracic Outlet Syndrome
  • Cervical Rib

So there you go. Changes are if you have CTS Symptoms you don’t have true CTS. And one more thing…

Not all doctors know how to treat CTS and related disorders. Chiropractors are experts and some (like us) even specialize in treating neck, arm, and hand pain. The treatment is 100% natural s usually covered by insurance (we belong to most plans).

To find out more about CTS check out the other blog posts on this blog.

To make an appointment for carpal tunnel treatment in San Francisco please call 415-392-2225.  We validate parking at the Embarcadero Center. 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Hand Pain For No Reason?

Hand Pain Treatment in SF

Hand Pain Treatment in San Francisco

We have been treating hand pain in San Francisco for over 22 years.

Every week, many people come to our clinic with hand pain that has no apparent cause. Some say they woke up with it…others say it just came on while they were performing normal work or household duties. For some, the hand pain comes and goes and may be getting progressively worse.

The obvious place to look is the hands themselves. Are they being overworked? This day and age most of us spend a good amount of time sitting at a desk in front of a computer doing repetitive motions with the arms and hands. This alone without adequate breaks or proper ergonomics and posture can lead to hand pain, numbness, tingling, burning and weakness.

There is a not so obvious place to look as well that could well be the primary contributor to your arm or hand pain. The neck or cervical spine. This is where all the nerves that innervate or control the arm and hands (upper extremities) originate  and they are very vulnerable to pressure or interference as they exit the spine.

Some of the conditions in the neck that can pinch the nerves and cause hand pain and related disorders are as follows:

  • Herniated or bulging discs in the neck
  • Facet Syndrome
  • Degenerative Disc Disease
  • Vertebral Subluxation
  • Bone spurs
  • Spinal Stenosis

Here are some of the potential symptoms from these conditions:

  • Neck and shoulder pain
  • Arm pain
  • Elbow Pain
  • Hand Pain
  • Numbness and Tingling
  • Weakness of Grip
  • Night Pain

These are also the symptoms of Carpal Tunnel Syndrome (CTS). In fact, many patients are misdiagnosed with CTS when the problem is actually in the neck. It’s easy to do since the symptoms are the same. This is why it’s so important to See a doctor who spends the majority of their day managing cases of hand pain and related disorders and knows how to treat them naturally. There are many chiropractors that specialize in this like we do.

The last thing you ant is unnecessary drugs or surgeries.

Patients come to our San Francisco Chiropractic and medical center because they know we are hand pain and carpal tunnel experts. We have medical doctors, chiropractors, physical therapists, trainers, massage therapists, and nurses, that routinely treat hand pain, naturally.

We have two clinics in downtown San Francisco to serve you.

So…if you are suffering with hand pain, numbness, tingling, burning, aching, neck or shoulder pain or night pain, you may want to give us a call.

To schedule an appointment with a hand pain doctor on San Francisco please call 415-392-2225. 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Carpal Tunnel SYMPTOMS vs. Carpal Tunnel Syndrome

carpal tunnel treatment san franciscoWe have been providing treatment for carpal tunnel syndrome and related disorders in San Francisco for over 23 years. 

Carpal Tunnel Syndrome (CTS) is when a nerve in the wrist (the median nerve) becomes compressed, usually due to repetitive motions over time, acute trauma (rare), or as part of other upper extremity musculoskeletal disease complexes.

Either the diameter of the carpal tunnel narrows or the contents of the carpal tunnel expand putting pressure on the median nerve (which originates in the neck).  The carpal tunnel is a small opening, about the size of the tip of your pinkey, that is created by the 8 carpal bones and the transverse ligament that holds them together. There is no extra space in the carpal tunnel.

Inside the carpal tunnel is the median nerve and some some blood vessels. The median nerve has protective sheaths around it that also secrete fluids which allow for the nerve to glide within the tunnel.

With overuse syndromes such as repetitive stress injuries (RSI) the fluid dries up and the nerve sheath and median nerve swell causing pain and dysfunction.  RSI can also cause the carpal bones to misalign which can irritate the median nerve as well. Trauma to the hand can also cause CTS. The signs and symptoms of carpal tunnel syndrome are as follows:

  • Hand Pain
  • Numbness and Tingling
  • Weak Grip
  • Night Pain
  • Burning
  • Neck, shoulder, elbow pain

So, true carpal tunnel syndrome is when there is compression of the median nerve in the carpal tunnel…either from the tunnel narrowing or the contents expanding. True CTS is rare. The majority of the time CTS symptoms are NOT the result of true CTS…they are the result of problems (nerve pressure) in the neck. 

