A no-nonsense approach to treating and resolving Carpal Tunnel Symptoms

A no-nonsense approach to treating and resolving Carpal Tunnel Symptoms

Are you experiencing wrist pain, and numbness in the hands especially at night, mostly in the first three fingers? Do you get shoulder and neck pain as well? Did your doctor diagnose you with Carpal Tunnel Syndrome (CTS) or Repetitive Strain Disorder (RSD) of the wrist and arm?

If you search through Google you are likely to find articles recommending things such as splints on the wrists as a first approach to care and that it is most likely found in women and aggravated by pregnancy. Most of these articles are advertisements written by medical departments, medical clinics, orthopedic offices, and hospital-owned treatment facilities. They often blame the condition on repetitive strain.

If you follow this one-size-fits-all advice and begin your journey in your local medical doctor’s office, you will be tested, diagnosed, and offered one-size-fits-all treatment options that may relieve the symptoms as your problem becomes more chronic over time. Since CTS can be different depending on who we are or how we have adapted, looking at the wrist for answers rarely solves the problem, however, treating the symptom may offer some relief temporarily with a brace, constant exercises, or therapy to the hand and wrist.

Ask yourself why is this an overuse problem for me, while other people you know who do the same activities suffer from this less than you do. many of us never experience these symptoms at all so what is different about you?

A Carpal Tunnel Story from a company you know.

Since 1994, I have been trained in performing Active Release Techniques (ART) and worked hard at mastering this method of myofascial release treatment. In 1999 joined a study Johnson and Johnson (J & J) was doing to evaluate ART’s effectiveness in treating and resolving Carpal Tunnel non-surgicaly. At the time J & J had been manufacturing in North Brunswick and other local facilities. They were experiencing high costs associated with physical therapy regimens that after dozens of visits did not resolve the condition, and wanted to avoid carpal tunnel surgeries on their workers as these methods did not have great results either.

ART originated in Colorado Springs, Colorado, and developed a reputation for treating and resolving the condition often in under 10 visits with lasting results in Colorado. Better yet, no drugs, splints, or surgery was needed reducing costs and risks and more importantly, employees were able to stay off disability and remain productive.

Dr. Cole who added us to the J & J study had sent us a handful of patients who all resolved in 10 visits or less using the methods I learned from ART.

One day, Dr. Cole called me and asked me if I would take on more of their patients who experienced Carpal Tunnel Syndrome. I asked her how the study was going. Her response was, not good and our office was the only one getting results.

As I trained in Active Release techniques with some of the other doctors of chiropractic in the study, I couldn’t understand why the other providers failed to resolve the condition.  I had been fighting with the worker’s compensation carrier on many of the patients because I treated the patient, rather than the wrist and forearm, and all of these patients also had problems in the feet, legs, lower back, and even shoulders.

The workers’ comp carrier would often insist I was not authorized to treat anything other than the wrist and arm, but the results showed patients improved quickly with a thorough holistic approach to care.   Eventually, I suggested they have me explain this at a future meeting to understand the medical necessity of a holistic approach to CTS.

This type of holistic approach is the foundation of chiropractic care.

Dr. Cole said she would like to continue sending us patients and for two years, we averaged 10 visits to resolve many of the shoulder, arm, and wrist pain patients.

I was asked a year later to speak at the J & J annual nurses meeting at Ortho in Somerville and asked them to bring in a patient I had never met before to take a history, evaluate, and treat.   The nurses were surprised at how the evaluation went and how the patient felt after the treatment.  They loved what they saw and continued to refer until a new medical director took over.

While we are no longer seeing those patients, my developing relationship with the new medical director resulted in many company executives visiting our offices and getting great results, naturally over the years.

Carpal Tunnel Syndrome is a symptom of poor adaptation over the years.

Most medical articles as the recent one published here in Discover Magazine are vague on the causes or why women more than men experience the condition.  The article while interesting to read and medically reviewed offers little useful advice on what the condition is caused by.   They also echo the same one-size-fits-all advice found in a Google search.

To resolve most musculoskeletal problems, the healthcare practitioner must look at the person, how they are built, their body style, and understand the condition as it applies to them.

One person’s hand numbness may have different mechanical reasons than another. Perhaps, the problem with diagnosing CTS is that you cannot one size fits all this condition to properly understand and treat it.  The recent Discover Medically reviewed article stated the following which illustrates this perfectly;

“It can be difficult to put a finger on a single cause of carpal tunnel; it is often a complicated back-and-forth of several different factors.

But repetitive hand use stands out as one of the more prominent culprits; the condition is therefore more common amongst occupations such as office workers, factory laborers, and tradespeople. But there is more to it than just repetitive strain.”

The problem often begins at the feet and carpal tunnel develops or worsens as poor adaptations over many years result in tightening of the arm, shoulder, and wrist resulting in nerve entrapments from the neck to the arm or wrist. Any or all of these entrapments can result in carpal tunnel syndrome and in the worst cases, the carpal ligament at the wrist causes entrapment as well resulting in the symptoms.

Perhaps this is why there is no single cause for the problem.

CTS is not a wrist problem. It is a problem of adaptation aggravated with repetitive motion resulting in hand numbness and ultimately wrist pain. Females have naturally wider hips, and different angles at the elbows and these traits contribute to why more women than men experience the condition.

It is a problem resulting from altered movement patterns in the lower body affecting the shoulders, neck, and upper body.   This is why so many carpal tunnel surgeries improve wrist pain while the other areas of the shoulder, neck, and even the elbow will continue to be symptomatic.   The carpal tunnel is the symptom, the healthcare provider must understand how to properly diagnose musculoskeletal problems, and myofascial adaptations to fully understand and treat it accordingly.   This is why one size fits all approaches don’t work as your CTS may be different than your co-workers.  Night splints are merely a band-aid.

Avoid the tests, surgeries, and splints, and do this instead.

Chiropractors trained in ART, Graston, and other soft tissue techniques who evaluate their patients and treat the problem of movement holistically should be your first choice for care.

It is commonly understood that who you visit first will determine your results, costs, and risks in the treatment of a condition.

Chiropractic patients often joke about how their elbow pain may have started with the opposite ankle.   This has to do with movement patterns, the effect on the joints of the body, and fascial system adaptations over the years.

If you diagnose and treat CTS properly, you may never experience the ankle, knee, hip, back, and other manifestations that were going to eventually hurt too.  The holistic philosophy of treating the problem rather than the symptom works best here.   Visit the chiropractor for one problem and resolve 4-5 problems that were considered normal until they hurt.  Seeing a chiropractor first can be proactive, cost-effective, and safe compared to other approaches, while you avoid costly nerve conduction tests or MRI scans that offer poor value diagnostics at a high cost.   Nothing compared to a thorough evaluation.

What to expect on your first chiropractic visit.

Today chiropractors will employ, joint manipulation, exercises, foot orthotics if necessary, and soft tissue treatment techniques to improve the way you move.

Ultimately, CTS and RSI are a movement problem that goes beyond just the hand, wrist, and shoulder. The nerve entrapments to the median nerve and even the ulnar nerve that can make the pinky numb and cause elbow pain are the result.

Those trained in myofascial methods such as ART, Graston, and others who understand how the myofascial system works and functions are best qualified to help those experiencing CTS.

Keep it simple; choose chiropractic first.

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