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Hand Pain For No Reason?

Hand Pain Treatment in SF

Hand Pain Treatment in San Francisco

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

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

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

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

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

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

Here are some of the potential symptoms from these conditions:

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

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

The last thing you ant is unnecessary drugs or surgeries.

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

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

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

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

Eben Davis

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

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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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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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Carpal Tunnel Syndrome – Nutrition Update

Carpal tunnel san francisco
Carpal
Tunnel Syndrome
(CTS) is a condition where the median nerve that arises in the
neck and travels through the shoulder, arm, and into the hand becomes
compressed. Compression of the median nerve results in tingling, numbness, pain
and/or weakness that affects the 2nd, 3rd, and thumb-side half of the 4th
fingers. It can wake sufferers up in the middle of the night, forcing them to
have to shake the hand and flick the fingers to “wake it up.” This can occur
multiples times a night, making for a long next day! We’ve discussed
chiropractic management strategies such as manipulation/mobilization of the
neck, shoulder, elbow, wrist and hand, the use of a cock-up splint (especially
at night and at times when driving), but more information regarding the use of
nutritional supplementation is lacking; hence the purpose of this Health
Update!

Let’s
look at what we are trying to accomplish by nutritional approaches for CTS:

  1. Anti-inflammation: Because of stomach, liver, and kidney side
    effects, NSAIDs such as ibuprofen, aspirin, and others may not be your
    best choice. Rather, consider Turmeric (300 mcg), Ginger (100 mg),
    Boswellia (100 mg), Rosemary (100 mg), Bioflavonoid (100 mg), Bromelain
    (50 mg), Vitamin C (1-3 grams/day), Vitamin E (400 IU/day), Vitamin D3
    (2000-5000 IU/day), Vitamin B-complex (especially B6, 9, and 12).
  2. Muscle relaxation: Calcium (1500mg/day), Magnesium (400 mg/day),
    Potassium, valerian root (vervain), B-Complex, L-Arginine, Rosemary,
    Catnip, Kava root, Chamomile, Cayenne Pepper, Horseradish, Lavender,
    Licorice, Devil’s Claw.
  3. Nerve repair: Folate (B9), B12 (cobalamin), Vitamin D3, B1 (Thiamin; minimum:
    1.2mg/day), B5 (Pantothenic acid), B3 (niacin; minimum 16 mg/day), B12.
  4. Managing systemic conditions:

a)       Diabetes
(dysinsulinism)
: Chromium
(picolinate or choloride), Alpha-Lipoic Acid, Omega-3 Fatty Acids (1000 mg of
EPA & DHA), Coenzyme Q10, Polyphenols (dark chocolate, green tea),
Botanicals (plant extracts such as garlic, prickly pear, aloe vera, fenugreek,
bitter melon and ginseng).

b)      Thyroid
dysfunction (hypothyroid)
: B-Complex
(100 mg of B1, 3, 5, & 6 3x/day; B2, 50 mg 2x/day; B12 1000-2000 mcg/day;
Selenium and iodine, Anti-oxidants (Selenium, Vit. C, Vit. E) Copper, thyroid
extract, organic iodine.

c)       Obesity
(BMI>30)
: Childhood
obesity: Vit. D (ages 1-13, 5 mcg/day), B12, Vit. C, Fiber, Calcium (an extra
300mg of Calcium= >2 lb. weight drop); other fat soluble vitamins (Vit. A,
E, and K), iron (iron is more commonly deficient in obese children and adults
and can lead to fatigue and poor mental health and memory function).

  1. Other considerations: General health: paleo diet, sleep quality, and
    exercise (see below).

You may notice that there is a lot
of overlap in many of these vitamin recommendations. If one were to give
nutritional recommendations for general health purposes, the anti-inflammatory
“big 5” might include 1. A good quality multi-vitamin mineral, 2. Magnesium
(often with calcium as a combined supplement), 3. Omega-3 fatty acids; 4.
Vitamin D; and 5. Coenzyme Q10. For CTS specifically, the addition of a B
complex seems consistently recommended above.
Controlling weight will reduce CTS risk and decrease the risk of acquiring
type II diabetes which increases CTS risk by itself. Perhaps an “ideal diet”
for everyone might include eating plenty of fruits, vegetables, lean meats, and
the elimination of gluten (grains) – referred to by some as the
“anti-inflammatory diet,” paleo diet, caveman diet, and Mediterranean diet. Fortifying
a great diet with vitamins is the “take-home” concept!

            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 Carpal Tunnel Syndrome, 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 for a complimentary carpal tunnel syndrome consultation.

