Carpal Tunnel Relief

Dr. Gregg Rubinstein discusses the signs and symptoms of carpal tunnel and how chiropractic care can help you find relief!

What is carpal tunnel syndrome and what are some of the causes of it?

Gregg Rubinstein:  Carpal tunnel is in the wrist. The carpal bones are a bunch of small bones that all kind of mesh together and they create these tunnels in which the nerves and the tendons and ligaments all pass through. When the tendons and nerves pass through these tunnels and there are also some blood vessels that pass through there as well, there is not a whole lot of space in there. If there’s the slightest mal-alignment syndrome with the carpal bones or the bones of the wrist, it’ll change the diameter of those tunnels and make them smaller. When the tunnels get smaller, it’ll put pressure on the arteries, veins, and nerves that are inside there. That compression on a nerve is the same thing we’ve spoken about in the past about joint dysfunction – when the spinal bones get misaligned, it’ll pinch the nerves.

Essentially, these are the nerves that are going through the wrist that are getting pinched and it’s essentially a pinched nerve in the wrist area is carpal tunnel syndrome –  the best and easiest way to describe it. Some of the things that cause it-  it’s really known as what’s called a repetitive stress injury or RSI. That can be from anyone sitting at a keyboard and typing for hours at a time. It’s common in people who play musical instruments, pianists, drummers. They are often seen in anything that has you doing the same thing over and over and over with your hands. Tennis players can see it. It’s common in a lot of people where there’s a lot of repetitive stress.

What are some signs and symptoms of carpal tunnel?

Gregg Rubinstein: Well, the most common signs and symptoms of that for carpal tunnel is usually going to be numbness or tingling in the hands, like an electrical sensation kind of shooting into the hands, pain when they put the wrist backwards into extension or when they go into flexion. All those different maneuvers will change the alignment and put more pressure in that tunnel where that nerve exists and the arteries exist. Any time you compress or make the hole where those nerves pass through smaller, you’re going to get pressure on the nerves. Any time you have pinching or irritation to the nerves, pain, numbness and tingling are going to be the primary signs that you’re going to see.

How do you know the difference between carpal tunnel, arthritis and tendonitis?

Gregg Rubinstein: Well, those are really good questions. The difference between arthritis, arthritis is very often going to be bilateral. If it’s rheumatoid arthritis, you’ll see it on both sides. Carpal tunnel most often will usually start on one side and not necessarily affect both sides. The real way to do it is what’s called differential diagnosis. What you’ll do, there are certain orthopedic and neurological tests that put the hands in certain positions. If you put it in this position and it’s a positive test and they feel like an electrical shock going into their hand, you can pretty rest assure, know that that sign is indicative of carpal tunnel.

There are other signs that are just indicative of arthritis which is more of like a general achiness and pain, tends to be worse at night. Carpal tunnel might be worse during the day when they’re actually engaged in the activities. Then, tendinitis, actually when the tendons that pass through the tunnels get inflamed, because ‘itis’ means inflammation that can actually create carpal tunnel. Those two conditions can actually go hand-in-hand because you’ll see swelling and inflammation of the tendons as they pass through the tunnels. Again, tendinitis is very often associated with over-use syndrome so it’s very difficult to differentiate those two because sometimes those two can actually be linked and related to each other. Then, another great way to determine the difference is to use your advanced imaging, your x-rays and MRI’s and CT scans. You’ll be able to determine that by looking for certain signs and symptoms that you’ll associate with those x-rays or MRI studies.

Are there non-surgical treatments available to help correct carpal tunnel syndrome?

Gregg Rubinstein: There absolutely are. One of the most important things is figuring out, well, if you have carpal tunnel syndrome, trying to avoid the actual situations or the repetitive stresses that cause it or contribute to it. You can back off of those and then the swelling and inflammation goes down. It creates more room in the tunnel and some of those cases can resolve just by eliminating the activity that caused it. You know what? It’s not so easy because someone who plays drums for a living or plays piano or is a legal secretary is going to have to use their hands repetitively no matter what because that’s their job.

There are certain things that you can do. There’s cock up splints that kind of splint the hands and put them in better positions to keep those tunnels more open. There’s also many doctors of chiropractic who can do manipulation to the joints of the wrist to help realign the carpal bones and create a little bit more space. Those are the really the non-surgical ideas that are most natural. Then, there’s always drug therapy, anti-inflammatory therapy for cases that don’t respond to manual therapies and non-surgical treatments. There are other options to consider before actually going and having the surgery.

How can the treatment for carpal tunnel syndrome also benefit a patient’s overall health and wellness?

Gregg Rubinstein: Well, one thing is the mental component because if you’re in pain and you’re uncomfortable, your attitude’s going to be a little different. It might not be as pleasant as it normally would if you’re suffering and you’re having discomfort. Just having a positive attitude towards things is going to help your overall health and wellness because we all know that stress and worrying and things aren’t going to have a positive effect on our health. Treating carpal tunnel syndrome in my office also requires making sure that there’s no pressure building up in the neck. There’s one theory about carpal tunnel that talks about a double crush syndrome –  meaning that there’s pressure actually occurring in the tunnel in the wrist but also pressure from the neck. Basically those nerve impulses kind of ping pong back and forth between the wrist, neck and shoulder and go back and forth.

In a chiropractors office, if we’re going to be doing manipulations and working on the wrist, we’re also going to be working on the neck and by clearing pressure off the neck and spine, keeping your nerve system clearer and free from interference, your body is overall going to function better because your nerve system is functioning better, understanding that the nerve system is the master system controlling every other system in your entire body including your immune system. The better your nerve system functions, the better your immune system functions, the less likely you’re going to be sick and your body is going to function at higher levels and be quicker to adapt to make the body actually healthier. It’s really important but it just comes as a general side effect of actually seeing a chiropractor and getting your spine adjusted and removing any interference of the nerve system at all.

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