The median nerve originates in the neck. It is actually created by branches of nerve roots that exit  the lower part of the neck (C5-8). Each of these nerves passes through bones. If there is any kind of nerve pressure on these nerve roots it can cause the same exact symptoms in the hand that you would get if you had true CTS.

This is why it’s so important to visit a doctor that routinely treats patients with carpal tunnel SYMPTOMS. Carpal Tunnel Syndrome is one of the most misdiagnosed conditions there is. It is not uncommon for an emergency room doctor or primary physician or nurse to make a CTS diagnosis for hand pain. The typical course of treatment is a wrist splint and Motrin. Meanwhile, the true cause in the neck is left untreated.

Some of the conditions in the neck that can cause carpal tunnel SYMPTOMS in the upper extremity are as follows:

  1. Bulging or Herniated Cervical Disc
  2. Vertebral Subluxation
  3. Thoracic Outlet Syndrome
  4. Facet Syndrome
  5. Degenerative Disc Disease
  6. Spinal Stenosis

There are other upper extremity disorders that can mimic CTS. The point here is you need to know what they are and how to check for them. And even more importantly…how to treat them before they get worse.

A chiropractor that specializes in carpal tunnel syndrome and related disorders is your best bet. We may take x-rays or order a nerve conduction test or MRI.  The treatments we use to treat these types of problems are spinal and extremity adjustments (gentle), massage, laser, exercise, ice/heat, physical therapy, ART, Graston, traction.

All cases present differently and are treated as such. Often times a patient that presents with carpal tunnel SYMPTOMS can be fixed in a fe days. Other times, with more chronic cases it takes months. And everything in between.

Whatever you do make sure you see an expert. My advice is to see a chiropractor. Call around. Search the internet and find out if the doctor is experienced in carpal tunnel treatment and call and speak to them.

And even if you do have true carpal tunnel syndrome, a trained chiropractor is your best treatment choice.  You can save yourself a lot of time and grief by doing some homework.

If you live or work in San Francisco you can see us. We also have medical doctors and physical therapists in the event you need them.

To make an appointment with a carpal tunnel doctor in San Francisco please call 415-392-2225. We validate parking at the Embarcadero Center.  

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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What is Carpal Tunnel Syndrome?


carpal tunnel treatment san franciscoWe have been providing treatment for Carpal Tunnel Syndrome and related disorders in San Francisco for over 22 years now. 

Here is an excerpt from an article on the great chiropractic consumer website Chiro-trust.org entitled Carpal Tunnel Syndrome-What Is It?:

Carpal Tunnel Syndrome (CTS) basically occurs when pressure is applied to the median nerve as it travels through the wrist on the palm side resulting in numbness, tingling, pain, and later, weakness of the grip and pinch functions. But, the median nerve can be pinched at many other locations as it courses down from the neck to the hand, which is why we examine and treat the CTS patient from the neck down! The median nerve has been described as the “eye of the hand,” as it is one of the three major nerves formed from the brachial plexus– that “highway” of nerves made up of the C5-T2 roots leaving the neck, merging together to eventually form the three main nerves of the arm. Because the median nerve function regulates pinch and grip strength, buttoning a shirt, writing a note, driving a car, and even sleeping are ALL affected by a median nerve pinch.

So, since the median nerve originates in the neck, and carpal tunnel symptoms are mostly in the hand, the neck-hand connection is often overlooked by doctors and therapist that do not routinely treat CTS.

Our carpal tunnel doctors in San Francisco have been treating CTS since before the dotcom boom-bust. In fact, we have successfully treated over 20,000 cases of carpal tunnel symptoms and upper extremity disorders. The secret is to ALWAYS examine and treat from the neck to the fingertips…on both sides. At our clinic we also check the entire spine and feet. A pedal imbalance such as a pronation or short leg can cause cervical muscle spams and interfere with nerve transmission to the hands. Interesting Huh?

Bottom Line:  Carpal Tunnel Symptoms are nothing to mess around with. You use your hands for everything. Patients with chronic hand pain are often depressed and have other problems such as sleeping disorders and lowered immune function. It’s a chain reaction that can overwhelm your life.

The good news is that a chiropractor that specializes in CTS can help…and results are usually seen right away.

To find out if you are a candidate for carpal tunnel treatment in San Francisco please call 415-392-2225.

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Cervical Decompression for Arm and Hand Pain

cervical decompression san francisco drx9000c

Cervical Decompression with the DRX9000c

We have been providing cervical spinal decompression treatment in San Francisco for over 10 years now. The machine we use is the DRX9000c.

