Carpal Tunnel Syndrome: A Shelburne Chiropractor’s Perspective
Carpal Tunnel Syndrome in Shelburne is the most common entrapment neuropathy, affecting 1 in 30 Americans. It can affect your work, recreation, and in this age of virtual communications, it can interfere with our relationships with our friends and family. How many have had trouble sleeping because of upper extremity pain? That is brutal. What about parenting little kids or being a grandparent and not being able to pick up or play with your grandkids?
What is carpal tunnel in Shelburne
Carpal Tunnel is often described as a disorder caused by compression at the wrist of the median nerve supplying the hand causing numbness and tingling and even pain in the arm, forearm, wrist and hand and especially the thumb, index and middle fingers. The median nerve travels from the neck down the arm to the fingers. The carpal tunnel is a passageway protecting the median nerve and flexor tendons.
It is commonly thought that when pressure is put on the carpal tunnel, the median nerve becomes overcrowded and can cause pain, numbness, weakness and a tingling sensation throughout the hand, but pressure on the median nerve anywhere along the path it travels can cause the same symptoms. While this condition is most commonly thought to be caused by repetitive hand use, other cases result from heredity, pregnancy, or other debilitating conditions like diabetes or rheumatoid arthritis. One of the most commonly overlooked causes may come from poor posture habits that result in vertebral subluxations (misaligned vertebrae) in the neck.
Carpal tunnel syndrome (CTS) and its impacts
CTS impacts as many as 10 million Americans with an average age between 40 and 50 years old. 50% may be due to genetic factors and women are three times more likely to develop carpal tunnel syndrome than men, commonly thought that it is because their wrists tend to be smaller but all the other anatomy like the tendons and nerves are smaller as well so I am not convinced that is the reason.
Bracing and surgery are the most common conventional approaches. Some individuals who undergo surgery gain grip and pinch strength 2 to 3 months later, but some people don't notice improvement until 6 to 12 months after surgery, if at all, while others may have poor outcomes.
People who struggle with CTS often describe it as fingers that feel useless and swollen and feeling the need to “shake out” the hand or wrist. Symptoms of numbness, tingling, weakness, and pain often first appear in one or both hands during the night.
Usually, in combination, some of the factors that can lead to carpal tunnel are surprising:
- Poor ergonomics in repetitive tasks including unhealthy postural habits
- Trauma or injury to the wrist that causes swelling, such as sprain or fracture
- An overactive pituitary gland causes oversized hands from excess growth hormone
- An underactive thyroid gland causes fluid retention and weight gain
- Rheumatoid arthritis
- Mechanical problems in the wrist joint
- Repeated use of vibrating hand tools
- Fluid retention during pregnancy or menopause
- The development of a cyst or tumor in the canal
Often, no single cause can be identified. People with diabetes or other metabolic disorders that directly affect the body’s nerves and make them more susceptible to compression are also at high risk.
Early diagnosis and treatment are important to avoid permanent damage to the median nerve. Sometimes, thickening from the lining of irritated tendons or other swelling narrows the tunnel and compresses the median nerve. As symptoms worsen, people might feel tingling during the day, especially with certain activities such as talking on the phone, reading a book or newspaper, or driving. Hand weakness may make it difficult to grasp small objects or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people with very severe CTS cannot determine between hot and cold by touch and may burn their fingertips without knowing it.
How We Approach Carpal Tunnel In Shelburne
Over 35 years we have helped more than 10K people get their health back and folks concerned with carpal tunnel syndrome have been among them. When we find someone has CTS, our goal is to not only help them resolve the symptoms, but also prevent any further progression, improve function and reduce pain, and provide long-term stabilization.
Identifying the cause is the first step to understanding if we can help. We conduct a thorough consultation where we really listen to what your concerns are, what you have noticed, what you think might be going on and then we become detectives where we uncover all the factors that have accumulated over time to land you where you are right now. carpal tunnel syndrome often runs in families. There may be learned family postural patterns that are perpetuated. Genetic variants passed down in families have also been found linked to carpal tunnel trouble.
Next, we will get our hands on your hands and spine with a comprehensive functional, orthopedic, and neurological exam and your body will tell us some things and combined, these will help us determine which additional tests we need to run to get the full picture of what’s going on. We will palpate each individual vertebra to assess its alignment and the curves in the spine as well as conduct a detailed assessment of the alignment of the tiny wrist bones.
There are seven tools we may use to fully understand what is going on and if we can help.
- We may use surface electromyography (sEMG) to identify imbalanced muscle patterns and dysponesis. Dysponesis is a reversible pathophysiologic state where neurophysiologic reactions consist of covert errors in energy expenditure. Essentially it is describing dis-ease and inappropriate and inefficient adaptation to the stresses one is encountering. These errors can drive the poor adaptation to repetitive use of the wrists and hands.
