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Carpal Tunnel Syndrome


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A summary of Chiropractic and Acupuncture treatment for Carpal Tunnel Syndrome provided by Dr. Kirk Johnson of Johnson Chiropractic & Acupuncture P.A.

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Carpal Tunnel Syndrome

  1. 1. Carpal Tunnel Syndrome The Chiropractic and Applied Kinesiology Treatment
  2. 2. Chiropractic Overview <ul><li>Chiropractic is a branch of the healing arts that believes in the bodies ability to heal from within, without the use of drugs and surgery. </li></ul><ul><li>Chiropractic care utilizes specific adjustments to the skeletal system to reduce nerve interference and restore normal biomechanics to the area of dysfunction. </li></ul>
  3. 3. Applied Kinesiology Overview <ul><li>Applied Kinesiology (AK) is a specific technique that uses manual muscle testing to assess the function of the body. </li></ul><ul><li>AK uses touch diagnosis, or patient therapy localization to determine where the cause of the problem exists. </li></ul><ul><li>AK also uses doctor challenge to determine the exact direction of the specific adjustment. </li></ul><ul><li>AK determines the treatment by utilizing the 5 factors of the intervertebral foramen. </li></ul><ul><ul><li>Nervous system </li></ul></ul><ul><ul><li>Neurolymphatic reflexes </li></ul></ul><ul><ul><li>Neurovascular reflexes </li></ul></ul><ul><ul><li>Cerebrospinal Fluid (Craniosacral respiratory mechanism) </li></ul></ul><ul><ul><li>Acupuncture Meridian Connectors </li></ul></ul>
  4. 4. Anatomy of the Carpal Tunnel <ul><li>The carpal tunnel is formed by the volar surface of the carpal bones bridged by the transverse carpal ligament. </li></ul><ul><li>This ligament attaches to the pisiform and hamate medially, and laterally to the scaphoid and trapezium. </li></ul><ul><li>The superficial portion of the carpal tunnel is created by the flexor retinaculum. </li></ul><ul><li>The flexor retinaculum attaches to the distal radius and ulna to form the anterior surface of the carpal tunnel. </li></ul><ul><li>The most anterior and superficial structure in the carpal tunnel is the median nerve. </li></ul><ul><li>This nerve is responsible for sensation to the thumb through the lateral portion of the 4 th digit. </li></ul><ul><li>This nerve also gives motor control to the opponens pollicis muslce. </li></ul><ul><li>This muscle allows for opposition of the thumb and little finger. </li></ul>
  5. 6. Symptoms of Carpal Tunnel Syndrome <ul><li>Carpal Tunnel Syndrome (CTS) has an onset of tingling and numbness in the thumb through the lateral half of the 4 th digit. </li></ul><ul><li>The presentation of tingling usually occurs first, as the tingling becomes worse some numbness may be noticed. </li></ul><ul><li>In severe cases of CTS, the numbness will lead to pain that wakes the patient up at night. </li></ul><ul><li>Thenar atrophy or wasting may be present in patients with long standing CTS. </li></ul><ul><li>People who utilize their hands for fine movement are most likely to suffer from CTS. </li></ul><ul><li>Unfortunately, in your profession you are subject to CTS. </li></ul>
  6. 7. Pain Presentation <ul><li>This demonstrates the normal pain pattern seen with CTS. </li></ul>
  7. 8. Muscle Dysfunction <ul><li>The pronator quadratus muscle plays a very important role in stabilizing the flexor retinaculum and the distal radius and ulna. </li></ul><ul><li>This muscle attaches to the distal ulna and radius and its action is to pronate the wrist. </li></ul><ul><li>When this muscle becomes weak it allows the radius and ulna to separate, therefore flattening the carpal tunnel. </li></ul><ul><li>When the carpal tunnel flattens the first structure that is effected is the median nerve. </li></ul>
  8. 9. Muscle Dysfunction <ul><li>The pronator teres muscle may be a contributor to the CTS. </li></ul><ul><li>The median nerve passes within close proximity of the pronator teres muscle. </li></ul><ul><li>This muscle originates at the medial elbow and attaches at about the middle of the radius. </li></ul><ul><li>In many patients with CTS this muscle is not functioning correctly. </li></ul><ul><li>This muscle must be corrected before the patient receives long standing relief from CTS. </li></ul>