The DRX9000c cervical decompression system treats bulging and herniated discs in the neck which are a primary cause of arm and hand pain.

The nerves that exit from the neck travel down the arm and into the hand. When these nerves become pinched from herniated or bulging cervical discs it can cause neck pain, shoulder pain, arm and hand pain, weakness of grip, numbness, tingling, even night pain.

Because these symptoms mimic those of carpal tunnel syndrome (CTS), herniated discs in the neck are often misdiagnosed as CTS. In fact, sometimes carpal tunnel surgery is even performed (even though the cause is in the neck)…if you can believe that.

Once it is determined that the underlying cause of a patients arm and hand pain is a herniated or bulging disc (by MRI) we will first attempt to help with conservative treatments such as chiropractic, massage, and physical therapy. In the event these treatments fail to deliver results we may recommend cervical decompression with the DRX9000c.

The DRX9000c is designed and built to treat herniated discs in the neck without surgery. Sometimes a combination of decompression, chiropractic and exercise works best. If we need the help of a medical doctor we have them as part of our team also.

To find out if you are a candidate for arm and hand pain treatment with cervical decompression in San Francisco please call 415-392-2225. We are in network for most insurance carriers. We also have validated parking at the Embarcadero Center where we are located.

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Is it Carpal Tunnel Syndrome or Pinched Nerve in Neck?

carpal tunnel doctors san francisco

Is it Carpal Tunnel Syndrome or the Neck?

We have been providing treatment for carpal tunnel syndrome in San Francisco for over 22 years.

One of the more common presentations of symptoms that we see at our chiropractic clinic in downtown San Francisco is computer related hand pain, numbness, tingling, burning, aching and weakness (some or all of these together). Sometimes there is associated neck shoulder, or arm pain.

So the question becomes…what is the underlying cause of the symptoms?

Sure, these are the classic symptoms of carpal tunnel syndrome (CTS), but the likelihood there is true CTS is rare. What’s more likely is that the cause of the CTS symptoms is a pinched nerve in the neck. After-all…the nerves that exit from in between the bones in the neck, travel into the upper extremities and innervate and control the arms and hands.

When there is pressure on these nerves in the neck it can cause the same signs and symptoms of true carpal tunnel syndrome.

Pinched nerves in the neck are mostly the result of bulging or herniated cervical discs, subluxated vertebrae, or degenerative disc disease…all of which respond favorably to chiropractic adjustments. In the event we need a little help, we have deep tissue laser or nonsurgical spinal decompression.

We do chiropractic adjustments to the neck, shoulders, elbows, wrists and fingers on both sides. We do massage and exercise as well. We are also concerned with proper ergonomics, sleeping positions and nutrition. It is this comprehensive approach that has allowed us to successfully treat thousands of patients with CTS symptoms over the years.

So…if you are experiencing the signs and symptoms of carpal tunnel syndrome and would like to find out if you are a candidate for care…please call 415-392-2225 and make an appointment with one of our San Francisco Carpal Tunnel Experts. Chances are, you will be glad you did :-)

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Hand Pain Treatment in San Francisco

Hand Pain Treatment in SF

Hand Pain Treatment in San Francisco Downtown

We have been providing natural hand pain treatment in downtown San Francisco for 22 years now in the Financial District. 

Most of our patients spend the majority of their day sitting in front of a computer doing repetitive movements with their arms and hands.  In addition, they are mostly under the stress of meeting deadlines and are expected to perform at a very high level.

On top of this, many of our patients are actively involved in sports and hobbies that require repetitive use of the upper extremities like weight lifting, cross-fit, cycling, and tennis.

This is the reason hand pain is so common with office workers and urbanites. Not to mention the fact that most of us then go home and spend more time on the computer. In fact, many are connected on the way to and from work. OUCH!

In my experience, the source of the hand pain is typically a combination of pressure on the nerves in the neck that innervate (connect to) and control the hand, and pressure in the wrist on the median nerve in the carpal tunnel. This is called “Double Crush Syndrome” and is one of the more common conditions we treat.

Many doctors and physical therapist have a good understanding of this condition but lack the ability to successfully treat it. In my opinion…and I have treated provided hand pain treatment to over 5000 patients, treatment must include the neck, shoulders, elbows, wrists, and fingers on both sides. It is also important to make sure the rest of the spine is in proper alignment and the legs are even. A short leg can cause muscle tension in the neck and lead to pinched nerves.

