Tag Archives: symptoms

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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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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Herniated Disc Symptoms and Treatment


Herniated disc san franciscoWe have been offering natural solutions for cervical and lumbar disc herniations in San Francisco for over 20 years now.

The spinal disc is a fibrous elastic cushion that sits between the bones of the spine. The spinal disc has two primary functions, to give the spine flexibility and to hold the bone above and the bone below together acting as a "ligament". Ligaments hold bones together. 

The spinal disc when healthy also helps creates a nice opening between the bones for the spinal nerves to exit, which travel, split, and eventually connect to all body parts controlling their functions.

With age, the spinal discs become less elastic and more rigid which predisposes them to injury and rupture (disc herniation). A trauma at any age can cause a disc herniation but for the most part they develop slowly over time.

Depending on the lifestyle choices you make, including your physical  activity level, diet, stress, body-weight, habits (smoking and drinking), work environment, sports injuries, car accidents, etc., you may be more prone to disc herniations than others.

A little known fact is that many of us have disc herniations and don't even know it and never will. That's right…we will live and die with them and they never bothered us.

Not all disc herniations cause symptoms. And, those that do cause symptoms such as neck pain, arm and hand pain, low back pain and sciatica do not usually require surgery. In fact, chiropractic care can more often than not help people with a herniated disc in the neck or back return to more normal lives.

For those people that have disc bulges (a less severe form of a herniation) or disc herniations that have symptoms that do not respond to conventional chiropractic care or physical therapy there is always nonsurgical spinal decompression with the DRX9000. The DRX9000 is a computerized machine specifically designed and built to treat disc herniations without surgery. We have one at our San Francisco Chiropractic and Spinal Decompression Clinic.

We also incorporate deep tissue laser therapy into the mix with difficult to treat disc patients to help control the pain and inflammation in the beginning. Disc decompression therapy takes 20-24 one hour sessions and is not covered by insurance. Success rates are very high.

So, there you go. Sure, a herniated disc can seem like a nightmare. It can also seem like there are no other options but cortisone injections or back or neck surgery. But that simply is not true because gentle chiropractic and spinal decompression will help the majority of all cases. if chiropractic or decompression fail to deliver you are still whole and can try other treatment options including surgery.

But just know…If you have back or neck surgery and there is any type of fusion involved you will be permanently excluded from ever being able to try spinal decompression. Try it first if you qualify…it's the smart thing to do!

To schedule an appointment to see if you qualify for herniated disc treatment in San Francisco please call 415-392-2225. Mention this blog post for a complimentary consultation and spinal decompression tour.

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 Herbs

Carpal tunnel symptoms natural care san francisco
We have been providing natural carpal tunnel treatment in San Francisco for over 20 years now.

Carpal
Tunnel Syndrome (CTS) is a condition caused by the compression of the median
nerve as it travels through the carpal tunnel in the wrist. The “source” of
median nerve compression can be soft tissue swelling, such as tendonitis,
bursitis, synovitis, capsulitis, etc. Last month, we discussed nutritional
supplementation for CTS in general. This month, the focus is on specific herbs
that can help this potentially disabling condition.

1.       Chamomile functions as a natural “tranquilizer.” It’s used for
muscle pain (as a relaxant), but can also help other problems such as menstrual
disorders, headaches, and tension. Chamomile facilitates relaxation of tight
muscles and has an anti-inflammatory property that soothes cramps.

2.       Kava Root is an herbal plant that is well known for its muscle
relaxing benefits. It is particularly helpful with extreme muscle pain.

3.       Valerian is a very effective relaxant that dates back to the
medieval times for curing ailments associated with muscle spasms such as muscle
cramps and neck problems.

4.       Catnip is also a natural muscle relaxant, and is a member of
the mint family. It is used as a sedative and muscle relaxer. Headaches due to
tension have been treated using a poultice containing catnip. Catnip has also
been found to reduce swelling in joints and reduce soft tissue injuries such as
tendonitis, bursitis, and capsulitis.

5.     Cayenne
Pepper
is a popular herb used in
cooking and can be found in many recipes. Cayenne pepper has been found to
significantly relieve the pain of muscle cramping.

6.       Horseradish has been reported to relieve extreme muscular stress
involved in cramps and muscle pain. One approach is mixing a few drops of
horseradish oil in bath water to reduce soreness associated with muscle aches.

7.       Lavender flower oil is well known as a very effective muscle
relaxant that provides relief caused by muscular tension. Using a circular
motion while massaging the oil over the achy muscle can be particularly
soothing. In addition to the mind/body relaxation benefits, an increase in
circulation allows the tense muscles to relax and heal.

8.       Licorice has the ability to reduce inflammation associated
with muscle pain.

9.       Devil’s Claw is a very popular anti-inflammatory herb that dates
back to the 18th century for the treatment of arthritis and many other painful
conditions. It’s also used as an effective muscle relaxer.

