Many people have heard of carpal tunnel syndrome and assume that any tingling in the hand is carpal tunnel syndrome. But what actually is carpal tunnel syndrome, and what causes it? First, let’s break down the anatomy involved with the carpal tunnel itself. The carpal tunnel is a tunnel located in your wrists. On one side are the eight carpal bones, or wrist bones. These bones make a sort of archway. Connecting the base of the arch is what’s known as the flexor retinaculum. This is a thick fibrous band that changes the arch into a tunnel. Inside that tunnel is a nerve known as the median nerve. It innervates the thumb, index finger, middle finger, and half of the ring finger. Along with the median nerve, there are nine tendons in the carpal tunnel: four from the flexor digitorum superficialis muscle, four from the flexor digitorum profundus muscle, and one from the flexor pollicis longus muscle. That’s a lot of structures for a small space. Carpal tunnel syndrome occurs when there is inflammation within the carpal tunnel, compressing the median nerve. This compression can cause a decrease in sensation in the three and a half fingers that the nerve innervates. It can even cause weakened grip strength, leaving the patient feeling like they’ll drop things like their cup of coffee or a dinner plate.
Common treatments include stretching, exercises, deep tissue laser, shockwave, and even surgery. Over half a million surgeries are performed in the US on a yearly basis. The surgery is a simple cut across the flexor retinaculum to relieve pressure on the median nerve. The downside is that once cut, this retinaculum never grows back or returns to normal.
Although common, carpal tunnel syndrome is extremely overdiagnosed due to poor diagnostics. Many patients will see a provider and get a carpal tunnel diagnosis without ruling out other common conditions with similar symptoms. Conditions like cervical radiculopathy, thoracic outlet syndrome, and other nerve entrapments can all present with symptoms similar to carpal tunnel syndrome. Without a proper examination, misdiagnosis is common, leading the patient to months of frustrating treatments that don’t work and even unnecessary surgery. With a proper diagnosis and proper treatment, patients see great results!
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How Our Care Plan Works
1. Better
No matter where you start, we can improve together. The first phase focuses on making progress in your current ailments. Typically, this means alleviating pain and helping you return to your daily activities as smoothly and quickly as possible.
2. Stronger
Now that you’ve made progress, how do we KEEP it? We’ve all experienced improvements, only to regress when our focus shifts. This phase empowers your body to sustain the hard-earned progress you’ve worked so diligently to achieve.
3. Healthier
True HEALTHcare! So often, we are only concerned with our sickness and dysfunction, seeking treatment only when we experience symptoms. This is SICKcare. During the healthier phase, we focus on your overall health and maintaining your well-being.
How We Treat Carpal Tunnel in Fuquay-Varina, NC
Carpal Tunnel Syndrome is a major problem for a lot of people and can really prohibit movement and comfort. Chiropractic care can help pinpoint the issue and make corrections to resolve the pain completely.
Comprehensive Consultation and Exam
When a new patient presents to Pinecrest Chiropractic with potential carpal tunnel syndrome, we start the same way we start every new patient appointment. We go through a thorough consultation, listening to every symptom you’ve experienced and how this is impacting your life. We follow that up with a movement screening and examination. We need to look at multiple structures, including the wrist, elbow, shoulder, and neck. Any one or multiple of these joints could be leading to the symptoms a new patient is experiencing.
Specific Chiropractic Care in Fuquay-Varina, NC
At Pinecrest Chiropractic, chiropractic care is a top choice for patients looking to treat carpal tunnel syndrome. We have the ability to treat all of the structures involved. First, we can adjust the joints of the wrist. There are eight carpal bones that arch together to create the carpal tunnel. If any one of these joints isn’t moving properly, the likelihood of carpal tunnel drastically increases. So, the first thing we will do is adjust these joints to return proper motion to them. Second, we can treat the other structures that run through the carpal tunnel. There are nine tendons that run through the carpal tunnel. If any one of these tendons (or the muscles that attach to the tendons) is tight or inflamed, it can cause carpal tunnel symptoms. We can correct this with a few different modalities, but the top two are dry needling and shockwave therapy. These are not only performed on the wrist itself, but also on the muscles farther up the arm. Lastly, we will want to treat the nerve itself. The top two ways to treat the nerve are through shockwave therapy and laser therapy. Laser specifically forces blood flow and increases oxygenation into the nerve itself. Shockwave will break down tissue, creating an inflammation response and forcing more healing in the area. Lastly, we will finish with home exercises, helping you correct the mechanical imbalances that contributed to the flare-up in the first place.
