You are sitting at your workstation, and it's toward the end of the day. Over the last several months, you have been noticing a peculiar pain in your wrists and in part of your hands. Numbness and tingling sensations are also present. At first, the pain and numbness went away after a few hours of rest, but now the symptoms last longer. You start to worry, because now your forearms and elbows feel very sore, and your neck and shoulders ache. When you go home to prepare dinner, simple things like using a knife and opening a jar are suddenly difficult to do.
 

Carpal Tunnel Syndrome

If you suffer from these symptoms, there is a good chance that you have Carpal Tunnel Syndrome (CTS). CTS occurs when the median nerve, a major nerve of the arm and hand, is being compressed. This important nerve originates in the neck, passes underneath the collarbone, travels down the length of the arm, and into the hand. It is responsible for sensory and muscle function in the thumb and first three fingers as well as parts of the forearm.

By definition, CTS occurs when the median nerve is compressed as it passes through the carpal tunnel a small space inside the wrist that also contains the nine flexor tendons of the forearm. The most common source of compression is from inflamed, swollen tendon sheaths (coverings) which can result from repetitive finger-dependent tasks like typing, mousing, filing, and hard gripping. As the fingers are moved repetitiously, the tendons slide against one another and cause "cumulative trauma" and swelling.

THE NECK -- WRIST CONNECTION

In many cases of Carpal Tunnel Syndrome, a second source of compression occurs in the neck where the median nerve begins! Cervical vertebrae (neck bones) can misalign as a result of poor posture, bad habits like cradling a phone with your neck or sleeping on your stomach; and from previous neck trauma, like for instance, a car accident.


The neck bones can compress the median nerve and produce symptoms similar to those caused by compression of the median nerve inside the wrist!


Doctors refer to this condition as a "double lesion neuropathy," or "double crush syndrome."

Even if treatment to the wrist successfully removes nerve compression in that location, symptoms will continue to persist if nerve compression in the neck remains!

It is because of this that CTS treatment limited to the wrist and hand is often insufficient and ineffective.

Many doctors fail to examine the neck when diagnosing and treating CTS, and unfortunately, many CTS sufferers don't get the treatment that they really need!

Standard medical treatment for CTS typically consists of prescription pain blockers, anti-inflammatory medication, hand stretches and exercises, wrist splinting, ultrasound treatment, and massage. If these methods fail, cortisone injections to the wrist are usually done to reduce inflammation (does all of this sound familiar?). By this time, the treating doctor may order two diagnostic tests: a needle EMG and a nerve conduction velocity (NCV) test. These are uncomfortable procedures that measure muscle and nerve function. If it is determined that the nerve is not functioning properly, wrist surgery becomes the final option: an incision is made on the wrist, and the transverse carpal ligament a band-like ligament directly over the carpal tunnel is cut in half in an attempt to relieve internal pressure. This is a risky procedure that oftentimes results in accidental cutting of adjacent nerves in the hand. Surgery has also been known to result in scar tissue formation, which can actually make the condition worse.

So, knowing this information, what should you do? If you believe that you are developing carpal tunnel syndrome, you should seek a doctor who specializes in treating this disorder and who completely understands how neck problems relate to CTS. If you have already been diagnosed with CTS and have been receiving standard medical treatment described above with no results, you should consult this type of doctor for a second opinion.

Doctors of Executive Express Chiropractic have been successfully treating cases of carpal tunnel syndrome in San Francisco for ten years now. Our treatment takes into consideration all factors that can contribute to the pain and discomfort associated with CTS. We examine each patient for potential median nerve compression sites starting in the neck, then shoulder, elbow, wrist, and hand. Gentle chiropractic adjustments are done to these areas to realign joints and remove pressure that they may be placing on the median nerve. Massage therapists do myofascial release and soft tissue mobilization, which helps to relax stiff muscles in the neck and arms that may also be contributing to nerve compression. Neck and wrist traction are gentle procedures used to help reduce nerve pressure in these areas. We also use Cold Laser Therapy which is FDA approved to treat neck, arm, and hand pain. In addition to all this, we educate our patients on proper workstation set-up (ergonomics), exercises and stretches, proper body mechanics (posture), and diet.


Helping Office Workers in Downtown San Francisco Get Out of PAIN...

Our practice, situated in the heart of the Financial District, was designed with the busy office worker in mind. These days, most office workers rely on a computer to get their work done, whether it's data entry, word processing, programming, accounting, or internet use. Although computer usage has simplified office work, it comes with a price. It requires us to place ourselves in harmful, stressful positions that our bodies were not designed to handle. First of all, it demands prolonged sitting. Over time, this can lead to weak back muscles and disc damage to the spine. Monitors sit low and are usually placed at an angle that forces the worker to bend and repetitively turn her neck. This can cause repetitive strain injuries (RSI) to the neck and shoulders and can also subluxate, or misalign neck vertebrae causing them to compress the nerves to the arms. Desktops are frequently too high or too low, which forces the worker strain her arm, wrist, and hand muscles. Add typical office duties like repetitive filing, writing, and pulling of heavy binders and it is easy to see why many office workers in downtown San Francisco injure themselves.

Since CTS and similar repetitive strain injuries are frequently work-related, employees often report their injuries to their employers and file a workers compensation claim. Since these conditions may also be caused by popular avocations such as tennis, bowling, and guitar playing, a qualified health provider must establish causation in order for it to be considered a compensable work injury.


Our treatment approach to carpal tunnel syndrome and repetitive strain injuries is extremely popular among downtown San Francisco office workers because of its effectiveness and non-invasiveness. We do not prescribe potentially harmful medications, give cortisone injections, or perform surgery. We do, however, work with talented medical doctors in the event that such drastic measures become necessary. Most medical doctors agree that a non-invasive approach is the preferred approach in treating carpal tunnel syndrome.


At Executive Express Chiropractic, you will receive the most powerful and complete, non-invasive treatment available for this potentially devastating condition.

If you are experiencing pain or numbness, it's definitely worth your time to investigate our treatment methods. Be aware that pressure to the median nerve left uncorrected can lead to long-term nerve damage and loss of function. Don't compromise the full use of your hands. Call or e-mail us today for a complimentary consultation with one of our doctors.