Tag Archives: expert

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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Whiplash Treatment Basics

whiplash treatment san francisco

Whiplash Treatment

We have been providing treatment for whiplash injuries in the San Francisco Financial District for over 20 years now.

Whiplash is a non-medical term typically describing what happens to the head and neck when a person is struck from behind in a motor vehicle collision. Let’s look at some basic facts about whiplash:

·         Before cars, trains were the main source of whiplash and was called “railroad spine.”

·         Better terms for whiplash injuries include “cervical acceleration-deceleration” (CAD) which describes the mechanism of the injury, and/or the term “whiplash associated disorders” (WAD), which describes the residual injury symptoms.

·         Whiplash is one of the most common non-fatal injuries involved in car crashes.

·         There are over one million whiplash injuries per year due to car crashes alone.

·         An estimated 3.8 per 1,000 people per year have a whiplash injury.

·         In the United States alone, 6.2% of the population has “late whiplash syndrome” (symptoms that do not resolve at one year).

·         1 in 5 cases (20%) remain symptomatic at one year post-injury of which only 11.5% returned to work and only 35.4% of that number returned to the same level of work after 20 years.

·         The majority of whiplash cases occur in the fourth decade of life, females>males.

·         Whiplash can occur from slips, falls, and brawls, as well as from horse-riding, cycling injuries, and contact sports.

·         Injury from whiplash can occur at speeds of 15 mph or less.

·         In the “classic” rear end collision, there are four phases of injury (time: 300msec)

o        Initial (0msec) – before the collision (the neck is stable)

o        Retraction (1-150msec) – “whiplash” starts where the head/neck stay in the original position but the trunk is moving forwards by the car seat. This is where the “S” shaped curve occurs (viewing the spine from the side).

o        Extension (150-200msec) – the whole neck bends backwards (hopefully stopped by a properly placed head rest).

o        Rebound (200-300msec) – the tight, stretched muscles in the front of the neck propels the head forward immediately after the extension phase.

·         We simply cannot voluntarily contract our neck muscles fast enough to avoid injury, as injury to the neck occurs within 500msec. and voluntary contraction or bracing takes 800msec or longer.

·         Injury is worse when the seat is reclined as our body can “ramp” up and over the seat and headrest. Also, a springy seat back increases the rebound affect.

·         Prompt treatment is better than waiting for a long time. Manipulation is a highly effective (i.e., COME SEE US!) treatment option.

 

            We realize you have a choice in where you choose your healthcare services.  If you, a friend or family member requires care for whiplash, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family both presently and in the future.

To schedule an appointment for whiplash treatment in San Francisco please call 415-392-2225. We can also do a complimentary in house or phone consultation to answer any questions you may have.

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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Car Accident (Whiplash) Treatment Options


Car accident chiropractor san franciscoWe have been providing effective treatment for car accident victims in downtown San Francisco since 1992. During this time we have managed thousands of cases of whiplash injuries to the neck and back.

Our current Whiplash topic continues
from last month when we reviewed the “mechanism of injury,” the “type of
injury,” and “prognosis.” This month, we will review the “nuts and bolts” of
the whiplash injury or, whiplash associated disorders (WAD). 

Whiplash diagnosis: The diagnosis of whiplash first and
foremost requires a thorough history. Here, we discuss the factors leading up
to the MVC (motor vehicle collision), the angle or direction of impact (front
end, angular, side or T-bone, rear end), whether the head was pointed straight
or rotated, whether the head hit anything inside the car, airbag deployment and
any related injury, seat belt location and effectiveness, the conditions of the
day (weather, road, lighting, etc.), the onset of each injured area including
neck, upper/lower back, headache, memory loss, and radiating symptoms (time
lapse to symptom onset), ER/ambulance involvement, the initial 24-48 hours, the
point of maximum pain intensity, job and non-vocational capabilities, prior
test results (x-ray, CT, MRI, lab, etc.), prior treatment effectiveness, and
more! The physical examination centers on observation (posture, patient
distress, mood); palpation or touching the injured areas; orthopedic tests
(looking for positions that either relieve or increase symptoms); range of
motion (how far forward, back, sideways, and in rotation can the head be
voluntarily moved and its related level of comfort, speed/quality of motion);
neurological exam (sensory, motor, cranial nerves, etc.); and special tests
(x-ray, CT, MRI, lab, etc.) if not previously done.

Course of care: The type and length of treatment will
vary based on the degree of injury (see last month’s “prognosis” discussion),
the initial response to care (improvement vs. worsening), the compliance of the
patient in modifying their activities, performing home-based care (ice, rest,
exercise, etc.), and the patient’s motivation to get better. The latter may be
partially dependant on factors like whether there is litigation planned or
occurring, their belief that they will “get better,” and how the health care
provider manages the care (the use of passive approaches where the patient must
go and see the doctor vs. active approaches where the patient is taught how to
self-manage through diet, exercise, activity modifications, education, etc.)

