Carpal Tunnel and the Shoulder

"Listen to your body".

Trigger Finger - is a tendon disorder which occurs when the tendon sheath swells so that the tendon becomes locked in the sheath and any attempts to move the finger will cause a snapping, jerking movement. Trigger finger usually strikes in the first finger and the palm side of the hand becomes inflamed.
Causes: Forceful gripping & Repeatedly grasping hard surfaces or handles
Contributing factors: Repeated contact with pressure points, age, Exposure to cold temperatures.
Symptoms: Spasms, Snapping movements, Jerking movements

Tennis Elbow is an inflammation of the connective tissue inside the elbow. I should note most of these sufferers never swing a racket or club.
Causes: repetitive tense or jerky throwing movements & Strong, forceful gripping
Contributing Factors: Work activities which require the arm for impact, sports such as golf - bowling - tennis, Improper position, Age
Symptoms: Pain, soreness, burning sensation, inflammation in the forearm

DeQuervain's Disease is a chronic inflammation of the tendon on the side of the wrist and the base of the thumb. When moving the thumb the individual will experience pain, tingling, swelling, numbness and discomfort.
Causes: Hand twisting, rapid & repetitive wrist motions, forceful gripping
Contributing factors: repetitive hand twisting, over exertion, age

Back Injuries are the most frequently injured body part and normally the result of cumulative traumas.
Causes: Improper lifting, reaching too high or too far, bending - twisting - turning activities, pushing & pulling movements, sitting & standing for prolonged periods, slips & falls
Contributing factors: improper posture and pressure on the spine, over exertion, heavy purses and briefcases, being over weight and out- of -shape
Symptoms: pain, stiffness, numbness, muscle weakness spasms, decreased range of motion.

What is Carpal Tunnel Syndrome? by:
What is Carpal Tunnel Syndrome? It is a painful condition of compression of the median nerve at the wrist. Usually the result of a decrease in the size of the carpal tunnel and/or an increase of the tunnel's contents. The carpals are the name give to the small bones in the wrist. They form an arch who's structure is supported by a very tough, fibrous ligament. The tunnel is the space create under the arch and over the ligament. The tunnel contains tendons of the hand and the median nerve. The median nerve is both the motor and sensory nerve to the thumb, index, and middle finger. Also sometimes half of the ring finger is affected.

How is Carpal Tunnel Syndrome caused? From compression of the median nerve by increasing the volume of the contents within the tunnel and /or decreasing the size of the tunnel proper. This can be caused by a combination of systemic and local conditions.
Systemic causes can be fluid retention - use of hormones - pregnancy - obesity - diabetes - thyroid disorders, rheumatoid arthritis, etc.. Local causes can be collapse of the arch structure of the wrist , fractures, dislocations, overuse, gout, osteoarthritis, scar tissue formation. Changes in occupational factors, especially the increasing use of computers throughout business and industry; are helping carpal tunnel syndrome achieve its dubious distinction as the most common cause of lost work time. While this condition was first reported almost 3 centuries ago, it is only in the last few years that extensive research on its cause and treatment has been undertaken.

Try these tests to see if you suspect Carpal Tunnel Syndrome:
Put the backs of both hands together and hold the wrists in forced flexation against each other for 60 seconds. Numbness and tingling; especially in the thumb, index, and middle fingers is an indicator.
Next bend your wrist backwards and tap repeatedly on the palm side of your wrist. Shooting or stabbing pain / or tingling into the hand { similar to hitting the "funny bone" } would be a strong sign of Carpal Tunnel Syndrome.

The most effective treatment plan will definitely involve modifying and hopefully eliminating aggravating activities; especially occupational. Ice is very important for the reduction of swelling in the wrist. Then adjustments to the wrist to normalize the arch structure. Also, adjustments to any accompanying elbow, shoulder, and neck problems. Continue to ice during the adjustment phase and add range of motion exercises {example: tracing capital letters in the air while you ice}. Evidence exists that vitamins B-6 and B-2 along with magnesium and glucaosamince sulfate may facilitate healing. Splinting is no longer recommended in most cases. IF a splint is used at all it should be very flexible support worn only at night if it's difficult to sleep. Or at work a splint is worn to function as a reminder to keep the wrist straight. Rehabilitation is started as soon as the person can stand the work. Wrist flexion and extension with dumbbells. High number of repetitions with very light weights. A very special kind of putty is used to do a series of squeezing exercises. All are geared to strengthen the supportive structures of the wrist and promote better healing.

Today vast differences in therapeutic approaches prevail among various health care practitioners. Chiropractic care provides conservative, cost effective CTS management that can prevent many patients from undergoing more radical treatment. The most radical of these: surgery, does not have a consistent recovery record. Diagnosis of CTS requires a thorough exam because there are many conditions {Thoracic outlet syndrome, trigger points in neck & shoulder muscles, cervical root lesian from disc disease} which mimic its symptoms.

Taking a comprehensive patient history, examining the involved area, and evaluating the overall musculoskeletal integrity are important keys to an accurate diagnosis. Conservative treatment options include chiropractic adjustments, nutritional supplementation, and rehabilitative exercise. Achieving and maintaining proper biomechanics throughout the body can provide relief from symptoms and prevent a relapse. You can reach Dr. Lyon at rtlxr@aol.com

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What can you say about the shoulder: by Duane Perkinson
Advancements in diagnostic procedures and technology empower today's doctors with a better understanding of the shoulder. The shoulder is relatively easy to dislocate and render unstable. I've been told the shoulder is like a golf ball balancing on a tee.
What makes the shoulder different from joints like elbows and hips? The shoulder is simply "hanging" and rotating. Technically; the head surface area of the upper arm bone is significantly greater than the point where a ball and socket unity is formed. Surrounding the upper arm bones are formations of muscles, tendons, ligaments, and cartilage. Literally this design keeps your arm bones from falling out of place. This design also gives the shoulder fantastic mobility. We can [well, some of us] hurl a baseball at 100 mph or do the breast stroke. Try that with a hip joint!

Overuse and misuse, even lack of use, lead to shoulder trouble. When muscles and tendons are excessively tight; they interfere with proper range of motion. Specific area body strengthening can prevent shoulder difficulties. Stretching is helpful for many reasons. You want to "work" the muscles in the shoulder blades that pull back or retract.{ Of course check with your doctor before starting any exercise program. And if something hurts- don't do it.}
Your mom always told you to sit up straight. Poor posture like forward head positioning doubles the force & pressure on your shoulders. If your head weighs 10 pounds and your head is held two inches forward; 30 pounds of pressure are now on your shoulders. Bio-mechanically if one part of your body is out of position; then another part of your body is experiencing greater force and pressure.

The same advance which increases our knowledge provide us solutions.
Adopt proper ergonomics in your work [you can see a basic P/C and laptop guide on our web site]. Avoid the kitchen table or hotel bed as work areas.
Implement an exercise program both at home and on the road. You can e-mail Dr. Lyon at rtlxr@aol.com for exercises we incorporate in our training programs.
Seek professional help if your body is signaling a warning {we have an online risk assessment at our web site}.
And avoid opting for an anti inflammatory like a cortisone shot as the initial treatment or answer to shoulder difficulties.