Hello, everyone! This is Dr. Bob Salamon with Lowcountry Chiropractic. I hope you are doing well and staying healthy! Winter is well and truly among us here in the Lowcountry, as evidenced by frosty windshields in the morning and nearly freezing temperatures at night. While these lower temperatures mean we might have to bundle up to stay warm, they mean something different for those who suffer with carpal tunnel. Carpal tunnel syndrome is a form of entrapment neuropathy, which is a “condition in which a nerve becomes compressed, or entrapped, between two other structures in the body… Repetitive motion can cause the ligament and bone to press or rub against the nerve.”
The median nerve, which passes through the wrist into the palm-side of our hands, is what is being compressed. (And the passage this nerve takes is, somewhat obviously, known as the carpal tunnel.) This nerve is responsible for almost all sensation in our hands and fingers, as well as our dexterity. When our wrists swell, due to overuse or a host of other factors, this nerve is compressed. Those with carpal tunnel syndrome experience weakness, numbness, tingling, and pain in their wrist and hand. It is possible to have carpal tunnel syndrome in one hand, but not the other. About 2.7% to 5.8% (or between 4 and 10 million) adult Americans deal with carpal tunnel syndrome. Usually, this syndrome is diagnosed in those between the ages of 30 and 60. If you have diabetes, high blood pressure, or arthritis, you are predisposed to developing carpal tunnel as well. Likewise, if you have a job which requires repetitive movements (such as assembly lines, keyboarding, construction, etc.), you are predisposed to developing carpal tunnel.
Winter can be a tough time for those who suffer with carpal tunnel syndrome, as winter conditions are known to exacerbate CTS. A study investigating the seasonal prevalence of carpal tunnel syndrome revealed higher rates of CTS diagnosis during winter months (50.8%), the lowest rate during summer months (38.9%), and equal rates during both spring and autumn (43.5% and 42.8%, respectively). These figures suggest temperature does play a significant role in the flare up of carpal tunnel symptoms. If you have carpal tunnel syndrome, you might notice an uncomfortable stiffness when your hands are exposed to the cold, increased numbness, or difficulty performing tasks. Sometimes, the median nerve can send pain signals up through the arm, neck, and even back. Similar to those with joint pain, those with carpal tunnel syndrome must take great care to stay warm during winter. Similarly, because colder temperatures can slow our blood flow, staying active is important.
For those suffering with carpal tunnel this winter, it’s recommended you wear the proper external gear, including gloves or mittens. If you are going to spend prolonged periods outdoors, you should keep hand warmers in your pockets. To combat stiffness, try stretching your hands regularly. Nothing fancy. Simply bending your fingers back towards your wrist as far as is comfortable and holding for ten seconds is enough. It’s important to take regular breaks when performing tasks with your hands, including cooking and typing. When you experience pain, twinges of numbness, or tingling, you should always stop whatever you’re doing. Continuing to work through the pain is counterproductive and could worsen your condition. If your carpal tunnel is triggered by an underlying medical condition, focus the bulk of your energy on addressing the root issue. If you’ve just come inside from a day spent in the cold, you might soak your hands in warm water or take a warm bath to stimulate blood flow.
Carpal tunnel syndrome is a progressive condition, which means—If you do not isolate the cause, your condition will steadily decline. A full deterioration of carpal tunnel syndrome could mean limited use of one’s hands, nerve damage, and pain. That’s why it’s crucial to seek medical care as soon as you suspect you might have carpal tunnel syndrome. The most common treatments for carpal tunnel syndrome include lifestyle modifications, oral corticosteroids, and wrist splints. The lifestyle modifications seek to cut out whichever repetitive task has triggered the inflammation putting pressure on your median nerve to begin with. Identifying this action shouldn’t be too difficult, as your pain will flare up most notably whenever you try to do this task. The oral corticosteroids are another means of targeting and suppressing your body’s inflammatory response. Finally, a wrist splint is intended to keep your wrist in a neutral position, which—in addition to helping heal inflammation—limits the amount of pressure placed on the median nerve. You might try intermittent icing and heating, as well, to bring down any swelling.
Now this first-line of treatment can be met with positive or not-so-positive results. If the initial condition does not improve, the next line of therapies may include local corticosteroid injections into the affected wrist. Non-steroidal anti-inflammatories, diuretics, and vitamin B6 might also be used to address inflammation. Ultimately, if nothing else works, open or endoscopic surgery might be recommended. Now, very few people are eager to undergo surgery and the vast majority of us would like to avoid going under the knife at any cost. That’s why I’m here to discuss alternative, noninvasive treatment methods for carpal tunnel. While surgery is sometimes the only path towards healing, it should remain a last resort. There are a few options you might also try before undergoing a surgical evaluation for your carpal tunnel syndrome.