Treatment options: The patient has the choice of following a traditional
medical model of initial anti-inflammatory medication, patient education, wait
and watch, and/or a physical therapy referral. The chiropractic approach
includes patient education, anti-inflammatory approaches (ice – NOT HEAT,
anti-inflammatory herbs), exercise training and manual therapies including
spinal adjustments. The latter, when applied properly, has been found to return
patients to work faster than other approaches with a shorter recovery time and
is less costly and more satisfying. When comparing treatment options beyond 6
or 12 months, the differences are more subtle. Other treatment options include
acupuncture, massage therapy, and various forms of exercise. When necessary,
injections, narcotics, and other pharmaceutical options exist but are not recommended as initial care
approaches. Behavioral and cognitive therapy can help people cope with chronic,
permanent pain related problems. There are many approaches to the management of
whiplash and the patient needs a “quarterback” or someone to help them with
these decisions. This is perhaps the
most important role of the chiropractor!

            We realize you have a choice in where you choose your
health-care services.  If you, a friend or
family member requires care for whiplash, we sincerely appreciate the trust and
confidence shown by choosing our services and look forward in serving you and
your family presently and, in the future.

To schedule an appointment with one of our San Francisco Car Accident and Whiplash Experts, please call 415-392-2225. Mention this blog post for a complimentary in house or telephone consultation. 

We specialize in Personal Injury Cases

 

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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Whiplash Syndrome: Defined


Whiplash experts in san francisco
We have been providing treatment for whiplash injuries in San Francisco for over 21 years now in the Financial District.

The term “whiplash” is a slang term
for a neck injury most accurately called a cervical acceleration-deceleration
(CAD) injury. Now you know why we call it “whiplash”! It suggests that the head
was forced through a range of motion that exceeds the barriers of our normal
tissue, resulting in injury to the neck.

             Though
a slip and fall, or even a bar-room brawl, can cause whiplash, whiplash is
usually associated with injuries that occur from a car accident or “motor
vehicle collision” (MVC). The term “syndrome” refers to a cluster of symptoms
that can include neck pain, headache, light-headedness, ringing in the ears,
visual disturbances, memory loss, nausea/vomiting, noise and/or light
sensitivity (usually associated with mild traumatic brain injury or,
post-concussive syndrome), TMJ (jaw) pain, radiating pain, numbness, and/or
weakness in the arm, limited neck movements, and more. Even the low back can be
injured in a whiplash injury!  In other
words, a whiplash injury can affect MANY different parts of the body, and the
clinical picture can vary widely from case to case.

            Whiplash
is diagnosed through a thorough history, paying particular attention to the
mechanism of injury – that is, how fast were you and the opposing vehicle
traveling, in what direction did you get hit (front, side, rear, angular, or
combinations), what size was your vs. the opposing vehicle, was your head
turned or pointed straight at the time of impact and did you hit your head?
Also, we will ask, what were your immediate symptoms compared to 30 min., 60
min., 3 hrs, 6 hrs later, the next morning, and when did your symptoms peak?
What activities (including work) have been affected, and to what degree? What
self-management approaches have you tried, and how have they worked? The more
we can learn about the accident and your immediate symptoms, or delay in
symptom onset, the better we can address your problems. The physical
examination is also very important as we will observe your movement quality,
posture, pain expression, palpate for muscle guarding, trigger points, and
swelling of the injured joints. We will also evaluate your neck and back range
of motion, assess your neurological functions, and assess extremity issues that
might be present. X-rays will more than likely be done and may include “stress
views” where you bend the neck forwards and backwards to assess the stability
of your spine. Comparison to older x-rays can be very helpful, if they exist.
Depending on the degree and type of the injury, special tests will be
considered such as MRI, EMG/NCV, laboratory tests, and perhaps others.

            Treatment
will consist of: addressing the acute inflammatory painful symptoms by the use
of gentle massage, mobilization and/or manipulation, electrical stim or a
different anti-inflammatory modality, review how to apply ice and/or heat, how
to bend/lift/pull & push properly to avoid irritation. We’ll teach you
exercises, proper sleep positions, and other home applied, self-help
techniques. The goals of pain management, functional restoration, and
prevention will be applied. If needed, coordinating care between our office and
primary care, orthopedic, neurology, or others will be smoothly managed as the
need arises.

            We realize you have a choice in where you choose your
healthcare services.  If you, a friend or
family member requires care for whiplash, we sincerely appreciate the trust and
confidence shown by choosing our services and look forward in serving you and
your family presently and, in the future.

To schedule an appointment with a whiplash specialist in San Francisco please call 415-392-2225. Mention this blog post for a complimentary consultation in house or by telephone.

Serving local 94111 since 1992

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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