Tag Archives: wrist

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.

Cold Laser Therapy and de Quervain’s

People have been asking lately about laser therapy, so I thought I’d explain it a little and sneak in a quick condition at the same time.

De Quervain’s is the name for tenosynovitis of the thumb extender and abductor muscles.  Which is to say the tendons that move your thumb hurt at the wrist because inflammation isn’t allowing them to move properly.  It is more common in women, but anyone doing repetitive motions with their thumb such as typing, cashiering, mechanics, etc. is susceptible.  If you have it you may notice a “squeaky thumb,” pain when moving your thumb and decreased grip strength.  In my experience this condition doesn’t usually go away on it’s own.  Similar to carpal tunnel syndrome it just keeps coming back unless you receive proper care.

Many things are done for treatment of this condition.  Chiropractic manipulation and massage of the area are beneficial as well as reducing use.  You’ll likely need to talk with your employer about decreasing or changing your duties for a time while you heal.  There are also many electrical modalities that are beneficial for de Quervain’s.

That’s where the Cold Laser comes in.  Cold Laser is called many names but it is all the same thing, particular light waves that have been found to increase cellular metabolism.  In essence when exposed to these wavelengths of light your cells heal faster, and hurt less.  That’s a good thing.

LLLTIt’s an odd sort of treatment because you normally don’t feel anything at the time.  Kind of like magic with good research behind it.  We just put this wand with a laser or LEDs on the injured area and hold it there for a few moments with the light on.  The reason I bring Low Level Laser Therapy (LLLT) up with this condition is the relief time.  Generally speaking my patients are able to notice effects of LLLT within the first day, but I had a patient with de Quervain’s who claimed instantaneous relief with LLLT.  It was amazing to me and worth reporting to you.

So, if you have pain at your wrist from thumb movement visit your chiropractor and ask them about Cold Laser Treatment.