Now, if you haven’t already been diagnosed with carpal tunnel, one of the first things you’re going to want to do is take part in a nerve conduction study. A nerve conduction study is a test which isolates the exact point at which the nerve is being impinged. Why is this important? Because carpal tunnel syndrome is caused by the compression of the median nerve at the carpal tunnel. If, indeed, your condition is being caused by the compression of a nerve elsewhere (say, the elbow or the cervical spine), then you’ll need different treatment. I’ve had patients come into my office who underwent surgery for their carpal tunnel and saw no difference afterwards because they were misdiagnosed. They never had carpal tunnel at all!
After your nerve conduction study, if your condition is being caused by a nerve compression somewhere other than the carpal tunnel, then you may respond excellently to chiropractic care. The main purpose of chiropractic care is to resolve subluxations. Subluxations are instances where a bone misalignment has caused a nerve to become compressed and, thus, irritated. A chiropractor can adjust the elbow, can adjust the neck, can even adjust the wrist (although if you’re experiencing swelling there, this might not be advised). A chiropractor can adjust any part of the body with joints (including, but not limited to: hands, feet, fingers, toes, legs, arms, backs, and necks). An adjustment of the wrist may be necessary, in the event your nerve conduction study reveals you are suffering from carpal tunnel syndrome, since carpal bones can potentially be pressing on your median nerve and contributing to your condition.
Therefore, your best bet when initially treating your carpal tunnel is to see a chiropractor. Chiropractic care is safe, noninvasive, and requires next to no downtime. If your first stop for treating your carpal tunnel is a doctor, you’ll probably follow a treatment route similar to what’s outlined above. There’s nothing wrong with such a treatment plan, but to give yourself the best chance at a pain-free life, definitely add a chiropractic appointment to the mix. If you reach out to us at Lowcountry Chiropractic, we’d be more than happy to formulate a plan for your treatment. You can schedule an appointment on our website, email, or call. I would love to perform an initial exam, speak to you about your condition, and begin working towards your pain-free future together.
Before I leave you, I would like to make note of one more thing. Lowcountry Chiropractic is hosting a food drive this December! That’s right! All food will be donated to the Lowcountry Foodbank. If you bring in five non-perishable food items, we will provide you with an exam, consultation, and x-ray for free. This package is valued at $191, but they are free to new patients! If you’re an existing patient and you refer a new patient to Lowcountry Chiropractic, you’ll receive five raffle tickets. Likewise, if you donate five nonperishable items, you’ll receive one raffle ticket. (Only five tickets per person.) The prizes available in this year’s raffle include a 50” flat screen TV; two $50 Walmart gift cards; and two one-hour massages. Make sure to bring in any items before December 22nd. We hope you’ll participate in this year’s food drive! If so, we’ll see you soon! Thank you for reading!
Hello, everyone! This is Dr. Bob Salamon with Lowcountry Chiropractic. I hope you all are doing well and staying well. Surely, we’re all recovering from indulging in our favorite Thanksgiving treats last week. As we move deeper into the holiday season, many of us are searching for ways to give back to our shared community. Before we dive into today’s topic, I’d like to take a moment to share an opportunity to give with you. This year, Lowcountry Chiropractic is hosting an Annual Christmas Food Drive! When you refer a new patient to our office, you’ll receive five tickets for a raffle prize drawing. This new patient will receive a complimentary consultation, exam, and x-rays—all of which are valued at about $191.00, free of charge. All they have to do is bring five non-perishable food items! If you have no friends or family to refer, bring five non-perishable food items down to our office in exchange for a single ticket. You can repeat this up to five times (per person). The prizes on the line include one 50” flat screen TV, two $50 Walmart gift cards, and two one-hour massages. Prizes will be awarded one per person. All food items will be donated to the Lowcountry Food Bank. Make sure you have those non-perishable items to us or have the new patient scheduled before December 22nd, 2021! We look forward to seeing how much food we are able to collect this holiday season for the benefit of our community and we hope you’ll help us!
Today, we’re discussing how chiropractic care can be used as a preemptive measure to lessen the need for surgery. Chiropractic care can be used, in specific instances, to help the body heal and alter the trajectory of an existing ailment, thus precluding the need for surgery. However, there are ailments which can only be rectified through surgery and therefore, regardless of the information shared here today, you should consult with your doctor about the full range of treatment options available to you. That said, no one wants to undergo surgery, for a multitude of reasons. Surgery often entails taking time off from work or school. First, to undergo the procedure. Then, to recover. Invasive procedures are often painful and require patients to consume medication to cope with discomfort and lessen the risk of infection. Even skillfully performed surgeries are likely to leave some kind of scar. For some, the cost associated with surgery is enough to ward them off seeking treatment for their ailment, which only leads to their worsened condition. In this regard, at least, chiropractic care presents an opportunity for individuals to not only manage their existing pain, but also work towards a pain-free future, without surgery.
It’s also important to note: Any reputable chiropractor can assess whether an injury or condition is truly treatable through chiropractic care and will refer you to a specialist or surgeon when necessary. This is merely an aspect of the duty of care between a chiropractor and their patient. While the goal is to reach a patient’s physical goals in the most minimally-invasive manner, when a surgical procedure is the only means of progressing, a chiropractor should do their best to work in tandem with the surgical team to ensure their patient receives the best care during and after their procedure.
