Tag Archives: hand

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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Pinched Nerve in the Neck?


DRXC spinal decompression SFWe have been providing neck pain relief in San Francisco since 1992.

One of the most common causes of neck, shoulder, arm, and hand pain is a “pinched nerve in the neck”. A pinched nerve is medical terminology (formerly doctor slang) for pressure on a nerve or nerve compression.

Here is how the Mayo Clinic defines a Pinched Nerve:

A pinched nerve occurs when too much pressure is applied to a nerve by
surrounding tissues — such as bones, cartilage, muscles or tendons. This
pressure disrupts the nerve’s function, causing pain, tingling,
numbness or weakness.


A pinched nerve can occur at several sites in your body. A herniated
disk in your lower spine, for example, may put pressure on a nerve root,
causing pain that radiates down the back of your leg (sciatica).
Likewise, a pinched nerve in your wrist can lead to pain and numbness in
your hand and fingers (carpal tunnel syndrome).

Me: A pinched nerve in the neck is usually the result of a herniated or bulging cervical disc, vertebral subluxation (misalignment), degenerative disc disease, facet syndrome, or moderate to severe sprain/strain from say a whiplash or sports injury (think football). This can happen all at once from a trauma or slowly over time from sitting in an awkward position at your workstation, poor sleeping habits (flat pillow with no support), or hobby’s like bowling, playing a musical instrument, knitting, or gardening.

These days, just about everyone spends a lot of time on the computer. Our chiropractic clinic is located in the SF Financial District so almost all our patients sit at a desk for very long hours performing repetitive tasks with the upper extremities on the computer. Many then go home and do more of the same. And a very high percentage of these people already had misalignments in the neck from years of school, studying, sports and life. The stress of working at the computer all day is just another layer of the onion that can accelerate the degnerative process and lead to pinched cervical nerves.

So, what can be done to prevent pinched nerves from happening and what is the best treatment once they do happen?

Well, I am a chiropractor, and I specialize in the treatment of neck, arm, and hand pain. So my opinion is biased owards chiropractic care and nonsurgical spinal decompression. Of course, most of the patients I treat are already experiencing pain and dysfunction. So, our primary focus is to treat the problem and get some relief. We do this using a combination of chiropractic adjustments to the neck, shoulder, arms and hands. We incorporate massage and stretching into the mix, as well as custom low tech exercises. If needed, we use deep tissue laser therapy to reduce inflammation and pain levels.

If a pinched nerve is due to a herniated or bulging disc and the patient does not respond to conventional chiropractic as described above than we will consider cervical spinal decompression with the DRX9000c. The DRX9000c is designed and built to treat cervical disc herniations naturally.

Sometimes we use a combination of everything we have to achieve favorable outcomes. Our 20years+ experience comes in handy when it comes to making decisions on pinched nerve treatment.

Along side the treatment we teach our patients how to prevent what we treat by making better lifestyle choices. Education on things like ergonomics, sleeping postures, nutrition, supplements, exercise/stretching, meditation and relaxation techniques are some of the things we weave into the treatment process.

If you would like to find out if you are a candidate for treatment at our San Francisco Chiropractic Clinic please call 415-392-2225. Ask for a complimentary consultation.  

By 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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San Francisco Deep Tissue Laser for Hand Pain

Our “Patient of the Week” is San Francisco Deep Tissue Laser Therapy patient Niko Major. Niko was searching for solutions for her hand pain, thumb pain, and arthritis. Medical care did not help and she was very frustrated and discouraged until she found our laser center online. Check out her story.
There are natural solutions for hand pain even when all else fails.
Deep Tissue Laser Therapy in San Francisco

To schedule an appointment for hand pain laser treatment in San Francisco call 415-392-2225. Mention this review for a complimentary laser session.

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.

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Carpal Tunnel Syndrome Awareness Week

We have been providing treatment for Carpal Tunnel Syndrome in San
Francisco
for over 20 years. Next week (October 15-19) we will be
demonstrating our carpal tunnel syndrome (CTS) treatments to the public.
If you have wrist, hand, arm, shoulder, or neck pain, you may have CTS
or a related disorder. Please call 415-392-2225 to schedule your demo
treatment.

Carpal Tunnel Syndrome Promo

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: Prevention

Carpal tunnel treatments in san franciscoWe have been providing treatment for carpal tunnel syndrome in San Francisco for over 20 years now in the Financial District, where it’s not uncommon for those involved in finance, legal, social media, and technology, to spend 10-12 hours per day in front of a computer doing repetitive motions.

More needs to be learned about carpal tunnel syndrome prevention.

Carpal
Tunnel Syndrome
(CTS) is a very common problem that is often associated with work related activities. Our focus this month is on how to prevent CTS. Of
course, if you already have CTS, read this Health Update to learn preventative
measures that also work while you receive treatment for CTS.