Serving local 94111 for over 20 years

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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Carpal Tunnel Syndrome and Repetitive Motion Injuries

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

In many cases, Carpal Tunnel Syndrome (CTS) results strictly from overuse activities though, as we have discussed previously, other conditions such as hypothyroid, taking birth control pills, pregnancy, diabetes, obesity, certain types of arthritis, etc. can also be involved as a contributor and/or the sole cause. When these conditions are present, they must be properly treated to achieve a favorable treatment outcome. However, the majority of cases are the result of a repetitive motion injury. So, the question remains: What is the role of the patient regarding activity modification during the treatment process of CTS? How important is it?

            To answer this question, let’s look at a fairly common type of CTS case at our San Francisco Carpal Tunnel Center. In our hypothetical case, the patient is female, 45 years old, and works sitting in front of a computer all day for an investment company.  Her job is to prepare reports and correspondence for clients. She is constantly leaning forward towards her computer screen and performing data entry. Her head moves back and forth from computer screen to document holder. She will often times do this for over an hour without a break, for up to 8-9 hours per day. She has been doing this for over 10 years.  A problem can occur when other workers fall behind on their work and she is called upon to do even more…or work load increases from new business. She always want to finish her work so she tends to overdo it.

Median Nerve Carpal Tunnel-SF

            So now, let’s discuss the “pathology” behind CTS. The cause of CTS is the pinching of the median nerve inside the carpal tunnel, located on the palm side of the wrist. The tunnel is made up of 2 rows of 4 carpal bones that form top of the tunnel while a ligament stretches across, making up the tunnel’s floor. There are 9 tendons that travel through the tunnel and “during rush hour” (or, when the worker is REALLY moving fast, trying to keep up with production), the friction created between the tendons, their sheaths (covering) and surrounding synovial lining (a lubricating membrane that covers the tendons sheaths), results in inflammation or swelling.  When this happens, there just isn’t enough room inside the tunnel for the additional swelling and everything gets compressed. The inflamed contents inside the tunnel push the median nerve (that also travels through the tunnel) against the ligament and pinched nerve symptoms occur (numbness, tingling, and loss of the grip strength). The worker notices significant problems at night when her hands interrupt her sleep and she has to shake and flick her fingers to try to get them to “wake up.” She notices that only the index to the 3rd and thumb half of the 4th finger are numb, primarily on the palm side. This is classic CTS from repetitive motion injury.

            At this stage, the worker often waits to see if this is just a temporary problem that will go away on its own and if not, she’ll make an appointment for a consultation, often at her family doctor (since many patients don’t realize chiropractic treatments REALLY HELP this condition). In an “ideal world,” the primary care doctor first refers the patient to the chiropractor for non-surgical management. Other treatment elements include the use of a night wrist splint, ice massage over the tunnel, and possibly modality treatments such as low level laser therapy and (one of the MOST IMPORTANT) “ergonomic management.” That means work station modifications, which will include reducing her workload, wearing a splint, taking frequent breaks, icing during the day, and modifying the work flow. Strict home instructions to allow for proper rest and managing home repetitive tasks are also very important. Between all these approaches, chiropractic is HIGHLY SUCCESSFUL in managing the CTS patient, but it may require a workstation analysis.

It is also imprtant to note that many of our San Francisco patients that present with carpal tunnel SYMPTOMS do not have carpal tunnel SYNDROME…they have pinched nerves in the neck. The nerves in the neck are what form the median nerve, which is the nerve involved in CTS. Presssure on these nerves can cause the same symptoms as true CTS. Often times there is both pressure on the nerves in the neck and CTS…this is called “Double Crush Syndrome”, a common diagnosis.

            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 San Francisco Carpal Tunnel Doctors call 415-392-2225. Mention this blog post for a complimentary consultation.

Email me: ebendavis@yahoo.com

Related articles:

Carpal Tunnel Syndrome and Chiropractic

Repetitive Strain Injuries: What’s Best?