- Rolling Thermography (RT) can be used to identify how disruption of the normal nerve supply to the organs, blood vessels and glands could be contributing to the inability to heal the wrists and hands. It identifies dysautonomia, a state of dysregulation of the nerves that control your organs.
- Heart Rate Variability (HRV) identifies specific stress patterns that are perpetuating the problem.
- We will use brain-based testing to see if you have asymmetric brain patterns that need to be addressed if they are a factor that is driving the dysfunction in the hands.
- Digital Range of Motion (ROM) is used to highlight which areas have fixations and dyskinesia, an abnormality in performing voluntary muscle movements.
- Digital Posture Analysis is used to identify altered proprioception, the inability to sense the precise position, location, orientation and movement of the body and its parts.
- Digital X-rays: X-rays are invaluable to see inside and to assess if any degenerative conditions have begun. We can refer you to a local facility to obtain the views needed.
Some other factors may also be used to complete the picture, such as genetic test results, nutritional assessments that may uncover inflammatory diet-styles that are feeding the fire of inflammation in the wrists, postural habits, and functional biomechanics analysis.
Specific Chiropractic Care | Shelburne
Because the central nervous system, your brain, and spinal cord, controls your wrist function, any interference in the flow of messages between the brain and hands can cause a breakdown in function. It can cause poor grip strength and reduce the adaptability to repetitive use.
If the bones of the spine are jarred out of alignment or normal movement from injuries or bad habits like poor posture, too much time spent at computers, tablets, cell phones or other devices, or even just stressed posture, it causes soft tissue damage, leading to inflammation. This is called a vertebral subluxation. This then irritates the delicate nerves which exit the spine. When irritated, your smart body will spasm the muscles around that joint to strap it down to protect it from further harm. It may not sound like it, but a muscle spasm is actually the body trying to protect itself. Really! This lack of movement then causes the discs to deteriorate over time, initiating the process of degeneration as the joints get rusty like an unused door hinge. This is known as osteoarthritis, or degenerative joint disease, which occurs from old traumas or ongoing postural stresses. That’s why it’s important to get regular spinal checkups so we can give it the attention it needs to be fully functional and prevent problems in the future.
Chiropractic care at Wellspring Chiropractic Lifestyle Center in Shelburne focuses on identifying and correcting vertebral subluxations, without drugs or surgery, restoring healthy normal spinal function and preventing degenerative disc disease in the spine. When the brain gets accurate proprioceptive messages telling it exactly where the body is in space, it has the best chance of controlling the muscles that move the bones so they can be moved into proper alignment to reduce and even eliminate carpal tunnel syndrome. Correcting spinal subluxations clears the distorted messaging to the brain and updates it to a more accurate neural self-image. Not adapting readily and appropriately to repetitive tasks is a classic example of a vague neural self-image. If you want a healthy body, you need a healthy nervous system, and if you want a healthy nervous system, you need a healthy spine. Who checks your spine?
Correcting the subluxations is the first step. After that, maintaining that alignment is key to reducing the chances of advancing degenerative changes. Could you ever exercise and get so fit that you would never have to exercise again? Once your wrists and spine are as healthy as they can get, it will be important to continue to take care of it so you don’t lose the ground you have covered and the gains you have made.
Custom Therapeutic Exercise Plan
We will customize a plan for you based on your functional assessment. This will include showing you the proper ways to move and rest to optimize healthy spinal alignment. You will be trained in specific strengthening exercises to support wrist function and you will learn the best practices for you to stay active without increasing your carpal tunnel symptoms, such as talking to your manager about workplace ergonomics.
Our three-legged stool model will help you in the office but also develop a plan for you at home with your individualized spinal and hand exercises and the best practices for changing bad habits into healthy lifestyle habits to prevent problems in the future so you have the best life possible.
Common conventional approaches are for the most part designed to manage it rather than correct the cause. Things like splinting at night, resting during the day from aggravating activities, taking frequent breaks to let your wrists rest while at work, especially if you use your hands on the job all day.
Over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) are not very helpful, steroids have dangerous side effects, and if you have had or are considering surgery: less than 50% of people achieve full recovery from surgery and 12% are made worse from complications from the surgery.
If left untreated, complications from Carpal Tunnel Syndrome may include impacting the other joints in the upper extremity resulting in elbow and shoulder problems as the body compensates for the lack of function in the wrists. Arthritis can develop, further limiting function.
