Carpal Tunnel Syndrome and Sleeping

Have you ever woken up in the middle of the night and noticed your hand sleeping to the point where you had to get out of bed and shake or flick your fingers to alleviate the numbness? If the numbness was primarily on the thumb-side half of your hand, it may have been carpal tunnel syndrome that woke you up. So, the question is, why is it such an issue at night?

To properly answer this question, let’s get familiar with the anatomy of the wrist.  There are 2 bones that make up the forearm – the ulna (on the pinky side) and the radius (on the thumb side). Just beyond that, there are two rows of four bones each called the carpal bones for a total of 8 small bones that make up the wrist joint. These carpal bones are arranged in a horseshoe or tunnel shape. When you look down at your wrist and wiggle your fingers quickly, you can see all the movement that occurs on the palm side of the wrist.  That’s a lot of movement!  You can also see the muscles on the upper half of the forearm moving rapidly as the fingers wiggle.

There are 9 muscle tendons that travel through the carpal tunnel, as well as some blood vessels and most important, the median nerve sits on top of all those moving tendons. Just beneath the floor of the tunnel is a ligament called the transverse carpal ligament. The tendons inside the tunnel are surrounded by lubricating sheaths that make it easier for the tendons to slide back and forth as we wiggle our fingers, grip to open a jar, type on a computer, play a musical instrument, or so on. Without the tendon sheaths, the friction between the rubbing tendons would quickly build up heat, resulting in swelling, pain and numbness.  However, in spite of the lubricating function of the sheaths, when we work our fingers and hands too much, swelling and inflammation does occur.

So, why do we have numbness at night when we aren’t working, gripping and moving our fingers repetitively? The answer lies in how we sleep. Since we are asleep, we cannot control where we position our hands and wrists. Most of us curl up in a ball and tuck our hands under our chin or someplace cozy.  Normally, when we bend our wrists, the pressure inside the carpal tunnel doubles. However, a carpal tunnel patient already has a higher level of pressure in their wrist. So, when a carpal tunnel patient bends their wrist in the exact same way, the pressure goes up even more – that is, 3, 4, 5, or more times than a normal person without their wrist bent. That is why a wrist “cock-up” splint works so well at night!  It keeps the wrist straight so you can’t bend it.  Often, this allows the CTS patient to sleep through the night instead of waking up 2, 3, or more times with numbness, tingling, and/or pain on the thumb half of the hand.

At Denver Chiropractic Center, we have extensive experience using Active Release Techniques to treat carpal tunnel syndrome. We release scar tissue in the muscles adjacent to the nerve, and can take the symptoms away by relieving the pressure of that nerve (the Median Nerve). Call us today to schedule your initial exam where we’ll tell you whether you’re a candidate for our treatment approach. 303.300.0424

We realize you have a choice in where you get your health care and we sincerely appreciate your trust in choosing our service for those needs.  If you, a friend or family member require care for CTS, we would be honored to render our services.

Low Back Pain & Scoliosis

Low Back Pain & Adolescent Idiopathic Scoliosis

Scoliosis is a curvature of the spine that is shaped like a “C” or an “S” when looking at the person from behind. I’m sure you’ve noticed when you’re at a beach, at a swimming pool, or walking in an airport, some people have a high shoulder, walk with a bit of a limp if one leg is short, and may have a shoulder blade that sticks out more than the other. Scoliosis often develops for unknown reasons (hence the term, “idiopathic”) during the adolescent age range between 10 or 11 years old and can progress, not change or less often, improve up to age 16 to 18. During these 4-6 years, the time when the adolescent is growing quickly, the curve often worsens without any intervention but few studies have looked at what types of treatment or combinations of treatment work the best, especially non-surgical methods.

A recent study was conducted that looked at the response to non-surgical treatment using conventional medical treatment (MT) vs. conventional MT plus chiropractic, as well as conventional MT and “sham” (fake) chiropractic treatment.  This is a pilot study using a small population of patients in order to determine if a larger scale study would be important to run (which was determined to be the case).

The conventional medical treatment approach included two groups – observation (a “wait and watch” approach) in a braced group verses a non-braced group. The chiropractic treatment group received spinal manipulation using “diversified technique” which is widely used where the patient is treated while lying on their stomach, sides, and back and the type of manipulation used was the thrust type where the “cracking” sound occurs (which is caused by the release of gas from the joint capsules and is technically called cavitation). This was applied to the regions determined by the chiropractor as requiring the treatment by using palpation (touch) methods, postural examination, range of motion, and x-ray and all chiropractors involved had 6-hours of training to assure consistent and similar approaches were used. Treatments were administered (determined by a survey of many chiropractors) at 3x/week for a month, 2x/week for a month, 1x/week for a month, and 2x/month for 3 months or as needed for a total of 6 months. The “sham” or fake chiropractic treatment used the same treatment frequency and similar positioning of the patient but purposely did not obtain a joint cavitation or “crack” but still seemed “real” to the patient.