Now, to understand why chiropractic care might be presented as an alternative, we must first understand how surgery could be considered the first option to treat musculoskeletal issues. Truthfully, many patients respond to joint or back pain by visiting their primary care doctor. Depending on the doctor, they may refer the patient to a chiropractor or an orthopedic surgeon. If the latter, then we have a clear explanation for why surgery would be the go-to option. Orthopedic surgeons, like chiropractors, seek to treat musculoskeletal issues. However, their mode of practice relies on invasive techniques.
For example, if a patient is suffering from a frozen shoulder, an orthopedic surgeon might recommend rotator cuff surgery. This surgical procedure involves shaving off any bone spurs which might be pinching the nerves in the shoulder and reattaching any tendons or ligaments which have torn. Rotator cuff surgery might be preceded by rest, nonsteroidal anti-inflammatory medication, stretching exercises, or steroid injections. Rotator cuff surgeries are often followed by several months of recovery and rehabilitation. As well, the surgery is associated with a risk of developing complications such as excessive bleeding, infection, and blood clots within the legs and lungs. Finally, even after the surgery, this is a chance the patient will not recover full range of motion in their shoulder joint and will continue to struggle with weakness or pain.
On the other hand, in the same instance of a patient presenting with a frozen shoulder, a chiropractor’s response would be completely different. Chiropractic care is based on manual manipulation of the body’s soft tissues and a handful of other noninvasive techniques. Therefore, a plan would be developed spanning a range from one to six months. During this time, the patient would receive chiropractic adjustments to relieve any subluxations within the spine or neck (which may be contributing to an irritated nerve connected to the shoulder). Similarly, the patient would receive regular massages, with a therapist skilled at expressed deep tissue lesions. The patient might be given a daily physical therapy regimen to follow at home, which serves to help rehabilitate the muscles within the shoulder slowly, over time. Some chiropractors offer laser therapies, electronic stimulation, dry needling, and more. All of these elements combine to give the patient’s body its best chance at healing itself. While surgeries often purport to be cure-all, chiropractic care never claims to cure anything. Rather, chiropractic care is always offered as a means by which the body can be cajoled and stimulated into healing itself.
A study published in Spine journal in 2013 revealed an interesting correlation between the first medical provider a patient visits and their resulting medical care. During this study, construction workers in Washington State who’d filed disability claims for back injuries were the object of fascination. According to the results of the study, 42.7% or nearly half of the workers who visited a surgeon first ended up undergoing surgery to resolve their back injury. Meanwhile, only 1.5% of the workers who saw a chiropractor first ended up undergoing surgery. We might infer from such a significant gap in percentages that many of those surgeries were conducted out of convenience rather than necessity. Likewise, we might also infer, it’s beneficial for those seeking to avoid surgery to see a chiropractor before a surgeon. In regards specifically to back pain, chiropractic care can yield a “significant reduction or elimination” of pain.
Chiropractic care can be used to treat sports injuries, shoulder pain, hip pain, whiplash, headaches, vertigo, plantar fasciitis, sciatica, disc injuries, and much more. Instead of using the type of injury to determine whether surgery or chiropractic care is better, you’d be better served by evaluating your unique needs. How long are you willing to dedicate to the healing process? What risks are associated with the recommended surgery? In comparison, what risks are associated with attempting to treat your injury with chiropractic care first? Are there any financial limitations weighing on your decision? What are your values as an individual? You must take each of these factors into consideration when choosing between surgery and chiropractic care.
In recent years, we’ve seen the true cost of the opioid epidemic. A meta-analysis and systematic review conducted in 2019 revealed patients who visited a chiropractor for their musculoskeletal pain conditions were “49% less likely to receive an opioid prescription than their counterparts who went to other healthcare providers.” The numbers don’t lie—that’s nearly half of the patients who sought chiropractic care. After surgery, intense pain medications present a challenge for those who are predisposed to addiction. As well, surgical complications which lead to prolonged discomfort can result in an unintended dependency upon these prescription drugs. If you’re a recovering addict or have a history of substance abuse in your family, chiropractic care offers a way around the medications necessary for highly-invasive surgeries.
At the end of the day, as a chiropractor, my one and only concern is the health and wellness of my patients. It’s possible to use a combination of chiropractic care and surgery to achieve optimal results. One aspect of my job is assessing what’s best for my patients and working with my patients to tailor a treatment plan which helps them live pain-free. Of course, I hope you’ll consider chiropractic care as an alternative or preemptive measure to surgery. And, if you do, I hope you’ll reach out to us here at Lowcountry Chiropractic. Give us a call or shoot us an email and we’ll respond as soon as we’re able. Remember: I’m Dr. Bob and I have your back covered! Until next time, thank you for reading!
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