Carpal Tunnel Syndrome and Repetitive Motion Injuries
Posted May 09 2012 12:00am
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.
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.
Carpal Tunnel Syndrome and ChiropracticRepetitive Strain Injuries: What's Best? Carpal Tunnel Syndrome: PreventionServing zip code 94111 in the San Francisco Financial District for over 20 years