Carpal Tunnel Syndrome Treatment
A Oklahoma City, OK and Surrounding Areas Chiropractor’s Perspective
The upper extremity is one of the most incredible parts of the human body. The number of different types of movements, from small, delicate movements to large, forceful movements that it performs is almost overwhelming. Only when we experience an injury or dysfunction in the upper extremity do we really get a sense of just how much we depend on this vital structure. This is no truer than with the hand and wrist, which provide a near-infinite amount of fine motor movements and provide our brain and nervous system with an endless supply of sensory information.
A major component for why the wrist and hand operates the way it does is the carpal tunnel. This structure is formed by a large band of tissue that wraps around the wrist. Underneath this tissue are muscle tendons that extend to the fingers, blood vessels, and the median nerve. The median nerve is responsible for controlling most of the muscle movements of the thumb, index, and middle fingers. It also allows us to maintain our grip strength, which is necessary for a variety of activities of daily living. When there is dysfunction or inflammation within the carpal tunnel, the fluid inside can increase the pressure on the median nerve, causing symptoms such as numbness, tingling, and pain in the hand and fingers. This is known as carpal tunnel syndrome.
Commonly, carpal tunnel syndrome is treated medically with a combination of medications, steroid injections, and, if those are unsuccessful, surgery. These types of treatments can bring unwanted side effects and pose more risk to the patient. The good news is, there are ways to treat carpal tunnel syndrome conservatively. At Venturis Clinic, we use a combination of many different treatments to address the underlying cause of your problem and help you heal in a natural, safe way.
Consultation and Exam
When you come to Venturis Clinic as a new patient, your first visit will consist of a consultation and examination. Before beginning care, Dr. Alvin Philipose wants to get to know you and understand your problem. He will review your history of the discomfort you are experiencing and how long it has been affecting you. Dr. Alvin Philipose also wants to know how this problem has been impacting your life. Many people with carpal tunnel syndrome have difficulty working, especially if their work involves extensive computer use. This information helps your doctor understand you and ensures that the best recommendations for fixing the problem will be given to you.
After the consultation, Dr. Philipose will do a detailed exam in which orthopedic, neurologic, and functional movement testing will be performed. This will help him understand your condition and what the root of the problem is. A consult and examination will give us a broader picture of what is going on and helps Dr. Philipose customize your treatment plan so that it will serve you best and get you back to doing the things that are important to you.
Specific Chiropractic Care
As chiropractors, we always look to the spine for the source of dysfunction and disease. However, carpal tunnel syndrome is a uniquely specific problem to the wrist. Even so, chiropractors are trained to evaluate and treat the wrist. After all, many tiny bones make up the wrist, which means there are many tiny joints there. If any of those joints are restricted, or if the bones are not positioned correctly, this can contribute to carpal tunnel syndrome occurring in the first place. Utilizing gentle manipulations to the wrist, chiropractors are able to release these restrictions and re-establish alignment of the carpal bones that make up the wrist. These adjustments improve range of motion, decrease pain, and provide a boost to the body’s ability to heal from this problem.
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Soft Tissue Work
Another critical component of treating carpal tunnel syndrome is helping the muscles to function more optimally. At our office, we do this through different types of muscle work. Remember, many muscle tendons pass through the carpal tunnel that can be negatively affected by inflammation. The muscle bellies themselves are in the forearm closer to the elbow, but the tendons are long and travel through the carpal tunnel all the way to the fingertips. Utilizing muscle work can help alleviate muscle tightness and tension and help restore normal function. Graston and Active Release Technique (ART) are two common muscle therapies utilized at the The Chiropractors at the Springfield Wellness Center. Both aim to remove adhesions in the muscle that can disrupt function. Graston uses metal tools to accomplish this, while ART utilizes dynamic stretching movements to achieve the desired effect. Both work very well for treating carpal tunnel syndrome in conjunction with other treatment modalities.
Numbness or Tingling
Often described as “Pins and Needles”, a common symptom of carpal tunnel syndrome is numbness or tingling in your hands or fingers. The thumb, index, middle, and/or ring fingers are usually affected, while the pinkie can evade the abnormal sensation. Some patients even describe it as being similar to an electric shock. The sensation is not always isolated to the hands and wrist, it can sometimes travel up your arm. Symptoms often occur at night, as most people sleep with their wrist bent placing pressure on the median nerve, and can even wake people sleep. During the day symptoms can be brought on by doing something with a bent wrist for a prolonged period like driving, reading a book, or holding your phone. At first, symptoms can come and go, but over time they may become more frequent and intense.
