Tag Archives: CTS

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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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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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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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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Hand Pain Causes


Hand pain treatment in SFWe have been providing natural solutions for hand pain in San Francisco since 1992.

The are many hand pain causes. Sure, if you use your hands too much it will make them sore. For instance, if out of the blue you assemble a 200 piece doll house for your daughter that requires lots of hand tools you will probably get sore hands. Or, if you use a new piece of exercise equipment, or start a new hobby or sport like tennis or golf you increase your chances of hand pain. This kind of pain is just the body telling you you did too much.

The kind of hand or wrist pain I am describing usually goes away quick and there are no repercussions. If you want to speed up your recovery you can use ice or some simple stretches…or just rest. Unless, you really overdo it and/or already had some hand problems bubbling under the surface.

For example…if by day, you are sitting in front of a computer doing repetitive movements with the arm and hands, you may be developing a repetitive stress injury and did not even know it. Then, you take up golf and your arms and hands begin to get really sore and don’t seem to recover. This is the type of scenario we see frequently at our Back, Neck, and Wrist pain Center in San Francisco.

Or, hand pain, wrist pain, forearm pain, numbness, tingling, or weakness of grip, just seems to develop out of the blue for no apparent reason. This is also common and can be very frustrating to patients as we use our hands for everything and for the most part take the use of them for granted.

The other thing is, the true source of your hand pain may not even be the hands or wrists (carpal tunnel syndrome)…it may be the neck. That’s right…the nerves that innervate and control the shoulder, arm, and hands originate in the neck. Pressure on these nerves in the neck from misaligned vertebrae (vertebral subluxations), bulging or herniated cervical discs, face syndrome’s, or degenerative disc disease can also cause pain, numbness, tingling, or weakness in the hands.

I know this sounds complicated but it really isn’t. Not for a chiropractor that specializes in hand pain and related disorders. Not sure if I would go to the emergency room for this, or even to my family doctor…because they just don’t have the experience to know what to do.

Wrist splints and Motrin is the usual treatment. Meanwhile, there is no examination of the neck to check for nerve pressure or interference. In fact, there are even some hand surgeons that don’t check the neck. I can’t tell you how many carpal tunnel surgeries I have seen in my 21 year career that were not necessary.

Anyway, if you have hand pain and it comes on gradually out of the blue, or you overdo it and the hand pain persists, you should probably see a chiropractor…not any chiropractor, but one that specializes in hand pain.

If you live or work near downtown San Francisco you can see us. If you don’t then email ebendavis@yahoo.com and ask me if I have a doctor I have trained to treat CTS in your area.

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

By Dr. Eben Davis

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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Post Surgical Nutritional Management of CTS

 


Carpal tunnel symptoms relief san francisco
Obviously, the goal of all health
care providers, including chiropractic management of Carpal Tunnel Syndrome
(CTS), is to AVOID surgical intervention, but this is not always possible. Last
month, we looked at herbal approaches to reduce inflammation with the focused
goal of preventing surgical need. But, as chiropractors, we also care for
patients post CTS surgery, and one of our treatment approaches beyond manual
therapies includes nutritional management.
 

As we all know, during the surgical
process, tissue damage occurs due to incisions, removal of injured tissue, and
other factors. Depending on the “success” of the surgical procedure, damage to
the nerves causing numbness, weakness, and/or other nerve related symptoms can
occur.

Often, nerves will regenerate during the healing process but not always
100%. This may be due to factors such as the amount of tissue damaged during
the surgery, the length of time CTS had been present pre-surgery, how well the
patient follows post-surgical instructions, as well as the general health and
overall condition of the patient. A healthy diet along with certain specific
vitamins can play a positive role in tissue healing and nerve regeneration.
Here are some examples:

 

1.    Folate or
vitamin B9
has been reported to
have beneficial effects on the genes located within the nerve cells that help
to regulate the healing process. One study published in 2010 reported that
folate helped to promote nerve repair in the central nervous system (CNS) in
rats, which is unique as typically nerve damage in the CNS does not usually
regenerate. Anti-inflammatory benefits have also been reported with vitamins
B6, B9, and B12.