  9. 10. AK Diagnosis <ul><li>AK will test for opponens pollicis muscle function in different hand positions. </li></ul><ul><li>When a weakness is found, the patient is instructed to approximate the distal radius and ulna, and the practitioner tests the muscle again. </li></ul><ul><li>If the muscle tests strong, the distal radius and ulna are separated and need to be adjusted. </li></ul><ul><li>The pronator quadratus muscle may be weak and can be reset using cold laser. </li></ul><ul><li>The carpal bones will be assessed for subluxation. </li></ul>
  10. 11. AK Diagnosis <ul><li>Cervical spine and neck musculature will be assessed for normal biomechanical function. </li></ul><ul><li>A “double crush” syndrome could be to blame, this is when the brachial plexus and median nerve are entrapped in the neck and the median nerve is entrapped in the carpal tunnel. </li></ul><ul><li>This is an important finding because if the proper structure is not maintained in the cervical spine the CTS may not be relieved. </li></ul>
  11. 12. AK Diagnosis <ul><li>In many cases, vitamin deficiency can cause the body to remain in a pro-inflammatory state. </li></ul><ul><li>Vitamin B-6 is found to be helpful in the management of CTS. </li></ul><ul><li>A supplement named Pro-Infla-Zyme will also help with the inflammation found in CTS. </li></ul><ul><li>Omega 3 fish oil supplementation can also aid in the reduction of inflammation. </li></ul>
  12. 13. Cutting Edge Technology <ul><li>Low level laser therapy (LLLT) or cold laser has gained FDA approval for the treatment of CTS. </li></ul><ul><li>Very few clinics in the area offer LLLT and are as experienced in cold laser protocol as Dr. Johnson. </li></ul><ul><li>My clinic offers Erchonia LLLT treatment. This cutting edge technology was used by Dr. Jeff Spencer D.C. on Lance Armstrong during all of his Tour de France victories. </li></ul>
  13. 14. LLLT, How Does it Work?
  14. 15. LLLT and Treatment of CTS <ul><li>The LLLT treatment will speed up the healing process and let you get back to work faster than with traditional treatments for CTS. </li></ul><ul><li>The anti-inflammatory and cell regenerating capabilities of LLLT are unmatched in conventional treatment. </li></ul><ul><li>Chiropractic care along with LLLT will resolve CTS symptoms in a very time sensitive matter. </li></ul>
  15. 16. Success Stories <ul><li>One of the first patients that I had ever treated presented with a long standing case of CTS. He had actually been a patient of one of my professor’s at Logan College of Chiropractic. The patient is a carpenter and his job was specific to finish and trim work. He needed the use of his hands. His hands were so painful that he woke up multiple times in the night. I treated this patient with chiropractic adjustments to the neck, shoulders, elbows, wrists, and hands. I also used LLLT on his hands 3 times a week. </li></ul><ul><li>He did not respond to the treatment for 2 weeks. During the 3 rd week of treatment he came in and said I didn’t wake up last night at all. This was the first time in 4 years he slept through the night without waking up. </li></ul><ul><li>His long standing CTS responded very well to chiropractic and LLLT. Because of his work I put him in wrist cuffs that helped to hold the distal radius and ulna together. </li></ul><ul><li>The LLLT was the difference in my care compared to my professor’s. Without the LLLT Sean would have been a surgical case. </li></ul>
  16. 17. Preventing CTS <ul><li>Steps that You need to take to prevent CTS </li></ul><ul><li>Regular Chiropractic maintenance visits </li></ul><ul><li>Frequent stretching of hand/wrist </li></ul><ul><li>Take breaks from fine hand movements every 30 minutes </li></ul><ul><li>Improve work place ergonomics </li></ul><ul><li>Ice your wrist, do not heat something that is already inflamed! </li></ul>
  17. 18. Links of Interest <ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul><ul><li> </li></ul>