            The concept is to think about
prevention as a matter of economics; as you lose time from work because of CTS,
if affects your bottom line, and I’m sure you have bills to pay and mouths to
feed (…or, at least one)! So please take the advice offered here seriously, as
we are genuine about our concern for your well-being and not losing work time
is a huge component of all of our “well-being!”

            If you’ve experienced sore wrists,
hands, sudden sharp jabs of pain up the forearm, noted numbness and/or burning
in your fingers (especially the index through 4th / ring finger), wake up at
night needing to shake and flick your fingers to “wake them up,” have weakness
in your grip strength, are slowing down at work (whether it’s typing/computer
work, assembly line work, cooking, waitressing, and so on), you NEED to do the
following NOW! The goal here is prevent work loss and surgery (as up to 6 weeks
lost work time will be required if surgery is needed).

  1. Anti-inflammatory
    measures: This starts with a healthy diet. STOP eating foods that inflame
    such as omega 6 rich foods (“GOOGLE” omega 6 and print out the list of
    food). Emphasize fruits, vegetables, lean meats, nuts and AVOID grains
    because of glutens, which many of us have a sensitivity against. Vitamins
    such as a multiple, magnesium, fish oil (omega 3’s), Vitamin D3, and CoQ10
    are GREAT! Freeze water in a small cup and rub it on the wrist/carpal tunnel
    until it gets numb (takes 3-5 minutes) and do that 2-3 times a day.
    Consider natural anti-inflammatories such as ginger, turmeric, cercumen,
    bioflavinoides and others.
  2. Stretch: Bear-claw,
    fist, “High-5” (opened hand with the fingers fanned out) reps, wrist
    extensions on the wall/table stretches (elbows straight).
  3. Rest: Cock-up splint,
    take mini-breaks, and get sound/restoring sleep. IT REALLY HELPS!
  4. Ergonomic
    modifications: Position your computer keyboard, mouse and monitor so that
    you are looking straight ahead at a slight downward angle and your elbows
    are at a 90° or slightly less of an angle when typing. Set an alarm on
    your computer to go off every 15 minutes as a reminder to “shake and
    flick” your hands, wiggle your fingers, do your stretches, and/or squeeze
    a soft ball. Write with a fat pen vs. a skinny one – this helps a lot!
  5. Weight management:
    Obesity is a common risk factor for developing CTS.
  6. Manage other health
    issues: Diabetes, thyroid disease, inflammatory arthritis, neck/shoulder
    or elbow problems can all contribute to or, even cause CTS.

            Think of the above measures as
minimums and obtain professional care to help you. You have choices between the
traditional medical model of cortisone shots, anti-inflammatory medication, and
surgery vs. chiropractic: manipulation and mobilization of the fingers, hand,
wrist, elbow, shoulder and neck as needed, splinting at night,
anti-inflammatory diet and nutrients, ergonomic modification and exercise
training, which ALL will help to treat as well as prevent future CTS problems,
EVEN IF you’ve had surgery already!

            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. Mention this article for a complimentary consultation and tour.

Serving local 94111 for over 20 years

Related Carpal Tunnel Syndrom Articles:

Carpal Tunnel Syndrome and Yoga Stretches

Carpal Tunnel Syndrome Facts

 

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 – More Facts!

Carpal tunnel syndrome relief san franciscoWe have been providing nonsurgical treatment for carpal tunnel syndrome in San Francisco for over 20 years now. Carpal Tunnel Syndrome is often times misdiagnosed and not treated properly. We try to stay current with the latest research and keep our patients and followers updated on these pages.  

Carpal Tunnel Syndrome (CTS) is a condition where a nerve in the wrist gets pinched resulting in numbness, tingling and sometimes grip strength loss. One of the first symptoms of CTS involves waking up at night due to the numb, tingly sensations. This initially occurs once in a while but  eventually  becomes more frequent, leading to very un-restful, sleepless nights. Most people do not initially attribute this sleep interruption to CTS but rather report, “…it’s coming from sleeping on my arm or lying in a funny position.” Because restful sleep is a very important health issue, this early CTS symptom should prompt the person to investigate the problem, but usually they wait, sometimes for months or even years, making treatment more challenging.

            Other symptoms may include waking up in the morning with wrist and/or hand pain, difficulty buttoning a shirt or threading a needle, radiating arm symptoms into the forearm, shoulder and/or neck, dropping silverware, pens, coffee cups, and, a specific pattern of numbness such as the index, middle, and part of the ring finger. The degree of functional loss varies from none to total disability, not being able to work or carry out many home activities. Some people notice the symptoms during the day while performing fast, repetitive movements such as playing piano, typing, using a computer mouse, crocheting/knitting, writing, assembly work, and more. Some of the most frustrating complaints from CTS patients are lost work time (due to both CTS symptoms and fatigue from not sleeping at night), a loss in earnings, lack of dexterity (buttons, tying shoes, turning a key in a door or car, fixing hair, applying make-up), daytime grogginess, and irritability that can impact their quality of life, including their relationships.

