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Tag: carpal tunnel syndrome

  • Carpal Tunnel Syndrome

    Carpal Tunnel Syndrome

    Carpal tunnel syndrome is a condition that affects more and more people today.  It is especially prevalent among people that spend a lot of time on the computer and can make work stressful.  It is treatable and its treatment will be discussed in further articles.

    The Carpal Tunnel

    The carpal tunnel of the wrist is made up of all the carpal or wrist bones which form an arch over the tunnel.  On the other side is the flexor retinaculum, a strip of fascia which forms the floor of the arch, securing either end of the arch.  The 2 components form a tunnel that allows nerves and blood vessels through.  Of particular importance is the median nerve which passes through the tunnel and supplies the thumb, index finger, middle finger, and half the ring finger with nerve impulses.  At rest, the pressure inside a healthy carpal tunnel is 2.5 mm Hg.  When there is carpal tunnel syndrome, the pressure inside the tunnel is more than ten times the normal amount: 32 mm Hg.

    Causes of Carpal Tunnel Syndrome

    This extra pressure compresses or pinches the median nerve affecting the functioning of the fingers it supplies.  These fingers might feel tingling, numbness or in extreme cases, weakness.

    Approximately 1% of the population suffer from carpal tunnel syndrome, but numbers are rising.  There is a genetic component to it, but the majority of people suffering from carpal tunnel syndrome get it from repetitive motions at work.  Occupations that involve lots of repetitive motions with the hands have higher incidences of carpal tunnel syndrome:

    • keyboard operators
    • assembly line workers
    • butchers
    • massage therapists (yikes!!!)
    • cigar makers
    • etc.

    Carpal tunnel syndrome may also arise from:

    • fracture
    • dislocation
    • diabetes (14% of carpal tunnel syndrome also suffer from diabetes)
    • other nerve impingements
    • motor vehicle or other accidents
    • premenstrual, pregnancy, menopause

    Symptoms of Carpal Tunnel Syndrome:

    • Tingling or numbness in the hand especially in the thumb, index, middle and half the ring finger
    • wrist pain
    • pain in forearm or elbow
    • usually in the dominant hand (left/right handed)
    • increased symptoms while sleeping
    • decreased range of motion of the wrist
    • swelling in the wrist or hand
    • Compression of the tunnel,

  • Time to Simplify

    I am surprised yet again to find that change keeps happening at the speed of life.  At the end of last year, in a sudden move, I decided to leave Body & Spine.  And just a couple of days ago, I decided to leave Back in Motion.  In the span of less than a month I went from 3 clinics to one and all it took was a couple of conversations.  Both splits were amicable.  I thoroughly enjoyed working at both chiropractic clinics.  This made the decision to leave especially difficult and probably delayed the decision by months.  I simply left because I needed to work less, enjoy life more, and take care of myself.  It is a shame.  I will miss both clinics and the people there.  It seems strange to imagine somebody else working there or the clinic operating without me.  I guess that means they were really good places to work.

    I found myself on the sure path to RMT burnout.  In school, we were taught very early in the program that the average RMT’s career is 5 years.  That’s it.  5 Years.  School for 3 years, work for 5 years and then the next career.  It sounded impossible.  They explained that part of it is due to the emotional burnout of always giving and caring to so many different people.  The other reason is the physical burnout.  The wear and tear of repetitive strain injuries on our bodies leads to carpal tunnel syndrome, tennis elbow, and chronic neck, shoulder and back pain.  Again, we heard their warnings without heeding them.  Without having massaged for more than 4 hours a week, we had no idea what it was really like.  Who could predict that the chronic injuries would grow so slowly?  Almost silently the body adapted to the constant strain of massage work.  One month you might have a sore thumb which gets better.  A few months later, your wrist gets sore and then heals.  Perhaps later still, some tennis elbow.  They all seem transient and just a minor hassle that comes with the job.  But left unattended, they stay for a while.

    I have survived the trigger thumb and the tennis elbow scares.  Right now, for the first time, I am suffering from carpal tunnel syndrome.  Another scare for RMT’s.  The signs came quietly at first:  Some mild discomfort, a clicking sound with certain wrist movements.  But this time, after hearing from my chiropractor that her official diagnosis of my condition was in fact carpal tunnel syndrome, I finally listened.  I decided on a few changes. I quit both chiropractic clinics.  By concentrating on my private practice I could replace my clinic hours with half as many private hours without feeling any financial pinch.   I also decided on a 5 day work week.  It sounds insane, but I spent most of last year working a 6 day work week.  And before the 6 day work week, there was the 7 day work week.  It sounds like absolute insanity and stupidity in retrospect, but at the time, I felt invincible.  I am going to limit my treatments to 4 treatment hours maximum per day until my carpal tunnel is resolved and possibly up it to 5 per day after that.  I know RMT’s that work 7 or 8 hours of treatments a day and are no worse for wear.  I don’t know how they do it.  I have great respect for them, but I have to respect my body and the fact that it is turning 40 this year.