2.    Cobalamin
or Vitamin B12
has also been
reported to facilitate nerve regeneration after injury. This, along with the
anti-inflammatory benefits, supports the use of B12 in the post-surgical CTS
patient.

3.       Vitamin D may also play a significant role in nerve
regeneration after surgery. In one study, vitamin D2 was found to have a
positive effect on nerve regeneration. Another study reported that D3 and
calcium together has strong anti-inflammatory benefits.

4.      Vitamin
B6
: There is evidence that
supports the use of B6 both before and after surgery. Some feel B6 acts
directly on nerve repair and others report a diuretic (fluid reducing) benefit.
One cause and/or complication of CTS is fluid retention, which commonly occurs
in conditions such as pregnancy, the use of birth control pills, obesity,
diabetes, and others. Thus, keeping fluids in our tissues under control can
certainly help CTS patients. Most studies agree that less than 200mg of B6 per
day is safe. The dosage should be carefully monitored as numbness/tingling (a
common CTS symptom) can be a sign of B6 toxicity.

5.       Vitamin C has long been reported to facilitate in the wound
healing process. It also is an effective anti-inflammatory agent, a common
problem in the cause of CTS as well as a negative post-surgical side effect. A
dose of 1000-3000mg/day spread out throughout the day is beneficial to the
post-surgical healing process.

6.      Vitamin E: As far back as 1967, Vitamin E been reported to
reduce inflammation. More recent studies report that when used in combination
with vitamin C, the two together works even better in reducing inflammation
than either one alone. Also, this combination was found to improve the body’s
ability to use insulin, which may also facilitate healing in the post-surgical
CTS patient.

            There are many others we didn’t get
to (such as B1, 3, 5; zinc, Bromelain, and Quercetin). Bottom line: Eat healthy, exercise, don’t smoke, and fortify
your diet with these nutrients!

            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 carpal tunnel treatment 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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Is it Carpal Tunnel Syndrome or Something Else?


Carpal tunnel symptoms treatment SFCarpal
Tunnel SYMPTOMS are a common group of complaints presented to chiropractic offices. Symptoms like arm pain, wrist and hand pain, elbow pain, night pain in the hand, weakness, loss of grip strength, numbness, tingling, loss of normal sensations in the arm and hands, and even neck pain.

Sometimes these symptoms are the result of true Carpal Tunnel Syndrome (CTS) and sometimes they aren’t. It’s our job to figure out the cause.


Usually, patients with CTS symptoms wait for weeks, months, or even years before seeking care,
thus making management more challenging. The history of the “classic” CTS
patient includes a mild, sporadic onset that gradually becomes more frequent
and intense. This usually leads to continued problems that start to affect
other areas proximal to the hand, such as the elbow, shoulder and/or neck. We
usually find that people will compensate during their activities, and instead
of moving the wrist and hand to perform a task, they will start to move their
elbow and shoulder more to avoid irritating movements of the hand/wrist. Over
time, overloading the muscles in these areas can lead to one or more conditions
commonly referred to as “cumulative trauma disorder” (CTD), which includes many
diagnoses including (but not limited to) tendonitis of the thumb (de Quervain’s
Disease), ganglion cysts, tennis elbow (lateral epicondylitis), golfer’s or
bowler’s elbow (medial epicondylitis), cubital tunnel syndrome (ulnar nerve
pinch at the medial elbow), tunnel of Guyon syndrome (ulnar nerve pinch at the
wrist), shoulder tendonitis (biceps, rotator cuff), thoracic outlet syndrome
(pinched nerve at the shoulder), and / or neck strain, neck herniated disk,
pinched nerve, and/or headaches. Many times, these conditions co-exist if the
patient has really abused themselves (such as music majors who may practice
playing their instrument for 4-5 hours a day) to a point where they are REALLY
injured in multiple areas.