Numbness may contribute to weakness in the thumb’s pinching muscles, which are controlled by the median nerve. If the median nerve is compressed, the brain can’t properly communicate with the muscles in the hand which can cause dysfunction and weakness, affecting your ability to grip and pinch. You may begin to drop objects, have difficulty with dexterity like the buttons on your shirt, or be unable to make a fist.
When a nerve is compressed, like the median nerve with carpal tunnel, pain is a common symptom. That’s because pain is the signal that your body uses to alert you that something is wrong. Pain or discomfort is not usually the first symptom of carpal tunnel syndrome but happens with gradual onset. Typically, pain follows numbness and tingling and resolves itself with the numbness and tingling has been alleviated. Carpal tunnel pain may be isolated to that hand, but it can also radiate up the forearm, sometimes reaching the shoulder. Shaking the hand or bending and straightening the fingers repeatedly may provide short-term pain relief. Long-term carpal tunnel pain relief is possible by relieving the pressure placed on the median nerve and restoring communication between the brain and the body.
Perhaps the most common population of patients who come to our office with carpal tunnel syndrome are people who work at a desk for a living. In this day and age, it is extremely common to be sitting at a desk working on the computer for upwards of 8-10 hours per day. The repetitive nature of this work tends to cause pain, numbness, and tingling in the hands and fingers from using the keyboard and mouse with such consistency. Additionally, doing this work day after day, month after month, year after year can reinforce the problem and make it stubborn and chronic.
If you work at a desk and are experiencing symptoms such as pain, numbness, tingling, burning, or weakness in the hands, there are a few tips you can try to help alleviate some of the discomfort. First, if possible, take more work breaks. If you can take a short break every hour, it can alleviate the tension that builds up in the wrists and hands which makes symptoms worsen. It’s a good way to reset the hands and prepare for another productive spell of work. Second, do some gentle stretching both before and after work. This can help warm your forearm muscles up so they are more mobile and under less stress as you begin your daily work.
Meat and Fish Processing Workers
Another group that is highly susceptible to developing carpal tunnel syndrome is meat and fish processing workers. This type of work is highly repetitive for long hours and involves a lot of handwork that involves grip. Whenever this is the case, it is known that it will cause strain on those muscle tendons and can create irritation and inflammation, which can lead to issues developing within the carpal tunnel. This type of work also involves a lot of flexion of the wrist, which puts a lot of strain on the median nerve and muscle tendons passing through the carpal tunnel.
Like with desk workers, one tip that could be utilized, if allowed, would be to take more frequent work breaks. Short breaks to help the muscles and joints reset could lead to better productivity overall and less strain on the joints. Another tip would be to wear wrist braces during work, which would be protecting the wrist from flexing too far forward. Keeping the wrist in more of a neutral position can help spare the nerve from increased pressure and the ensuing carpal tunnel syndrome symptoms that follow.
People With Diabetes
Sometimes carpal tunnel syndrome can happen as the result of a medical condition, as opposed to stemming from the kind of work a person does for a living. One such medical condition that has been known to cause carpal tunnel syndrome is diabetes. This is primarily because diabetes increases fluid retention, which in turn can cause swelling in the hands and feet. Remember, there is only so much space within the carpal tunnel, so when inflammation and fluid are taking up that space, it can have a profound effect on the median nerve. Diabetes is also harmful to nerves and can lead to severe conditions such as peripheral neuropathy in the hands and feet if left uncorrected.
If you suffer from diabetes and carpal tunnel syndrome, one thing that can be done to help reduce symptoms is supplement with Vitamin B6. This vitamin acts as a natural diuretic and can help release some of the excess fluid that is retained. In turn, this decreases the fluid pressure in the carpal tunnel being applied to the median nerve. Also, making lifestyle changes such as changing your diet or adding regular exercise to your daily routine can not only alleviate the symptoms of carpal tunnel syndrome but also improve your overall health and diabetic condition.
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Frequently Asked Questions
What is prolotherapy good for?
Many conditions respond well to prolotherapy, such as facet syndrome (back and neck arthritis), whiplash, joint sprains, degenerative disc disease, osteoarthritis, tennis elbow, sprains, chronic tendonitis, Ehler’s-Danlos Disease, Bulging disc, knee pain, shoulder pain Vagus nerve inflammation and more.