10.   Peppermint oil has been used to treat conditions associated with
muscles aches. Pouring some drops of peppermint oil in a hot bucket of water to
soak a foot, ankle or lower leg (possibly combined with Epson salt) can be very
relieving.

11.   Other
natural muscle relaxants include

Cramp bark, Passiflora, Bergamot, Cardamom, Basil, Ginger root, and others.

            It is appropriate to COMBINE
these natural herbal approaches with other treatments that are known to work
well in the treatment of CTS. Chiropractic can provide: 1. Manipulation and
mobilization of the neck, shoulder, elbow forearm, wrist, hand, and fingers; 2.
Cock-up splints to be worn at night and at times during the day such as
driving; 3. Physical therapy modalities such as electric stim, ultrasound,
light or laser therapy, magnetic field; 4. Work station and other ergonomic
modification recommendations; 5. Exercise training, and more.

            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 one of our carpal tunnel syndrome doctors in San Francisco please call 415-392-2225. Mention this blog for a complimentary consultation.

Serving downtown local 94111 and surrounding areas

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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Is it Really Carpal Tunnel Syndrome?

Carpal tunnel treatment san franciscoWe have been providing treatment for carpal tunnel syndrome in San Francisco for 21 years now.

At one point during the “Dot-Com” go go years we were know as The Carpal Tunnel Injury Center. During this time we treated over 10,000 cases with “Carpal Tunnel SYMPTOMS”. The most common signs and symptoms of carpal tunnel syndrome (CTS) are as follows:

  • Arm, Wrist or Hand Pain
  • Numbness or Tingling in the Arm and Hands
  • Weakness of Grip
  • Night Pain
  • Swelling of the Hands and Fingers
  • Pain that radiates from the Hands into the Forearm
  • Elbow Pain
  • Loss of Sensation in the Fingertips

These are the classic signs and symptoms of CTS. True carpal tunnel syndrome is caused by pressure on the Median Nerve in the wrist. The Median Nerve which actually originates in the neck passes through the 8 carpal bones which form a tunnel in your wrist called the “carpal tunnel”. There are also some tendons and blood vessels in the tunnel.

The tendons in the carpal tunnel can get over-worked and become inflamed which puts pressure on the Median Nerve. The carpal bones themselves can lose their proper alignment from trauma or repetitive trauma and put pressure on the Median causing CTS.

Women have a smaller carpal tunnel and are more prone to CTS. Carpal Tunnel is common in pregnant women because they take on water to build and protect the baby and this can cause swelling of the tendons in the tunnel and CTS. Smokers have a much higher incidence of carpal tunnel syndrome. High fat and high salt diets can cause water retention and CTS symptoms. Certain medications can cause CTS symptoms as well. Patients with Diabetes and other diseases (obesity) are more prone to CTS.

Then, there are the occupational risks of jobs that require repetitive motions such as office workers on a computer, hair cutters, meat cutters, assembly line workers. We work primarily with SF Financial District office workers.

Hobby’s such as bowling, tennis, racquetball, knitting, golf, or anything that requires lots of hand motion will also predispose you to carpal tunnel syndrome.

But here’s the deal. In spite of everything I outlined above…only a small percentage of patients that present with carpal tunnel SYMPTOMS actually have carpal tunnel SYNDROME.

Huh!…What do you mean?

Well, here’s why…Pressure on the nerves in the neck that form the Median Nerve (see image above) causes the same symptoms as pressure on the Median Nerve in the carpal tunnel.

That’s right. Just like pressure on a garden hose near the faucet will cause the same symptoms as pressure on the hose near the sprinkler (a decrease in water flow).

Pressure on the median nerve at the source causes the same symtoms as presure on the median nerve in the carpal tunnel.

And you are way more likely to have pressure on the nerves in the neck…what chiropractors call a “Subluxation” or Pinched Nerve, than you are to have true CTS.

The reason for this is simple. As the nerves exit from the bones in the neck they are vulnerable to Subluxations. All the spills and falls we took as a child. Sitting at a desk at school for 12-18 years, sports injuries, car accidents, sitting at a desk all day at work…LIFE!

Yes, just being alive and having an active lifestyle predisposes us to Subluxations in the neck and carpal tunnel symptoms.

If your doctor does not know to look at the neck you may never get the right treatment. And, just because your doctor is able to identify the neck as the source of the problem does not necessarily mean they know how to treat it. This is why we get so many referrals from medical doctors and therapists…our chiropractors know how to treat subluxations and pinched nerves in the neck…and carpal tunnel syndrome.

We use chiropractic adjustments to the neck, arms, and hands, deep tissue laser, Graston and Active Release Techniques, Kinesiotape, Exercises and more. We have perfected our methods over the years and have taught it to other chiropractors as well.

So, if you think you may have carpal tunnel syndrome and would like to find out if we can help…please call 415-392-2225 to schedule an appointment with one of our San Francisco Carpal Tunnel Doctors.

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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