The primary outcome used to determine “success” was a reduction of the scoliosis curve measured on x-ray at a 6-month point. Using the standard medical model, those with curves of 20-25 degrees require careful observation, curves 26-40 degrees are potential candidates for bracing, those greater than 40 degrees are potential candidates for surgery and, an increase in curve by more than 5 degrees measured twice a year or every 6-months is considered failure.

The results are interesting. Of those receiving only conventional medical treatment, none improved and one failed. The same occurred in the conventional MT plus sham/fake chiropractic. NO ONE failed and one improved in the chiropractic treatment plus MT group making it the only successful non-surgical treatment approach in the study. The preliminary findings from this study are huge! Chiropractic treatment in this group of adolescent children was determined to be THE ONLY non-surgical approach that had the ability to maintain (not allow the curve to progress) or even better, improve the curve!

At Denver Chiropractic Center, we work with many patient who have scoliosis. We combine Active Release Techniques to release tight soft tissues, chiropractic adjustments to increase spinal mobility, and physical therapy exercises to help retrain the nervous system. Call us today to see how we can help. 303.300.0424

We realize you have a choice in where you get your healthcare services.  If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.

Denver Chiropractic Center Weekly Health News For You

Have you ever noticed that you seem to drag during November and December? Well, there’s a reason for this. As the days get shorter and you get less time in the sun, your brain produces less Serotonin, the feel good brain chemical. The result is usually a little fatigue, less energy than normal, and the annoying urge to eat sugar. This is why many of us gain weight this time of year.

The best defense is to essentially go with the flow. Cut yourself some slack, try not to totally cave in to it, and know that soon the days will start getting longer (December 22). Try to get outside for a walk or run at least 3 times a week, even if it’s just for 20 minutes. Try getting to the slopes or going out for some Nordic fun – snowshoeing or cross country. Open up those blinds and let the daylight in. It’ll help.

Mental Attitude: Commuting To Work Is Bad For Your Health! Spending hours each day behind the wheel or crammed in a public train or bus, commuting to and from work is bad for your health. Those who commuted reported more everyday stress, exhaustion, missed work days and generally poorer health. Those with longer commutes reported even worse health. Duke University, Oct 2011

Health Alert: Under Construction! Nearly all construction workers will experience one or more work-related injury or illness over a lifetime, plus a greater risk of premature death. Over a 45-year career, a construction worker has a 75% chance of a disabling injury, and a one in 200 chance of being fatally injured on the job. An individual who begins construction work at the age of 20 has a 15% chance of developing chronic obstructive pulmonary disease and an 11% chance of developing dust-related parenchymal chest X-ray changes. Center for Construction Research and Training, Oct 2011

Diet: Strawberries & Stomach Ulcers. Scientists discovered strawberry consumption might help reduce and or slow the formation of stomach ulcers caused by alcohol consumption, viral infections and nonsteroidal anti- inflammatory medications, like aspirin and ibuprofen. Plos One, Oct 2011

Exercise: Good Reasons. Exercise helps speed recovery from chemotherapy treatments, increases the ability to supply blood to the skin for cooling and increases the thickness of the cartilage in your joints. Surgeon General’s Report on Physical Activity and Health, 1996

Wellness/Prevention: Cranberry Juice vs. Cranberry Extracts. Cranberries have been recognized for their health benefits for years, especially in preventing urinary tract infections. However, it was found that drinking actual cranberry juice is much more effective in preventing a Urinary Tract Infection than simply consuming cranberry extracts. Food Science and Biotechnology, Oct 2011

Active Release: Posture and mobility. Do you ever catch yourself all hunched over, briefly horrified by your won bad posture? Recent research by Gray Cook from Functional Movement Screens points to poor posture and mobility of the thoracic spine as a contributing source of many problems- from hamstring injuries to back pain to headaches. We can help you with that. Active Release, spinal adjusting and rehab can all be used to improve posture and spinal mobility. If you have chronic back pain, we can help you. Give us a call: 303.300.0424

Thanks For Reading!

Denver Chiropractic Center

303.300.0424

Dr. Glenn Hyman

Dr. Jeff Stripling