What are the risks of prolotherapy?
Theoretical risks of prolotherapy injections include soreness, infection or neurological (nerve) damage. Injections should be performed by trained physicians using universal precautions diagnostics examinations and tproper examinations. This results in very minimal side effects.
What is the average cost of prolotherapy?
Costs vary quite a bit from $150-$1500 dependent on type and contents of injections.
Is prolotherapy a permanent fix?
Prolotherapy is an all-natural, permanent treatment, as it relies on the body repairing itself to reduce pain. In contrast, pain relievers and anti-inflammatory medications only provide temporary relief. Booster shots as well has wellness therapies including stretching, massage, chiropractic, dry-needling and strengthening will help maintain progress.
Who is a good candidate for prolotherapy?
More specifically, prolotherapy may be right for you if you experience any of the following: Damaged or lost tissue, especially surrounding the joints. If patients have tried various traditional treatments including prescription drugs, physical therapy, or steroids but seen minimal to no results, prolotherapy may be right for you.
Why does prolotherapy hurt so much?
A patient is generally sore for a couple of days after Prolotherapy. This is because the injections have to go through some muscles to get to the ligaments and tendons. To help the muscle soreness resolve itself sooner, dry needling and moist heat applied to the area is recommended.
Is prolotherapy better than cortisone?
Cortisone can cause tendon rupture, particularly of the achilles tendon. Prolotherapy is a proven orthopedic treatment to reduce pain and strengthen weakened joints without the negative side effects of cortisone.
What are the pros and cons of prolotherapy?
Prolotherapy is great for strengthening weak joints and creating heightened muscle functionality, such as increased movement and flexibility. However, there are some risks involved, for example it is a shot like any other so there could be pain or tenderness to the injection site.
What should you not do after prolotherapy?
Due to the numbness we ask that you refrain from any strenuous activities but to stay mobile. Continue to move affected area to decrease soreness and stiffness. You should avoid strenuous physical activity for 2 days following injections. You will experience some pain and soreness 2-5 days after your treatment. Do not take any anti-inflammatories, pain medications or steroids during treatments. This may inhibit your body’s ability to heal the affected tissue.
How long does prolotherapy take to heal?
Most ligaments and tendons heal within a period of 3 months; however, the majority of healing after a prolotherapy session occurs in the first two weeks.
How many prolotherapy sessions will I need?
Prolotherapy treatments vary from person to person and from injury to injury. Many patients have experienced some relief of their pain with only one session. The average person requires anywhere from 3-12 treatment sessions spaced about 3-6 weeks apart from each other.
How long does a prolotherapy injection last?
On average, patients experience one year of improvement and relief from prolotherapy. However, there is a huge variation and sometimes improvement lasts from three months to 15 years.
What is injected during prolotherapy?
Prolotherapy involves injections of a mild irritant into the injured part of your body. Most of the time the injection contains saline, dextrose (a type of sugar), and lidocaine, which is a numbing agent. Dr. Philipose custom tailors the injection, so the exact composition depends on your needs. These injections may include natural collagen, minerals, amino acids and other natural substances to accelerate healing compared to traditional prolotherapy.
Is prolotherapy better than surgery?
Prolotherapy is considered a viable alternative to surgery, and as an option to pain medications, cortisone and other steroidal injections. The Prolotherapy procedure is considered a safe, affordable option that allows the patient to keep working and/or training during treatment.
Can prolotherapy reverse arthritis?
One study with 90 adults with knee osteoarthritis involved some participants getting monthly prolotherapy injections of dextrose for 3 to 5 months. Those who received prolotherapy saw a significant improvement in pain, function, and stiffness scores.
Does prolotherapy regrow cartilage?
Prolotherapy is an injection of a non-biologic substance with localized effects for repairing connective tissue injuries of the musculoskeletal system. Recent studies in humans show that prolotherapy stimulates cartilage regeneration.
Are you sedated for prolotherapy?
Prolotherapy is a safe, cost effective injection technique used for treating musculoskeletal injuries and chronic pain in various parts of the body. It is noninvasive, has limited side effects and does not require sedation.
What does dry needling actually do?