            A question that often arises is, what is carpal tunnel syndrome? A simple answer is “tendonitis” or, inflammation of the tendons that connect the muscles on the palm side of the forearm (flexor muscles) to their respective tendons that attach in the hand and fingers. Digging a little deeper, there are nine of these tendons that travel through the tunnel, rubbing together as we move our fingers and all is usually well unless there is too much friction resulting in swelling in this confined space. In fact, CTS remains silent until the swelling starts pushing or compressing the median nerve at which point the numbness, tingling, pain, etc., are noticed. 

            So, the next question is, what can be done to stop the inflammation from compressing the nerve? A very common treatment approach is the use of a cock-up splint at night, which stops us from bending the wrist in our sleep. In a normal, non-CTS wrist, the pressure in the carpal tunnel increases 2-fold when we bend our wrist; however, if inflammation already exists inside the carpal tunnel, the pressure increases by many multiples. This is why sleep interruption is so common in CTS as we just can’t control our wrist position at night. Another common anti-inflammatory approach is cortisone shots into the carpal tunnel and/or taking an anti-inflammatory drug like ibuprofen. The chiropractic answer to anti-inflammation is ice (preferably ice massage over the palm side wrist) and anti-inflammatory nutrients such as ginger, tumeric, boswellia, and others. What gives chiropractic the “edge” over non-surgical medical care is the addition of joint and soft tissue manipulation of the hand, wrist, forearm, elbow and when needed, the shoulder and neck. The latter improves circulation, reduces fixation or adhesion between tissues and allows the tendons to slide with less friction resulting in better function as noted by longer ability to play piano, type, write, etc.

            Another “key” item to CTS treatment is identifying and finding a solution to a poorly designed workstation so the wrist/hand does not have to work in an awkward manner. Here, the position of a computer screen, how a tool is held, and how long repetitive work is allowed are modified.

            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 call 415-392-2225. Mention this blog post for a complimentary consultation.

Serving zip code 94111 and local areas 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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Carpal Tunnel Syndrome: Surgery or Chiropractic?

Carpal tunnel syndrome treatment san franciscoCarpal Tunnel Syndrome (CTS) is a very common problem. The American Association of Orthopedic Surgeons (AAOS) reported that in 2007, there were 330,000 carpal tunnel release surgeries performed. The main reason to have the surgery is to “open up” the tunnel. That is, the transverse carpal ligament or “floor” of the tunnel is released so the contents inside the tunnel are able to move more freely, reducing the pressure inside the tunnel. Essentially, this is the goal of any treatment (surgical or not): improving the depth of the tunnel, thus reducing the pressure from inside the tunnel allowing the tendons to slide better as the muscles on the palm-side forearm contract to move the nine tendons that pass through the tunnel and attach to the fingers and thumb. However, there are non-surgical methods (such as chiropractic) for reducing the pressure within the tunnel that should be first attempted as surgery is always reported to be the “…last resort” for good reason. There can be surgical complications, the effects may be only partial, and there is an average of 30% grip strength loss following the transverse ligament surgical release. Also, a primary crush site of the nerve roots in the neck should be rules out before surgery. So, the question is, how can chiropractic approaches reduce the pressure inside the carpal tunnel without somehow changing the length of the transverse carpal ligament?

Carpal tunnel chiropractic or surgery

            The roof of the tunnel is made up of two rows of four bones for a total of eight carpal bones that arch over the nine tendons that pass through the tunnel. The height of the tunnel is dependant on the position of those eight bones, especially three of the eight bones that make up the proximal row at the top of the cave. These are technically the lunate (located at the peak of the roof which tends to drop down lowering the roof of the tunnel), the scaphoid (located on the thumb side of the roof), and the triquetrum (located on the pinky side of the roof). The latter two bones tend to shift up and out and when the middle bone drops down, the tunnel flattens making the space tighter or smaller. This is how chiropractic adjustments of the wrist help. There are specific techniques we use to reposition the lunate and outer two bones that shift up and out. In addition, we can either tape or use an elastic wristband to hold the tunnel “open” after the adjustment.

Note: Not all chiropractors are carpal tunnel experts. Please make sure to do your homework and find out if the chiropractor is proficient in neck, arm, and wrist adjustments.

            The use of a night splint to keep the wrist in a straight or slightly “cocked-up” position is also highly beneficial as the pressure inside the tunnel goes up as much as 6-8x when CTS is present when the wrist bends to the end points of upward or downward bending. Also, we will treat all the possible points of possible compression including the neck, shoulder, elbow, forearm and wrist which ALWAYS gets better results than treating only the carpal tunnel.

            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. Mention this blog post for a complimentary consultation.

Related Articles:

Carpal Tunnel Syndrome and Chiropractic

Repetitive Strain Injuries: What’s Best?

 

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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