Grip Strength Associated with All-cause Mortality
Loss of grip strength is a common problem with carpal tunnel syndrome. There was an interesting study that showed that loss of grip strength was a predictor of earlier death from all causes. Are you wondering how that could possibly be? Let’s review what we have learned so far. The hands are controlled by the brain which must send the messages down the spine and branch out along the nerve roots that exit from between the vertebrae. The nerves that control the hands come out of the brachial plexus which comes from the nerves from the neck. At the top of the neck is where the brain stem lives. The brain stem is where all the control centers for all the organ systems are. If there is a misalignment in the neck that is affecting the function in the hands like a loss of grip strength as is experienced with carpal tunnel syndrome, then the misalignment could also be putting pressure on the brain stem which could then begin to affect any of the organ systems.
Another study showed improvement in grip strength following chiropractic adjustments to reduce vertebral subluxation. This was associated with improved motor system function. The nerves coming out of the neck to control the motor function of the upper extremity also carry nerve fibers that control the function of the blood vessels organs and glands. If there are subluxations disturbing the normal flow of messages coming out of the neck causing muscle weakness, perhaps it could also cause weakness in organ function. It would seem that if the subluxations were corrected, organ function could also improve.
Benefits of Chiropractic Care for Carpal Tunnel in Shelburne
Research shows the following benefits of chiropractic care:
- Reduced pain and discomfort
- Reduced inflammation
- Improved spinal alignment and symmetry
- Improved range of motion
- Improved flexibility
- Increased activity and improved lifestyle
- Improved joint and nervous system function
- Decreased strain on muscles.
- Improved grip strength
Unlike the invasiveness of surgery and the addictiveness of opioids, chiropractic care is non-invasive and non-habit forming. Compared to the costs of surgery, ongoing prescription medications, and the treatment of their side effects, not to mention the increased costs in overall health care for a degenerating spine, chiropractic care is extremely cost-effective.
Frequently Asked Questions
Can a chiropractor in Shelburne correct your carpal tunnel?
At Wellspring Chiropractic Lifestyle Center, using time-tested safe, gentle approaches, we have helped improve the spinal neural integrity of many members of the Shelburne community including many who are looking to address carpal tunnel concerns. By aligning the spine and clearing the nerve interference that allows for balanced muscle function that supports a more symmetrical structural alignment, chiropractic care is one of the most effective ways to correct CTS.
Can you correct carpal tunnel without surgery with a natural approach?
Yes, to avoid surgery and chronic use of medication to manage carpal tunnel problems, people have had great success with natural approaches like chiropractic care, spinal exercises and improving posture/ergonomic habits.
What does carpal tunnel pain feel like?
People who struggle with CTS often describe it as fingers that feel useless and swollen, and feeling the need to “shake out” the hand or wrist. Symptoms of numbness, tingling, weakness and pain in the arm, forearm, wrist and hand and especially the thumb, index and middle fingers often first appear in one or both hands during the night. As symptoms worsen, people might feel tingling during the day, especially with certain activities such as talking on the phone, reading a book or newspaper, or driving. Hand weakness may make it difficult to grasp small objects or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people with very severe CTS cannot determine between hot and cold by touch, and may burn their fingertips without knowing it.
How can you tell that a person has carpal tunnel?
Besides the classic symptom picture of numbness, tingling, weakness and pain in the arm, forearm, wrist and hand, there are three tests that can be used. Phalen’s test, Tinel’s Tap test and grip strength test.
What problems can carpal tunnel cause?
Besides numbness, tingling, weakness and pain in the arm, forearm, wrist and hand, arthritis and loss of sense of temperature can develop.
Key Words: Alignment, all-cause mortality, biomechanics, bracing, brain-based chiropractic, brain-based testing, Carpal Tunnel Syndrome, central nervous system, CTS, chiropractic adjustment, chiropractic care, cyst, diabetes, digital ROM, digital posture analysis, digital x-rays, dysautonomia, dyskinesia, dysponesis, entrapment neuropathy, ergonomics, flexor tendons, fluid retention, functional exam, genetic, grip strength, hand, healthy lifestyle habits, Heart Rate Variability, HRV, inflammation, median nerve, menopause, neural self-image, neurological exam, NSAID, numbness, opioids, orthopedic exam, osteoarthritis, overactive pituitary, palpation, posture, postural analysis, pregnancy, proprioception, range of motion, rheumatoid arthritis, ROM, Rolling Thermography, RT, sEMG, spinal exercises, spinal cord, spinal neural integrity, steroids, subluxation, surface Electromyography, therapeutic exercise, tingling, tumor, underactive thyroid, vertebra, vertebrae, vertebral subluxation, vibrating hand tools, weight gain, wrist
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