Dry needling treats muscle tissue, and its goal is to reduce pain, inactivate trigger points and restore function. It rarely is a standalone procedure. Rather, it often is part of a broader physical therapy approach incorporating other traditional physical therapy interventions into treatment.
What is dry needling and does it hurt?
We use very thin filament needles. The initial feeling of the needle entering through the skin is very minimal; much less than a vaccination or having blood drawn. Once the needle reaches the muscle, the twitch sensation feels more like a deep cramp and doesn't last long (15-30 seconds).
How long does dry needling results last?
After dry needling, experiencing some slight soreness is normal, and you will typically note an improvement in your symptoms within one to two days. How long the benefits will last will vary per individual. The first few treatments will usually have a short length of relief spanning over several days.
How many sessions of dry needling do you need?
If treatment zones are found and the correct muscle groups are targeted, sub-acute conditions will improve after three – four consecutive sessions, with chronic injuries requiring five – six consecutive needling sessions.
Does dry needling remove knots?
Dry needle therapy resolves muscle knots by inserting a very thin needle directly into the trigger point. The knot responds to the interruption and relaxes immediately. Most patients agree that dry needling doesn't hurt in the way that you might think!
How deep do dry needles go?
Superficial dry needling involves inserting a needle at a depth up to 10 mm or into the subcutaneous tissue and may be combined with manipulation of the needle while in situ.
Does dry needling reduce inflammation?
The micro tears caused by the needle prompts the body's natural defenses to get to work, bringing nutrient-rich blood to the site and boosting tissue repair. Dry needling also helps to dissipate inflammatory mediators, those substances that gather in an area of inflammation.
Is dry needling good for arthritis?
Dry needling is an effective treatment in reducing pain from osteoarthritis because it increases blood circulation around the joint, thereby providing natural relief.
What exactly does a chiropractor do?
A chiropractor is trained to make sure your body is functioning as optimally as possible by using spinal manipulations and other therapies to relieve pain in your joints and muscles. These spinal adjustments will increase blood flow and nerve conductivity to the joints and muscles that are experiencing pain. They are taught philosophically to find and treat the cause rather than just the symptoms.
Is it healthy to go to the chiropractor?
Spinal manipulation and chiropractic care are generally considered safe, effective treatments for acute low back pain, the type of sudden injury that results from acute or chronic conditions such as strains, arthritis or disc injuries.
What are the benefits of chiropractic care?
• Improves neck pain.
• Reduces reliance on opioid pain relievers.
• Eases back pain.
• Possible reduction of osteoarthritis symptoms.
• Eases headache symptoms.
• More affordable treatment for chronic back pain.
• High satisfaction.
• Reduces scoliosis symptoms.
What are the cons of seeing a chiropractor?
Spinal and joint manipulation has a chance to go wrong and may cause unwanted injuries. So it is important that you only have an appointment with an experienced chiropractor that performs the necessary examinations and diagnostics to ensure safe treatments. DO NOT ALLOW a physical therapist or any other untrained person try a manipulation especially without X-rays.
When should you go to a chiropractor?
Chiropractors are most sought after to treat neck and low back pain due to acute or chronic pain. If you experience back pain that lasts for more than a few days, consult a chiropractor for an assessment.
What cracks when you see a chiropractor?
During a back adjustment, your back undergoes quick, gentle stretching of the spinal facet joint, so you may hear a cracking or popping noise. This is caused by small pockets of air or bubbles, which are in the fluid that surrounds your joints.
Why do chiropractors want you to keep coming back?
Changing your posture, changing your spine's ability to move, changing your muscle health and structure take time. Months in fact. All muscles have memory and your body wants to go back to its old patterns instead of creating new healthy ones. That is why adjustments need to be repeated again and again
Is chiropractic care is ineffective?
Critics are skeptical mainly due to the fact that chiropractic care does not involve medications or any invasive surgeries. Some have associated this practice with some side effects and fatal complications in some cases resulting in death or stroke. It also goes against the medical philosophy of not prescribing medications. In recent years there has been a comparison that shows not only Chiropractic to be safe, but healthier and more successful than taking steroids and medications. There are also various techniques now that prevent any type of injuries due the gentleness of the adjustment.
Why do some chiropractors crack and others don't?
The noises you hear during chiropractic treatment depend on the technique used. For example, some techniques cause a cracking sound, and others don't, but both can be highly effective, depending on your needs. So, whether you hear an abundance of pops or none at all, you don't need to worry.