Monday, January 13, 2014

CTS, Exercise, and Chiropractic | Yankton Chiropractor | Brian Olson, DC


Carpal Tunnel Syndrome (CTS) is a condition characterized by numbness, tingling,
and/or pain located on the palm side of the wrist, hand and into the index,
third, and half of the ring finger. It’s caused by pressure exerted on the
median nerve as it passes through the “tunnel” located in the wrist. The “floor”
of the tunnel is a ligament while the “walls” are made up of eight small carpal
bones that lock together in the shape of a tunnel. There are nine tendons
(tendons attach muscles to bones allowing us to move our fingers), sheaths
covering the tendons, blood vessels, and the median nerve that ALL travel
through the tunnel, so it’s packed pretty tight. ANYTHING that increases the
size of any of these structures or anything “extra” that shouldn’t be there can
increase the pressure inside the tunnel, pinch the median nerve, and result in
the classic numb/tingling symptoms that wake people up at night, or interfere
with work or driving.

In the Unites States (US), about 1 out of 20 people will suffer from CTS.
Caucasians have the highest incidence rate and women are affected more than men
by a 3:1 ratio between ages of 45-60 years old. Only 10% of the reported cases
of CTS are under 30 years old. Occupational CTS (as of 2010) affects 8% of US
workers with 24% attributed to manufacturing industry jobs. This equates to
approximately 3.1 million cases of work-related CTS in 2010. The risk of
developing CTS increases with age, diabetes, hypothyroid, pregnancy, taking
birth control pills, having an inflammatory arthritis, being obese, pinched
nerves in the neck, thoracic outlet, elbow, and others. Therefore, managing CTS
requires a thorough evaluation in order to assure accuracy in the diagnosis.
With this background information, let’s look at the question, WHAT CAN YOU DO TO
HELP CTS? One answer is, don’t age – good luck with that! In addition to keeping
your weight under control, exercise can be VERY effective and YOU can be in
charge of that process, but we have to teach you the exercises.

1)  The Carpal Stretch (“nerve gliding”): Place your palm on the wall near
shoulder height with the fingers pointing down at the floor and press the palm
of the hand flat on the wall. Lastly, reach across with the opposite hand and
pull your thumb back off of the wall and hold for 5-15 seconds.
2)  The Wrist Extensor Stretch: Do the same as #1 but place the back of the hand
on the wall in front of you, again fingers pointing downward. Here, there is no
need to stretch the thumb.
3)  The “Bear Claw”: Make a fist and then open up the hand. Keep the small
finger joints flexed while extending the knuckles at the base of each finger
straight (not bent). Repeat 5-10x.
4)  Putty Squeeze: Simply squeeze putty in your hand for two to five minutes
until fatigued.
5)  Yoga has been shown to reduce pain and improve grip strength in CTS
patients!
Now the question, “…can these exercises prevent surgery?” The answer is “maybe.”
They certainly help in some cases, but a multi-dimensional treatment plan is the
BEST approach. This includes:  1) Chiropractic manipulation of the hand, wrist,
elbow, shoulder, and neck; 2) Soft tissue “release” techniques of the muscles in
the forearm, upper arm, shoulder, and neck; 3) Cock-up wrist splint to be used
at night, and in some cases, at times during the day; 4) Ergonomic management of
your work station or situation (to minimize repetitive insult to the area); 5)
Nutritional support that may include an anti-inflammatory diet and nutrients
(vitamins, minerals, herbs, etc.), and 6) Managing any contributing conditions
like diabetes, hypothyroid, and/or the others. Here’s the GOOD NEWS:
CHIROPRACTIC can manage these six steps, though some cases will require
co-management with primary care and/or specialist.

We realize you have a choice in whom you consider for your health care provision
and we sincerely appreciate your trust in choosing our service for those needs.
If you, a friend, or family member requires care for Carpal Tunnel Syndrome, we
would be honored to render our services.  Visit www.olsonchiropracticcenter.com for more information.

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