            Limiting this discussion to pinched
nerves in the neck and upper limb, the question often arises, “…how do you know
where the nerve is pinched?” The answer centers around determining an accurate
history to find out  EXACTLY where the
patient feels numbness, tingling, weakness, and/or pain as each nerve
innervates a different area. For example, if a patient says, “…I feel numbness
in my 4th and 5th finger,” this tells us that the ulnar nerve is pinched (as
opposed to numbness in the 2nd, 3rd, or 4th fingers which suggests median nerve
pinch — more classic of CTS). If the patient says the numbness affects the arm
from the elbow down to the 4th and 5th finger, this suggests cubital tunnel
syndrome (ulnar nerve pinch at the medial elbow). If the numbness affects the
person from the shoulder to the 4th and 5th finger, thoracic outlet syndrome
becomes a probable diagnosis. And lastly, if the neck, shoulder, arm and hand
(on the pinky side) are numb, we are suspicious of a pinched nerve in the neck.

            Then, we confirm our suspicions with
a more detailed physical examination. Here, we test for compression of a nerve
at the neck by positioning the head in a backwards, rotated position and
holding it for about 10 seconds to see if the numbness is reproduced. We can
also manually (with our hands/fingers) compress the various nerve pathways to
see if numbness occurs at the front of the neck, the shoulder under the collar
bone, at the elbow and wrist counting the seconds to time the onset of numbness
and mapping the numbness location. Placing the shoulder, elbow, and wrist in
different positions can pinch the nerve as well, and mapping the location of
the numbness tells us where and to what degree the nerve is pinched.

We will
also perform a neurological exam testing reflexes and strength, as well as
sensory function using a sharp object. A special test called an EMG/NCV
(electromyography and nerve conduction velocity) can be obtained to further
verify the location and degree of nerve pinching and damage. At our San Francisco Back, Neck, and Wrist Pain Center we first try conservative treatment before ordering nerve tests or MRI.

            The advantage of chiropractic
management is that we will treat EVERY LOCATION that may be contributing to the
CTS symptoms, whether the pinch is in the neck, shoulder, elbow and/or wrist.
Managing the WHOLE PERSON, not just the wrist or CTS is KEY to a successful
outcome. And we can do this in a very short period of time. We can adjust from the neck to finger tips on both sides in a matter of minutes. We also have tools such as deep tissue laser therapy that can help speed the healing process as well as advanced soft tissue treatments such as Graston Technique.

            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 with a carpal tunnel doctor in San Francisco please call 415-392-2225 and ask for a complimentary consultation.

 

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 and Hand Numbness

Doctor for CTS in San FranciscoWe have been providing treatment for Carpal Tunnel Syndrome in San Francisco for over 20 years.

Carpal Tunnel
Syndrome (CTS) sufferers frequently report a cluster of symptoms, but almost
all have one symptom in common – numbness, usually in digits 2-4 on palm-side
of the hand. CTS is usually attributed to an over-use type of injury such as
repetitive work including (but not limited to): typing, assembly work,
packaging jobs, machine operators, and many more.

The patients we treat in the SF Financial District spend the majority of their day in front of a computer doing repetitive motions with their arms and hands. Then, they typically go home and spend more time on the computer. Heck, most do it in between work and home on laptops, tablets, or smart phones.

Last month, we discussed CTS
“Facts” and learned many important points about CTS. This month’s focus centers
around the common question, “….where is this numbness coming from?”

Carpal tunnel pain doctor SF
To answer this, let’s
review the anatomy: The carpal tunnel is made up of 8 small “carpal bones” that
form an arch or tunnel, and the base of the tunnel is formed from the
transverse carpal ligament. There are nine tendons that attach muscles in the
forearm to each finger and work when we grip or form a fist with our hand.
Wiggle your fingers and look at your wrist and forearm – do you see all the
activity or movement going on?

The tendons travel
through sheaths which help lubricate the sliding tendons. When we move our
fingers fast (such as typing, playing piano, performing assembly work, etc.),
friction and heat builds up, resulting in swelling. If adequate rest does not
occur, the increased pressure from the swollen tendons end up squeezing all the
contents within the tunnel, which includes the median nerve. It’s the median
nerve pinch that results in the numbness, tingling, and/or pain into the index,
third and forth fingers.

