Monday, December 13, 2010

Carpal Tunnel Syndrome Conservative Treatment Options?

As I continue my review of other chiropractors and their blogs, I came across Livonia Chiropractor Kevin Venerus, D.C.  In his article Carpal Tunnel Syndrome - Conservative Treatment Options? he reviews common presentations, causes and treatment for the non-surgical management of Carpal Tunnel Syndrome (CTS).

Dr Venerus points out that most CTS sufferers present with a complaint of pain and or numbness/tingling in the palm side of the hand.  

Dr Venerus states that the cause of CTS is most often a history of prolonged wrist use in full flexion or extension.  Other, less frequent causes can be cysts, fractures, dislocations, fluid retention, rheumatoid arthritis, diabetes, and connective tissue disorders.

Here is where I will interject.  Carpal Tunnel Syndrome is defined as pressure on the median nerve.  The median nerve is the nerve that goes through the wrist into the hand.  

Place your hand so your palm is up.  In this position the bones of the wrist form a flat bowl like shape - this is the bottom part of the tunnel.  A ligament goes across the top from left to right across this bowl.  This is the top of the tunnel.  Nerves, blood vessels and tendons go through this tunnel into the hand and fingers.

In my experience most cases of wrist and hand pain are NOT CTS.  How do I come to that conclusion?  Because there is no pressure on the nerve.  How do I know that?  Direct pressure on any nerve will limit the impulses in that nerve.  If nerve impulses are decreased the muscles that the nerve goes to will ATROPHY.  Atrophy is a withering of muscle.  So if you really have CTS the muscles in your palm, especially those below the thumb will be smaller and weaker.  If that's the case with you - there's a good chance you really do have CTS.

Another thing Dr Venerus does not point out is that the carpal tunnel is only one of four places where this nerve can be impinged.  The others are the forearm, shoulder and neck.

Here's a video that shows a simple test for CTS.

As for treatment in his Livonia Chiropractic clinic, Dr Venerus suggests B Complex vitamins, ultrasound, and adjustments.  He also points out a patient satisfaction study that appeared in the Journal of the American Medical Association.  In this study they found that almost 1/3 rated their satisfaction as "poor."  

Kevin Venerus, D.C.
10988 MIddlebelt Rd
Livonia, MI 48150

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