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One of the most expensive and poorly treated conditions of the computer era is carpal tunnel syndrome.  It has frequently been poorly diagnosed and the treatment of this common conditions costs business and industry thousands of dollars in lost work time and disability. It is most common among people who type on computer keyboards or who perform other repetive tasks with their hands,  arms, shoulders and neck. Current treatment methods often fail to bring long term results and sometimes results in worsening disability.  Common treatments used for the condition are wrist splints, massage, injections into the area of pain and discomfort, medications, nutritional supplements, physical therapy, exercises including stretching and finally when all else fails, surgery.  Recently, these arm conditions have more appropriately been reclassified as Cumulative Trauma Disorders (CTD’s).

Typical Symptoms

The typical CTD sufferer may note the following:

• Arm/Hand/wrist pain.
• Arm/Hand Numbness.
• Raising the arm makes the hand go numb(Nerve root adhesion).
• Numbness in the first finger and thumb(true carpal Tunnel).
• Numbness in entire hand or finger tips(Nerve root adhesion).
• Wrist pain/thumb pain.
• Shoulder Pain.
• Neck Pain
• Stiffness in the hand or forearm.

Appropriate diagnosis

Commonly, to diagnose the condition, patients have been subjected to Nerve Conduction tests and simple orthopedic tests which make the hand go numb.  CTD’s actually are comprised of quite a number of different conditions which must be diagnosed properly to be treated successfully. The truth is, more often than not, the condition does not involve the Carpal Tunnel.
Dr.’s Leahy and Mock1 in their article from Chiropractic Sports Medicine published in 1995 theorized the condition results from  muscular adhesions in the forearm and other structures along the path of the nerve roots, as they pass down from the neck to  their  respective nerves.  In proving their theories, these chiropractic physicians treated thousands of patients in Colorado showing a 96% success rate with the average case lasting six visits.  He also extrapolated the formula which explains why people develop this problem  and how to prevent it.   Dr. Leahy has recently passed on his knowledge to other doctors willing to learn this new technology.  Myofascial Release loosens the area and the doctor mobilizes the joint involved through joint manipulation. Another method that has also gained momentum and is very effective is Graston Technique which uses tools to actually resolve the adhesions.  Both methods have their strengths however, it is ultimately the chiropractors diagnostic skills rather than just the technique that will ultimately help you resolve the problem. Since many upper body conditions such as carpal tunnel, are created in the lower body when the core muscles are functioning poorly, you want a doctor who looks at you, not just the symptoms you showed up with.
To appropriately diagnose this condition, a doctor must examine the entire arm, check for adhesions (tissues stuck to eachother which interfere with normal nerve function) and systematically work them away by hand.  The doctor should also check your feet, pelvis and other contributing factors since problems in the pelvis will pull the shoulders forward and cause the arms to tighten. Over the past few years, a new breed of doctors such as our office now does active evaluation and treatment, which further improves our results because when we treat an area, we can immediately test it for improved function and change what we are doing on the fly which is far more efficient and cost effective. When this is done properly, the problem often resolves quickly and with appropriate periodic exercises, usually does not return.

Appropriate Treatments     Myofascial Release Technique’s, Graston Technique, Exercises

One must define what is appropriate in the treatment of CTD.  A good definition is “Any treatment method which is cost effective, yields reliable results in the majority of the population and is scientifically valid.”  Current treatment methods do not meet this criteria. The typical CTD case costs an average of $15,000 including the surgery.   Many other therapeutic approaches, including wrist manipulation show promise in the treatment of the condition although dysfunctional muscles and soft tissues will not allow for proper wrist joint function since there is often limited flexibility of the areas where the adhesions exist.
Myofascial Release Technique’s  and Graston Technique meets the criteria for “Appropriate Treatment.” These are  cost effective methods which often results in quick resolution of the condition and its symptoms. Many of the more difficult cases, including those that failed with surgery have succeeded.  Many Cts’s respond favorably to treatment within six visits or less.  Many other common arm complaints such as tendonitis (tennis elbow, golfers elbow) and shoulder complaints are present when a patient has the CTD syndrome.  Myofascial Release treatment and Graston Technique can resolve these problems as well. There is a cascade of event s(called the kenetic chain)   which includes neck motion, shoulder motion, elbow motion and wrist motion, as well as foot, knee and hip. Any dysfunction along this kenetic chain can result in common overuse syndromes of the arm, shoulder and wrist. A thorough practitioner will often check the relationship of these structures when a CTD is present.
The treatment consists of the doctor checking for adhesions and working them away by hand as he/she finds them on each session and then challenging the results using active evaluation techniques.  The treatment is usually not painful and the area being treated may experience  soreness for a day or two following the treatment. An experienced practitioner can very quickly resolve many of these conditions and will give you appropriate exercise designed to prevent a reoccurrence.
For further information, you can visit our web site at backfixer1.com

1. Improved Treatments for Carpal Tunnel and related Syndrome’s.  Chiropractic Sports Medicine
Vol9 #1 1995 Pgs. 6-9, Williams and Wilkins.