Our hand pain treatment will usually include chiropractic adjustments to the neck, shoulders, arms, and hands, as well as myofascial release, cervical traction, custom exercises, and ergonomic instruction. We will also address sleeping postures and nutrition. It all matters.

A hand pain treatment visit at our chiropractic center takes about 30 minutes. In the event of severe hand pain or injury from trauma, we may refer you to one of our physical therapist or medical doctors , either onsite or at another location. We also may need to take x-rays or perform diagnostic tests to quantify your problem.

The bottom line is this…when it comes to hand pain treatment not all chiropractors, medical doctors or physical therapist are equal…experience matters!

To schedule an appointment for hand pain treatment in San Francisco please call 415-392-2225.

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Carpal Tunnel Treatment Options

CTS in SF

Carpal Tunnel Relief in SF

We have been providing carpal tunnel treatment in San Francisco for over 20 years.

The goal of any treatment approach for Carpal Tunnel Syndrome (CTS) is to return the patient to normal. That means addressing all OTHER health related conditions that can cause CTS such as diabetes, hypothyroidism, birth control pill use, pregnancy, rheumatoid arthritis (and many of the other related arthritic-like disorders), as well as double or multiple crush (pinched nerve) syndromes. That’s right! CTS can be caused by MANY other conditions besides simply overusing the arms and hands. When overuse PLUS any of the above mentioned conditions “gang-up” on you, managing BOTH is necessary.

            One “universal” goal in CTS treatment is to reduce inflammation. This can be accomplished by several approaches: 1) STOP, reduce, and/or modify the causing activity. Examples include repetitive use of a hammer, screw driver, stapler, assembly line work, typing/computer work, driving with a firm grip on the steering wheel, bicycle riding, and MANY more! The key to successful management of CTS is to slow down, stop/rest, and for long-term success, change how the task is performed (modify the work station). 2) Wearing a cock-up wrist splint. This is usually restricted to night time use since we cannot control our wrist position while sleeping and the pressure inside the carpal tunnel “normally” doubles at the extremes of the wrist forwards or backwards. Thus, keeping the wrist straight at night significantly reduces or eliminates the numbness/tingling that can cause multiple sleep interruptions. It can also be worn during the day IF it doesn’t interfere with the person’s activity. If the activity requires frequent bending of the wrist, you’ll end up fighting against the wrist splint and that can actually worsen your CTS! 3) Ice cupping or massage. Freeze water in a Styrofoam or paper Dixie cup (like home-made popsicles) and peel away the top third to expose the ice. Rub it over the palm side of the wrist until you feel numbness. At first, it will feel Cold, followed by Burning, Aching, and finally Numbness (hence the acronym, “C-BAN”). The length of time to achieve numbness is usually three to five minutes, but make sure you quit at the point of numbness as the next stage is frostbite! 4) Anti-inflammatory nutrients. An anti-inflammatory diet is one that is rich in fruits, vegetables, lean meats, omega-3 fatty acids, and avoids glutens, omega-6 fatty acids (fast foods, etc.), and refined carbohydrates (sweets, sodas, etc.). Also, there are many REALLY GOOD nutritional supplements that can effectively reduce inflammation without the typical side-effects that affect the stomach, liver, or kidneys which are common to NSAID drugs like aspirin, ibuprofen, or Aleve. Also, NSAIDs can inhibit an important chemical (a prostaglandin) that is needed for healing, and therefore, it can actually slow down the healing process (so try the nutritional approaches first)! Nutritional options include proteolytic enzymes, Bromelain, papain, bioflavonoid, Vitamin C, Vitamin D, Vitamin E, Coenzyme Q10, and many more.

            Treatment options beyond those mentioned above are typically surgical, IF you decide to go to a surgeon. However, chiropractic care includes identifying and treating the source(s) of nerve irritation, as it is often more than just nerve pinching at the carpal tunnel. Other common locations of median nerve entrapment includes the pronator teres muscle in the forearm just past the elbow on the palm side, less often at the shoulder, and again quite frequently in the neck where the nerve exits the spine. If these areas of nerve pinching are not released, recovery is less likely (with or without surgery)! Bottom line, you can always have surgery but you can’t “un-do it.” Try chiropractic first as it’s the least invasive, least costly, and often the quickest way to find relieve from CTS!

            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.

Providing carpal tunnel relief in San Francisco since 1992.