Mixing all of these treatments together gives you the best chance at success, not just for the short term, but for long-term changes as well.
Custom Therapeutic Exercise Plan
All nine of the tendons that go through the carpal tunnel help with wrist and finger flexion (making a fist). For many people struggling with carpal tunnel, the cause is inflammation or tension in those muscles or tendons. A custom exercise plan will help strengthen those muscles and tendons to decrease the inflammation in the carpal tunnel. Each plan is different, but almost all include gentle stretching of the muscles followed by progressive strengthening. Every patient gets access to their plan through our application and through their email so they have video copies of each exercise.
Soft Tissue Work
Soft tissue work is extremely helpful and common when treating carpal tunnel. Carpal tunnel syndrome almost always has some component of muscle and ligament inflammation and damage. This is where soft tissue work comes in. There are many different types of soft tissue work, including shockwave, laser (both discussed below), dry needling, and IASTM (instrument-assisted soft tissue mobilization). Dry needling is performed with a thin, solid needle inserted directly into the muscle belly. What this needling does is create an inflammatory cycle directly in the muscle and tendon where the needle is inserted. This inflammatory cycle means that for the next two to three days following treatment, your body will work through the healing process, clearing away the inflammation and tension.
Instrument-assisted soft tissue mobilization (IASTM) uses a stainless steel tool to scrape the muscle and fascia. We often joke that the tool looks like a fancy butter knife, and it is scraped along the muscle belly, breaking down the scar tissue, allowing the body to heal the area correctly.
Deep Tissue Laser
Deep tissue laser is the best way to treat all of the involved tissues that can cause carpal tunnel syndrome. As discussed, there are many things that run through the carpal tunnel and can contribute to the symptoms. An inflamed median nerve, inflamed tendons, or generalized swelling can all cause carpal tunnel syndrome, and all can be treated with deep tissue laser.
The deep tissue laser works through a process called photobiomodulation. This is the technical way of saying that light is used to create a metabolic change in the tissues. Infrared light is used and will penetrate 2-3 inches deep into the tissue, which will increase mitochondrial production, making more ATP, as well as increase oxygenation and circulation. All of this is the process by which our body naturally heals itself, using energy (ATP) to bring in more blood flow and circulation.
Shockwave Therapy
When carpal tunnel syndrome is primarily caused by the tension and inflammation within the tendons in the carpal tunnel, shockwave is the best modality to implement. Shockwave works by using pressure and sound to penetrate into the tissues. This buildup of pressure is directed using a hand-held device, operated by one of our staff members, which directs the force into a specific location. It feels like a mix between a TENS unit and a massage gun. With this, you can feel an immediate change in the tissue tension, melting away those trigger points and creating an opportunity for our body’s natural healing process to take over. This is focused on the forearm, where the muscle tension originates. Patients often notice an immediate difference in symptoms.
Common Causes of Carpal Tunnel in Fuquay-Varina, NC
Pregnancy
Carpal tunnel syndrome is a common side effect of pregnancy. This happens due to the increased swelling throughout the entire body. For many women, the swelling gets so severe in the wrist that it starts to pinch the median nerve, causing carpal tunnel syndrome. Even though it usually resolves postpartum, the symptoms may be severe enough to treat during pregnancy. Treatment during pregnancy is very similar to treatment for patients who are not pregnant, with the only difference being the use of deep tissue laser. With adjustments, stretching, and shockwave therapy, symptoms can be greatly reduced or completely alleviated during the remainder of the pregnancy.
For the few patients whose carpal tunnel syndrome develops during pregnancy and doesn’t self-resolve postpartum, we treat in a similar way, looking to decrease the inflammation and remove the repetitive actions that are flaring up symptoms.