Carpal Tunnel Syndrome: Prevention

Chiropractor San Francisco Google+

Serving zip code 94111 in the San Francisco Financial District for over 20 years

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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Fibromyalgia Treatment Challenges

Fibromyalgia Pain Therapy San FranciscoFibromyalgia (FM) is a disorder involving chronic pain that has no known cause. It is characterized by widespread musculoskeletal pain, sleep disturbance, fatigue and mood disorders. FM affects about 2% of the US population and ranges between 1% and 11% in other countries.  It is more prevalent in adult women than men (3.4% vs. 0.5%) and is most common with increasing age with the highest occurrence between 60-79 years of age. The criteria for the diagnosis of FM was established in 1990 by the American College of Rheumatology as widespread pain of at least 3 month duration and pain on palpation (pushing with the fingers) of at least 11 of 18 specific tender sites on the body. Pain, fatigue and sleep disturbance are observed in all patients with FM. Additional features can include: stiffness, skin tenderness, post-exertional pain, irritable bowel syndrome, cognitive disturbances, overactive bladder syndrome or interstitial cystitis, tension or migraine headaches, dizziness, fluid retention, paresthesias (numbness), restless legs, Reynaud’s phenomenon (white finger disease), and mood disturbances. FM is also strongly associated with anxiety, depression, chronic fatigue syndrome, myofascial pain syndrome, hypothyroidism, and many of the inflammatory arthritic diseases. Though there are no specific tests for FM, neurotransmitter deregulation including serotonin, norepinephrine, and substance P, result in an abnormal sensory processing in the brain and spinal cord. This results in a lower pain threshold commonly seen in FM.

            The treatment of FM may be best looked at from 3 specific goals which include: 1. Alleviate pain; 2. Restore sleep; and 3. Improve physical function. Thus the most successful approach to the treatment of FM has been reported to be multidisciplinary or, involving several different types of health care providers. Clinical tools often used by doctors to monitor symptom change include a 0-10 pain scale, a body function scale called the Fibromyalgia Impact Questionnaire (FIQ) which measures physical function, common FM symptoms and general well-being; and, for measuring the physical and emotional side of FM, the SF-12 or SF-36 (SF = “short form” and either a 12 or a 36 item tool). The use of these tools helps monitor the success of the treatment that is being applied to the patient.

            Though medications are reported as an important treatment option (such as an anti-inflammatory, analgesic, anticonvulsant, hypnotic, corticosteroids, opiates, various injections and more), the focus of this discussion is aimed at the alternative or complementary treatment approaches, as many FM patients cannot tolerate the side effects of the many different medications. Alternative approaches include cognitive behavioral therapy (counseling), exercise (strength & flexibility), acupuncture, and chiropractic treatment approaches, particularly manipulation but also soft tissue therapies and guided exercise training. Physiological therapeutic approaches frequently used in chiropractic clinics include low-power laser therapy, hydrotherapy such as whirlpool, Balneotherapy – using minerals and oils in the moving water, pulsed electromagnetic field, traction and massage therapy. Another exercise approach that can have great value in managing stress and facilitating sleep is Yoga. The key to a successful treatment outcome requires finding a “team” of health care providers that are willing to listen to the patient and work together to improve the patient’s quality of life. Through this concerted team approach, in addition to the patient taking responsibility by performing exercises on a regular basis, following a proper diet (we prefer a plant-based diet), and getting adequate restful or restorative sleep, FM can be quite well “controllable” and, a relatively “normal” lifestyle can be enjoyed. Your chiropractor can play the lead role in helping you manage your FM treatment regimen.

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment for Fibromyalgia Treatment in San Francisco, call 415-392-2225. Mention this blog post for a complimentary FM assessment and recommendations. 

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 and Ringing in the Ears

Whiplash chiropractor in san franciscoThe term “whiplash” usually brings to mind neck pain, headaches and/or a stiff neck. However, there are other symptoms associated with whiplash that we don’t usually think of, such as ringing in the ears or, tinnitus. In the absence of whiplash, there are many people who experience an occasional ringing or sound of some sort in their ears. The ringing may seem to keep time with the heartbeat or, in cadence with breathing and is more common over the age of 40, and more common in men. The sound can be a buzzing, ringing, roaring, hissing or high pitched noise that usually lasts only seconds or minutes at the most. So, think of those times when you’ve noticed tinnitus and ask yourself, “…how would that affect me if that noise never stopped or lasted for hours?”

