All Posts Tagged: Carpal tunnel syndrome

Factors That Can Hinder Carpal Tunnel Syndrome Recovery

As with most musculoskeletal conditions, treatment plans for carpal tunnel syndrome (CTS) advise non-surgical or conservative management initially, with surgery only in emergency situations or after non-surgical options are exhausted. Can we know who will benefit the most from non-surgical treatment?

A study conducted a two-stage analysis which included an initial evaluation followed by non-surgical treatment and a re-evaluation one year after non-surgical treatment concluded. The main aim of the study was to analyse factors contributing to the long-term effects of non-surgical treatment of CTS and to identify failure risk factors. Read more here.

The study involved patients diagnosed with CTS, of which an occupational cause was identified in (76%). Treatment included a total of ten sessions of whirlpool massage to the wrist and hand, ultrasound, and median nerve glide exercises performed at home. The subjects were divided into three age groups: <50, 51-59, ≥60 years old.

Whilst the majority of patients felt substantial progress in both stages of the study, some did not. Patients with more acute cases, as evidenced by poor results on a nerve conduction velocity (NCV) test, were less likely to respond to care, which highlights the importance of seeking early treatment for CTS as soon as symptoms develop.

Furthermore, participants who did not improve the setup of their working environments and reduce the overuse of their hands at work or who did not modify their routines to reduce the stress applied on the hands and wrist, reported much lower levels of improvements at the one-year point. Interestingly, age was not found to be a significant factor, which is surprising, as past studies have reported that being over 50 year of age is a risk factor.

Not only are Osteopaths trained in the same non-surgical treatment methods used in this study, but they can combine such approaches with nutritional counselling (to reduce inflammation) and manual therapies to improve function in the wrist and other sites along the course of the median nerve to achieve the best possible results for their patients.

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Carpal Tunnel Syndrome

An Osteopathic Approach to Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition that happens when stress on median nerve passes through the wrist creating symptoms such as weakness, tingling or numbness. Surgery usually isn’t required initially, unless there is some cause for emergency action as a result of, for example, a broken wrist. In the main, Osteopaths will recommend perusing all non-surgical practises before consulting a surgeon.

So what happens when you contact an Osteopath for CTS?

First we will qualify existing symptoms and health history. The information you proved enables us to understand more about the intensity and frequency of your symptoms. Understanding a patients history we can understand better elements that are known to contribute to an increased risk for CTS. These elements could be such as hypothyroid, pregnancy, the pill and diabetes.

Next the Osteopath will carry out a thorough inspection, most prominently of the median nerve. The median nerve comes from the spinal cord in the neck as nerve roots meander down through the shoulder, beyond the elbow through to the wrist. If at any point along this journey the nerve is compressed, a patient could possibly feel CTS-like symptoms, so it’s paramount to locate whereabouts the nerve is “pinched” in order to ensure the best possible outcome for treatment.

It can be a very complex issue as the median nerve can be compressed at several points. This can be referred to as a double or multiple crush syndrome. Furthermore, the median nerve isn’t solely the nerve that creates this sensation to the hand. When entrapped, the ulnar and radial nerves can also result in these symptoms in the hand and can be mistaken for CTS by the Osteopath because it’s the most commonly known peripheral neuropathy.

Once all the possibly contributing factors are ruled out and a patients hand and wrist symptoms are identified, the Osteopath will advise a course of treatment that may include manipulation, mobilization, therapeutic exercises, modalities, wrist splinting, and even dietary recommendations, depending on the patient’s unique situation. Sometimes anti inflammatory foods can help. The overriding aim is to reduce pressure on the median nerve by restoring normal motion in the affected joints, as well as in reducing inflammation that may be a result of a variety of causes.

While patients with more extreme cases of CTS can be aided from non-surgical approaches, like Osteopathic care, it’s important to be mindful that it may take longer for such patients to experience improvements in pain and disability, and Osteopaths may not be able to completely reverse the disease if it is too advanced. The sooner a patient seeks care, the better their chance for achieving a desired outcome.

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Carpal Tunnel Syndrome Might Be Hereditary?

Carpal Tunnel Syndrome Might Be Hereditary?

Carpal tunnel syndrome (CTS) is a problem created by compression of the median nerve that changes the nerve’s function (neuropathy), which results in pain and numbness/tingling (paresthesia) mainly on the palm-side of the wrist and hand. Hormonal changes and repetitive motions are known to increase the risk for CTS. However, it could be there is a hereditary factor involved.

Conditions that can increase the risk for CTS, such obesity, thyroid issues, diabetes, rheumatoid or osteoarthritis, can be genetic. In addition, surveys indicate that having a relative with CTS increases the risk that you may also develop the condition, but it’s not certain to what level genetic links are responsible versus shared lifestyles amongst family members.

Harvard professor Dr. David Ring and colleagues presented their results from 117 previously published studies to ascertain the strength of a “cause-and-effect” relationship for CTS using a scoring system that included both biological and occupational factors. Their analysis showed that genetic risk factors were twice as strong as the evidence supporting occupational risk factors, such as overuse.

Dr. Barry Simmons, chief of the Hand and Upper Extremity Service at Brigham & Women’s Hospital reported that 75-80% of CTS found in women age 50-55 is idiopathic, or caused by an unknown, further supporting genetics as the main factor. Dr. Ring states, though the evidence suggests genetics are a risk factor for CTS, there could well be epigenetic factors or environmental changes to genes based on diet or particular habits might increase a person’s risk beyond their genetic makeup. As of 2015, no epigenetic factors have been identified in idiopathic CTS.

On a positive, even if you have a genetic history of carpal tunnel syndrome, you can reduce your risk for developing CTS. By managing any conditions or activities that can increase inflammation along the course of the median nerve. Patients may consider maintaining a healthy weight, regular exercise, eating a low-inflammation diet and taking regular breaks from activities that require awkward or vibrating positions, for example.

If you are suffering CTS-related symptoms in the hand and wrist, a thorough examination by an osteopath can help with a solution and treatment plan. Contact of you need help with Carpal Tunnel Syndrome.

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