There are other
conditions that can either complicate or cause CTS. These include: hypothyroid
disease (due to myxedema), diabetes (due to neuropathy), inflammatory arthritis
(of which there are several kinds – rheumatoid is the most common), and
pinching of the nerve either in the neck, shoulder, elbow or forearm (called
double or multiple crush syndrome).

The reason
chiropractic helps so much is that we can alleviate the pressure on the nerve
from the neck down to the wrist and restore nerve function. This alleviates the
multiple sleep interruptions, weakness in the grip that is so common, as well
as helping to restore the nerve’s function. Many studies support the success of
chiropractic and CTS – try it first as surgery should be the last resort.

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 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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Interesting “Carpal Tunnel Syndrome” Facts


Carpal tunnel symptoms san franciscoCarpal
Tunnel Syndrome (CTS) results in numbness, tingling, and sometimes weak grip
strength due pinching of the median nerve as it travels through the carpal
tunnel at the wrist. There are many conditions that are similar to CTS, many of
which we have discussed in the past. The following is a list of “13 fun facts”
aimed at helping to properly identify CTS, knowing what to do about it, and at
helping to make an informed decision as to whom to seek help for it.

 CTS is most
common in women, age >50, who work in a repetitive, rapid moving manually
demanding occupation (typing/computer work, line assembly work, waiting tables,
and more).

  1. CTS is
    complicated by the presence of obesity, diabetes, hypothyroid, pregnancy,
    taking birth control pills, and other conditions that cause inflammation
    (rheumatoid arthritis and others).
  2. CTS may develop
    on the dominant side, the non-dominant side or both– each case is individual.
  3. CTS symptoms may
    FIRST present as morning or night time numbness that can wake the sufferer up
    once or many times during the night.
  4. CTS sufferers
    USUALLY wait for weeks, months or even years before seeking help for it, which
    is a risk factor for a delayed recovery – GET HELP ASAP!!!
  5. CTS can often be
    managed without surgery– especially IF you have it treated sooner rather than
    later.
  6. CTS surgery may
    be necessary if non-surgical care fails. This may be due to the nerve being
    damaged beyond a certain point (an EMG/NCV or, electromyography/nerve
    conduction velocity helps determine this along with an accurate history and
    examination).
  7. CTS non-surgical
    care includes: chiropractic manipulation of the wrist, elbow, shoulder and/or
    neck– depending on the case. All health care providers usually include a night
    wrist splint, anti-inflammatory measures, ergonomic modifications of work
    stations, and stretching exercises.
  8. CTS non-surgical
    success favors chiropractic because of the inclusion of the manual therapies.
    When only exercise, night splinting, and NSAIDS are used, the success rate
    drops off dramatically.
  9. Reduced thyroid
    function makes CTS worse because of the unique type of swelling associated with
    hypothyroidism called “myxedema.” Because of the confined space available in
    the carpal tunnel, a small amount of swelling can result in nerve compression
    and the classic numbness/tingling symptoms in the middle three fingers on the
    palm-side of the hand.
  10. CTS is worse at
    night because it is impossible to control the position of the wrist while we
    sleep. As a result, we tend to curl the wrist and hand under our chin, and when
    the wrist bends forwards or backwards, the pressure inside the carpal tunnel
    increases significantly due to the change in tunnel size. This is why wearing a
    wrist splint at night REALLY HELPS as it keeps the wrist from bending, keeping
    the tunnel as wide as possible, thus lowering the pressure within it.
  11. CTS patients
    respond well in some cases to vitamin B6. This is due to the healing effects of
    B6 (peridoxine) on neuropathy and/or it’s anti-inflammatory qualities. Other
    anti-inflammatory nutrients include ginger, turmeric, boswellia, bioflavinoids,
    white willow bark, quercetin, and others.
  12. CTS patients do
    not always improve after surgery. This can be due to the fact that the median
    nerve is frequently “pinched” in more than one area such as the neck, thoracic
    outlet (shoulder), pronator tunnel (elbow) as well as at the wrist. When more
    than one compression is present, this is referred to as “double” or “multiple
    crush syndrome.”

            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 carpal tunnel relief 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.

More Posts - Website

Follow Me:
TwitterFacebookLinkedInGoogle PlusYouTube