Before we discuss the association of tinnitus with whiplash, let’s review some facts our San Francisco whiplash doctors have discovered about tinnitus. There are two primary types of tinnitus: Pulsatile and Nonpulsatile. Pulsatile tinnitus is often caused by sounds created either by blood flow problems in the face or neck, muscle movements near the ear, or changes in the ear canal. The non-pulsatile tinnitus is usually caused by nerve problems involving hearing in one or both ears. The later is sometimes described as a sound coming from inside the head. The most common cause of tinnitus is from hearing loss that occurs from aging – technically called presbycusis. However, it can also occur from living or working in a loud environment. Tinnitus can occur with many types of hearing loss and can be a symptom of almost any ear disorder. Other common causes include earwax buildup, certain medication side effects (aspirin, antibiotics), too much caffeine or alcohol intake, ear infections – which can lead to rupture of the eardrum, dental problems, TMJ or jaw problems, following surgery or radiation therapy to the head or neck, a rapid change in environmental pressure (airplane rides, elevators, scuba diving), severe weight loss from malnutrition or dieting, bicycle riding with the neck extended for lengthy time-frames, high blood pressure, nerve conditions (MS, migraine headache), as well as other conditions such as acoustic neuroma, anemia, labyrinthitis, Meniere’s disease, otosclerosis and thyroid disease. The good news is that most of the time, tinnitus comes and goes and does not require treatment. When tinnitus is associated with other symptoms, does not get better or go away, or is in only one ear, it is wise to consult with us. Spinal manipulation and other chiropractic treatment approaches are often VERY helpful in resolving tinnitus with the benefits of avoiding the need for medications, all of which carry secondary side effects. Chiropractic approaches are also highly effective when tinnitus is accompanied by dizziness or vertigo, usually requiring treatment applied to the upper neck area.

So, how does whiplash cause tinnitus? There are primary as well as secondary causes that can give rise to tinnitus after whiplash. After looking at the long list of causes above, direct trauma to the head such as hitting the side window, the back of the seat, the steering wheel, mirror and/or windshield makes obvious sense. Secondary causes often involve the TMJ or jaw which is commonly injured in whiplash. By itself, TMJ can cause ear pain, tinnitus, vertigo (dizziness), hearing loss, and headaches. Because many nerves that innervate the neck and head arise from the neck as well as from the cranial nerves, spinal manipulation of the neck as well as certain cranial manipulations can have a dramatic benefit in treatment of whiplash induced tinnitus.

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 a complimentary consultation for whiplash treatment in San Francisco, call 415-392-2225. Mention this article and also receive a free ice gel pack.

 

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 Night Pain

Carpal tunnel doctors san francisco

Have you ever woken up in the middle of the night and noticed your hand sleeping to the point where you had to get out of bed and shake or flick your fingers to alleviate the numbness? If the numbness was primarily on the thumb-side half of your hand, it may have been carpal tunnel syndrome that woke you up. So, the question is, why is it such an issue at night?

Well, Carpal Tunnel Syndrome and Night Pain are connected.

But to properly answer this question, let’s get familiar with the anatomy of the wrist.  There are 2 bones that make up the forearm – the ulna (on the pinky side) and the radius (on the thumb side). Just beyond that, there are two rows of four bones each called the carpal bones for a total of 8 small bones that make up the wrist joint. These carpal bones are arranged in a horseshoe or tunnel shape. When you look down at your wrist and wiggle your fingers quickly, you can see all the movement that occurs on the palm side of the wrist.  That’s a lot of movement!  You can also see the muscles on the upper half of the forearm moving rapidly as the fingers wiggle.

There are 9 muscle tendons that travel through the carpal tunnel, as well as some blood vessels and most important, the median nerve sits on top of all those moving tendons. Just beneath the floor of the tunnel is a ligament called the transverse carpal ligament. The tendons inside the tunnel are surrounded by lubricating sheaths that make it easier for the tendons to slide back and forth as we wiggle our fingers, grip to open a jar, type on a computer, play a musical instrument, or so on. Without the tendon sheaths, the friction between the rubbing tendons would quickly build up heat, resulting in swelling, pain and numbness.  However, in spite of the lubricating function of the sheaths, when we work our fingers and hands too much, swelling and inflammation does occur.

So, why do we have numbness at night when we aren’t working, gripping and moving our fingers repetitively? The answer lies in how we sleep. Since we are asleep, we cannot control where we position our hands and wrists. Most of us curl up in a ball and tuck our hands under our chin or someplace cozy.  Normally, when we bend our wrists, the pressure inside the carpal tunnel doubles. However, a carpal tunnel patient already has a higher level of pressure in their wrist. So, when a carpal tunnel patient bends their wrist in the exact same way, the pressure goes up even more – that is, 3, 4, 5, or more times than a normal person without their wrist bent. That is why a wrist “cock-up” splint works so well at night!  It keeps the wrist straight so we can’t bend it.  Often, this allows the CTS patient to sleep through the night instead of waking up 2, 3, or more times with numbness, tingling, and/or pain on the thumb half of the hand.

            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 a complimentary consultation with one of our carpal tunnel doctors in San Francisco, call 415-392-2225 and mention this blog post.

 

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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