Manual Labor
Carpal tunnel syndrome is common in people who regularly work with their hands, especially in repetitive motions. This may include painters, construction workers, carpenters, manufacturing workers, and even some healthcare workers. Repetitive motion and vibration are two of the biggest culprits with these employees. Just like every other patient who presents with similar symptoms, we start with a comprehensive exam. Once diagnosed, treatment includes the same modalities, but will focus more on finding ways to modify or better support the repetitive motions causing the symptoms and flare-ups.
Desk Workers
Desk workers are similar to those listed in the manual labor category. These symptoms come from the repetitive motion of typing. The repeated flexing of the fingers can create tension and eventual inflammation within the muscle bellies of the forearms and the tendons that run through the carpal tunnel. Once again, finding ways to decrease the inflammation and treat the cause of the symptoms is the key to seeing symptoms alleviated.
How to Avoid Carpal Tunnel Surgery in Fuquay-Varina, NC
Proper Diagnosis
The number one way to avoid carpal tunnel surgery is with a proper diagnosis. Around half a million carpal tunnel release surgeries are performed in the US every year. The idea with a carpal tunnel release surgery is to cut the flexor retinaculum, which is the “roof” of the tunnel. By cutting this, the surgery decreases the pressure on the median nerve at the wrist. The problem is that if the median nerve is compressed at any point (in the neck, in the shoulder, in the elbow, etc.), it creates swelling along the entire nerve. So a nerve compression in the neck can cause the nerve to swell in the carpal tunnel, creating carpal tunnel symptoms. In this example, the issue isn’t with the wrist, so performing surgery on the wrist limits the recovery and doesn’t fix the real cause. A proper diagnosis is the first step to recovery.
Conservative Treatment
At Pinecrest Chiropractic, the second way we help patients avoid carpal tunnel surgery is with conservative treatment. Conservative treatments boast a 70% success rate with carpal tunnel. These treatments include exercises, stretching, rehabilitation exercises, deep tissue laser therapy, and shockwave therapy. Even if conservative treatment fails, just by trying conservative treatment first, you increase the success rate of the surgery. So conservative treatment first is almost always a great option.
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609 Attain St #141, Fuquay-Varina, NC 27526
Frequently Asked Questions About Carpal Tunnel
Can chiropractors in Fuquay-Varina, NC help with carpal tunnel?
Yes. Pinecrest Chiropractic regularly and successfully treats carpal tunnel syndrome.
What exercises can you do when you have carpal tunnel?
Median nerve glides are one of the best and most common exercises for carpal tunnel syndrome.
How do I permanently get rid of carpal tunnel?
Permanently getting rid of carpal tunnel syndrome starts with identifying what was causing the flare-up. Once we identify this, we can treat the symptoms and work to make changes to what caused the flare-up in the first place.
Is a hand massage good for carpal tunnel?
A hand massage may be helpful for initial symptoms of carpal tunnel syndrome. Massage can decrease the tension on the muscles and tendons that pass through the carpal tunnel.
What aggravates carpal tunnel?
Compression of the median nerve is the cause of carpal tunnel syndrome, most commonly due to inflammation. It’s often made worse by repetitive movements, especially those requiring wrist and gripping motions.
Do cortisone shots help with carpal tunnel?
A cortisone shot may help with the symptoms of carpal tunnel syndrome for the short term. Symptoms may change, but it has done nothing to treat what was actually causing the carpal tunnel syndrome itself, so symptoms will most likely return in a few weeks or a few months.
What’s the best thing to do for carpal tunnel?
The best thing to do for carpal tunnel syndrome is to seek guidance from a professional on finding ways to modify movements and treat the underlying condition.
How do chiropractors in Fuquay-Varina, NC help with carpal tunnel?
At Pinecrest Chiropractic, we will attack carpal tunnel syndrome from every direction, utilizing every tool we have at our disposal.
How can I prevent my carpal tunnel from getting worse?
You can prevent carpal tunnel syndrome from progressing by modifying the things that seem to flare it up the most.
$99 New Patient Special
Includes consultation, exam, doctors report of findings, PosturePro analysis, and first adjustment.
