Carpal
Tunnel Syndrome (CTS) results in numbness, tingling, and sometimes weak grip
strength due pinching of the median nerve as it travels through the carpal
tunnel at the wrist. There are many conditions that are similar to CTS, many of
which we have discussed in the past. The following is a list of “13 fun facts”
aimed at helping to properly identify CTS, knowing what to do about it, and at
helping to make an informed decision as to whom to seek help for it.
CTS is most
common in women, age >50, who work in a repetitive, rapid moving manually
demanding occupation (typing/computer work, line assembly work, waiting tables,
and more).
CTS is
complicated by the presence of obesity, diabetes, hypothyroid, pregnancy,
taking birth control pills, and other conditions that cause inflammation
(rheumatoid arthritis and others).
CTS may develop
on the dominant side, the non-dominant side or both-- each case is individual.
CTS symptoms may
FIRST present as morning or night time numbness that can wake the sufferer up
once or many times during the night.
CTS sufferers
USUALLY wait for weeks, months or even years before seeking help for it, which
is a risk factor for a delayed recovery – GET HELP ASAP!!!
CTS can often be
managed without surgery-- especially IF you have it treated sooner rather than
later.
CTS surgery may
be necessary if non-surgical care fails. This may be due to the nerve being
damaged beyond a certain point (an EMG/NCV or, electromyography/nerve
conduction velocity helps determine this along with an accurate history and
examination).
CTS non-surgical
care includes: chiropractic manipulation of the wrist, elbow, shoulder and/or
neck-- depending on the case. All health care providers usually include a night
wrist splint, anti-inflammatory measures, ergonomic modifications of work
stations, and stretching exercises.
CTS non-surgical
success favors chiropractic because of the inclusion of the manual therapies.
When only exercise, night splinting, and NSAIDS are used, the success rate
drops off dramatically.
Reduced thyroid
function makes CTS worse because of the unique type of swelling associated with
hypothyroidism called “myxedema.” Because of the confined space available in
the carpal tunnel, a small amount of swelling can result in nerve compression
and the classic numbness/tingling symptoms in the middle three fingers on the
palm-side of the hand.
CTS is worse at
night because it is impossible to control the position of the wrist while we
sleep. As a result, we tend to curl the wrist and hand under our chin, and when
the wrist bends forwards or backwards, the pressure inside the carpal tunnel
increases significantly due to the change in tunnel size. This is why wearing a
wrist splint at night REALLY HELPS as it keeps the wrist from bending, keeping
the tunnel as wide as possible, thus lowering the pressure within it.
CTS patients
respond well in some cases to vitamin B6. This is due to the healing effects of
B6 (peridoxine) on neuropathy and/or it’s anti-inflammatory qualities. Other
anti-inflammatory nutrients include ginger, turmeric, boswellia, bioflavinoids,
white willow bark, quercetin, and others.
CTS patients do
not always improve after surgery. This can be due to the fact that the median
nerve is frequently “pinched” in more than one area such as the neck, thoracic
outlet (shoulder), pronator tunnel (elbow) as well as at the wrist. When more
than one compression is present, this is referred to as “double” or “multiple
crush syndrome.”
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 relief in San Francisco please call 415-392-2225
- CTS is
complicated by the presence of obesity, diabetes, hypothyroid, pregnancy,
taking birth control pills, and other conditions that cause inflammation
(rheumatoid arthritis and others).
- CTS may develop
on the dominant side, the non-dominant side or both-- each case is individual.
- CTS symptoms may
FIRST present as morning or night time numbness that can wake the sufferer up
once or many times during the night.
- CTS sufferers
USUALLY wait for weeks, months or even years before seeking help for it, which
is a risk factor for a delayed recovery – GET HELP ASAP!!!
- CTS can often be
managed without surgery-- especially IF you have it treated sooner rather than
later.
- CTS surgery may
be necessary if non-surgical care fails. This may be due to the nerve being
damaged beyond a certain point (an EMG/NCV or, electromyography/nerve
conduction velocity helps determine this along with an accurate history and
examination).
- CTS non-surgical
care includes: chiropractic manipulation of the wrist, elbow, shoulder and/or
neck-- depending on the case. All health care providers usually include a night
wrist splint, anti-inflammatory measures, ergonomic modifications of work
stations, and stretching exercises.
- CTS non-surgical
success favors chiropractic because of the inclusion of the manual therapies.
When only exercise, night splinting, and NSAIDS are used, the success rate
drops off dramatically.
- Reduced thyroid
function makes CTS worse because of the unique type of swelling associated with
hypothyroidism called “myxedema.” Because of the confined space available in
the carpal tunnel, a small amount of swelling can result in nerve compression
and the classic numbness/tingling symptoms in the middle three fingers on the
palm-side of the hand.
- CTS is worse at
night because it is impossible to control the position of the wrist while we
sleep. As a result, we tend to curl the wrist and hand under our chin, and when
the wrist bends forwards or backwards, the pressure inside the carpal tunnel
increases significantly due to the change in tunnel size. This is why wearing a
wrist splint at night REALLY HELPS as it keeps the wrist from bending, keeping
the tunnel as wide as possible, thus lowering the pressure within it.
- CTS patients
respond well in some cases to vitamin B6. This is due to the healing effects of
B6 (peridoxine) on neuropathy and/or it’s anti-inflammatory qualities. Other
anti-inflammatory nutrients include ginger, turmeric, boswellia, bioflavinoids,
white willow bark, quercetin, and others.
- CTS patients do
not always improve after surgery. This can be due to the fact that the median
nerve is frequently “pinched” in more than one area such as the neck, thoracic
outlet (shoulder), pronator tunnel (elbow) as well as at the wrist. When more
than one compression is present, this is referred to as “double” or “multiple
crush syndrome.”
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 relief in San Francisco please call 415-392-2225