Call 415-392-2225

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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Carpal Tunnel Syndrome: Self Diagnosis


Natural carpal tunnel treatment in downtown  san francisco
We have been providing natural treatment for Carpal Tunnel Syndrome (CTS) and Symptoms in the San Francisco Financial District for over 20 years now.

Carpal
Tunnel Syndrome (CTS) is technically a “pinched nerve” in the wrist (carpal
tunnel) that results in numbness, tingling and later, weakness in the
distribution of the median nerve (thumb, index, 3rd, and half of the 4th
finger). There is a limited amount of space within the carpal tunnel. In
addition to the median nerve, there are 9 tendons and their sheaths, a network
of blood vessels, the joint capsules, the bony “roof” and ligamentous “floor.”
Any condition that distorts the shape of the tunnel  (inflammatory conditions like rheumatoid
arthritis, ganglion cysts, bony spurs, or conditions that result in swelling
like overuse, pregnancy, taking birth control pills, hypothyroid, obesity,
and/or conditions that create neuropathy like a pinched nerve in the neck,
shoulder or elbow, diabetes and post-chemotherapy) can result in median nerve
irritation. The carpal tunnel naturally changes its shape when we flex and
extend the wrist, so occupations that require wrist bending (especially if it’s
prolonged and a fast pace is required) such as carpentry (especially the use of
vibrating tools), waitressing, assembly line work, typists, and even sleeping
at night with the wrist bent can result in CTS.

            The diagnosis can be tricky because
of all the possible causes (of which, some are described above) and to make
matters even more challenging, there can be two, three, or more of the causes
all contributing to the problem at the same time! In the clinic, there are
certain positions to test how long (in seconds) it takes for the numbness,
tingling and/or pain to occur when we place the wrist in extreme flexion or
extension. We’ll compress the carpal tunnel (and nerve pathways at the elbow,
shoulder, and neck), as well as tap over the carpal tunnel with a reflex hammer
creating a “funny bone” sensation usually into the 2nd or 3rd finger. Blood
tests for rheumatoid (and other inflammatory) arthritis, diabetes and thyroid
dysfunction are very helpful when trying to differentiate between several
possible causes. An electrical conduction test called electromyogram (EMG) and
nerve conduction velocity (NCV) can also be very helpful in determining the
severity of CTS.

            So the question is, can you “self-diagnose”
CTS? The answer is: sometimes. However, with that said, if the symptoms are
“classic” (numbness/tingling in the thumb, fingers 2-4, which shaking and
flicking your fingers relieves at least partially; it’s waking you up at night
especially, if a night splint helps reduce the frequency of waking and
intensity of numbness), then you “probably” have CTS. Here are some common
questions included in a CTS questionnaire that we often use in the clinic to
assist with the diagnosis: SYMPTOM
SEVERITY
(score each on a 0-4 scale): 1) Pain severity at night? 2)
Nighttime frequency of waking with pain? 3) Amount of daytime hand/wrist pain?
4) Frequency of daytime hand/wrist pain? 5) Duration (in minutes) of daytime
pain/numbness? 6) Severity of numbness? 7) Severity of weakness? 8) Tingling
intensity? 9) Nighttime severity of numbness or tingling? 10) Nighttime
frequency of numbness or tingling? 11) Difficulty grasping / using small
objects like keys or pens? FUNCTION
SEVERITY
(0-4 scale): 1) Writing. 2) Buttoning clothes. 3) Holding a book
while reading. 4. Gripping of a telephone handle. 5) Opening jars. 6. Household
chores. 7. Carrying grocery bags. 8. Bathing and dressing. The maximum score
for SYMPTOM SEVERITY is 11×4 = 44
and for FUNCTION 8×4 = 32. To determine
the percentage, divide your score by 76 (the maximum possible) and multiply it
by 100. In general, scores >50% may be indicative of CTS. However, as
previously stated, a definitive diagnosis must include a detailed history,
examination, sometimes special tests. Therefore, it is important to see us! If
you have CTS, we will outline the type and length of care with you and MOST
IMPORTANT, we can usually manage CTS without the need for surgery!

            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.

To schedule an appointment for natural carpal tunnel relief in San Francisco call 415-392-2225

Altadonna Communications ©

 

Eben Davis

I am a Chiropractor in the San Francisco Financial District specializing in chronic neck, arm and hand pain. I also treat herniated discs using spinal decompression, whiplash, sports injuries, headaches, and Fibromyalgia. My clinic is certified in the use of Deep Tissue Laser Therapy with the LiteCure LCT-1000 for conditions such as shoulder pain, TMJ and Plantar Fasciitis. I have been in practice for over 20 years.

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