    I guess that this is my first official public whine.  I hope to be an RMT for a good long time.  I love the profession and I love the positive impact I make on people’s lives and don’t want to give it up for anything.  So hopefully with these steps I will be able to enjoy the most amazing profession for a little longer.

    At current I am not working at Body & Spine any longer.  I will still be available at Back in Motion until February 13.  After that date, I will only be available for treatment at the Pape & Danforth location.

  • Research: Acupuncture Better than Corticosteroids for Carpal Tunnel Syndrome

    The May 2009 issue of The Clinical Journal of Pain included the results of a randomized controlled trial comparing the use of acupuncture vs corticosteroids for the treatment of carpal tunnel syndrome. The study showed positive results favouring acupuncture.

    The study followed 77 subjects that were either given acupuncture (8 treatments over 4 weeks) or the corticosteroid prednisone, taken orally, daily for 4 weeks.  Acupuncture proved to have better results for controlling pain, numbness, tingling, and weakness.  Acupuncture had better results for night time awakening and motor function.

    Acupuncture also has less side effects and is safer than corticosteroids.  The side effects of a typical medical acupuncture treatment for carpal tunnel syndrome are:

    • minor bruising at the needle site that lasts 1 day after treatment
    • the sensation of a slight “prick” with the insertion of the needle, but not during the treatment

    Here is a list of the side effects of the corticosteroid prednisone:

    • increased appetite
    • indigestion
    • nervousness or restlessness
    • darkening or lightening of skin color
    • dizziness or lightheadedness
    • flushing of face or cheeks
    • hiccups
    • increased sweating
    • sensation of spinning
    • Decreased or blurred vision
    • frequent urination
    • increased thirst
    • confusion
    • excitement
    • false sense of well-being
    • hallucinations (seeing, hearing, or feeling things that are not there)
    • mental depression
    • mistaken feelings of self-importance or being mistreated
    • mood swings (sudden and wide)
    • restlessness
    • skin rash or hives
    • abdominal or stomach pain or burning (continuing)
    • acne
    • bloody or black, tarry stools
    • changes in vision
    • eye pain
    • filling or rounding out of the face
    • headache
    • irregular heartbeat
    • menstrual problems
    • muscle cramps or pain
    • muscle weakness
    • nausea
    • pain in arms, back, hips, legs, ribs, or shoulders
    • reddish purple lines on arms, face, groin, legs, or trunk
    • redness of eyes
    • sensitivity of eyes to light
    • stunting of growth (in children)
    • swelling of feet or lower legs
    • tearing of eyes
    • thin, shiny skin
    • trouble in sleeping
    • unusual bruising
    • unusual increase in hair growth
    • unusual tiredness or weakness
    • vomiting
    • weight gain (rapid)
    • wounds that will not heal

  • Tingling or Numbness in Your Fingers

    tingling in handTingling (paresthesia) or numbness in your fingers is a common symptom that many don’t take seriously.  It may seem mildly annoying or even funny at times.  Most people at some time have experienced that sensation when we wake up in an odd position and find that our arm is numb, dead or lifeless.  We can flail it around it and it moves as if it weren’t a part of our body anymore.  We can smack it against the wall and still, we don’t feel any pain.   In this situation, we are experiencing a nerve impingement from lying in a way that almost all nerve signals to the arm are being blocked.  Luckily, this happens rarely for most people and disappears as soon as we wake up and start moving around.   The tingling or numbness we may feel in our fingertips on cold days or possibly every day is a less severe but more permanent type of nerve impingement that many of us suffer from.

    To understand how this works, think of a nerve as a garden hose.  Its job is to carry nerve signals or water to the muscles or garden.  If we step on the hose with all of our weight, we can cut off the water or nerve supply completely.  If we step on it a little bit, we can cut off a percentage of the water or nerve supply.  Consider that our garden needs water and that completely cutting off the water supply for a long period of time will kill everything that grows in the garden.  By the same token, restricting the water supply by 50% would have effects as well.  It may take more time, but eventually the plants may grow smaller than normal, or some may die off.

    Our bodies are similar. If the nerve supply to our arm is restricted or pinched for a long period of time we may notice that the affected arm has less strength, its muscles seem smaller, and it is more prone to injury or pain than the unaffected arm.  Often people with nerve impingements may develop tendonitis (ie. tennis elbow, golfer’s elbow) before they ever notice any serious tingling or numbness.

    I can perform some simple orthopedic tests to see if you are suffering from a nerve impingement and offer a treatment plan of massage, acupuncture and postural re-education to help relieve impingements such as carpal tunnel syndrome or thoracic outlet syndrome and restore normal nerve functioning.