Tag Archives: hand

Carpal Tunnel or Double Crush Syndrome

Carpal Tunnel Syndrome (CTS) is an over diagnosed and often misdiagnosed condition.  Research has indicated that surgery or wrist supports for carpal tunnel syndrome are not very effective when additional compression of the nerves is occurring in either the shoulder or neck.  In order to treat a condition you must find the root cause.  For CTS like symptoms, the cause is often at the nerve root.

Image from: American Chiropractic Clinic Vietnam website

When a nerve is compressed only a little bit there are sometimes no noticed symptoms.  However, when you compress a nerve a little bit in multiple locations the results don’t just add up they can multiply.  This is termed Double Crush Syndrome (DCS).  For the nerves in our arms this means if you have a little neck problem and a little shoulder problem, then that minuscule problem at the wrist may be exaggerated.  The nerves to our hands run a gamut.  They come out from the neck joints, travel through the often tight scalene muscles, between the collarbone and the first rib, through the armpit, down the arm and through the carpal tunnel.  At all of these choke points nerves can be compressed.  It is therefore very important to find where the cause or causes of the injury are to determine whether you truly do have CTS or if it’s a DCS.  Especially before slit your wrists (with a surgery). The standard of care for carpal tunnel treatment is, conservative care first.  Chiropractic is conservative care, and chiropractors are trained in diagnosis and treatment of percisely these neuromusculoskeletal conditions. Chiropractors will usually treat these symptoms by manipulating the wrist, elbow and neck as well as utilizing massage, ultrasound therapy, wrist supports, and other modalities.   According to The University of Maryland Medical Center:

“…studies support the use of chiropractic treatment for CTS. In the first study, 25 individuals diagnosed with CTS reported significant improvements in several measures of strength, range of motion, and pain after receiving chiropractic treatment. Most of these improvements were maintained for at least 6 months. A second study compared the effects of chiropractic care with conservative medical care (wrist supports and ibuprofen) among 91 people with CTS. Both groups experienced significant improvement in nerve function, finger sensation, and comfort. The researchers concluded that chiropractic treatment and conservative medical care are equally effective for people with CTS”

If chiropractic is equally effective, and has less side effects, shouldn’t you go visit your chiropractor for that hand pain and numbness you’ve been feeling.

Thoracic Outlet Syndrome

I’ll begin my discussion of common chiropractic conditions with Thoracic Outlet Syndrome (TOS).  I had a patient the other day present with this, so I thought I’d start with it.

This syndrome is usually noticed with tingling, numbness, or odd sort of ache in your arm or hand.  Symptoms are commonly only on one side, but can be present in both.  People will often notice these symptoms more when they raise their hands over their head.  If you’ve ever had your arm “fall asleep” or hit your funny bone it is similar, but more constant.

These symptoms can be caused by problems with blood vessels, but 95% of the time they have more to do with the nerves of the arm.  These nerves come out of the spinal cord from the lower neck and go through places where they could be easily pinched or irritated.  Starting at the spine these nerves travel through a narrow space in the bones then through the muscles of the neck called the scalenes.  They then travel between the ribs and collarbone, through the armpit, and then through the muscles of the arm and forearm. At any point or many points in this trip they can be compressed by inflammation, sprain, strain, subluxation or other injury that has occurred.  So there may be more than one source.

Depending on the cause there are many things that your chiropractor will do to treat TOS. They will correct any subluxations that they find that may be contributing, they should recommend massage for any tight muscles, as well as ultrasound or laser therapy to address other soft tissue components.

There are also things that you can do.  If diagnosed with TOS you should avoid overhead work, limit your work with your arms to light duty for the duration of care, usually about 8-12 weeks.  You should modify your activities such as decreasing your upper body workout level or alternating the arm you use to carry your bags or child.

Approximately 85% of patients with TOS will improve with conservative care.  Occasionally surgery or more invasive measures may be necessary to remove scar tissue adhesions, an extra first rib, or if there is vascular involvement.

TOS can be frustrating, but it is also very treatable.  As with every condition, the sooner you come in for help the better.  I have seen great results in treating this condition, and would be happy to help you with it.  Contact your local chiropractor for additional information.