Dr Davis' Back & Wrist Pain Blog

Is it Really Carpal Tunnel Syndrome?

We have been providing treatment for carpal tunnel syndrome in San Francisco for 21 years now.

At one point during the "Dot-Com" go go years we were know as The Carpal Tunnel Injury Center. During this time we treated over 10,000 cases with "Carpal Tunnel SYMPTOMS". The most common signs and symptoms of carpal tunnel syndrome (CTS) are as follows:

• Arm, Wrist or Hand Pain
• Numbness or Tingling in the Arm and Hands
• Weakness of Grip
• Night Pain
• Swelling of the Hands and Fingers
• Pain that radiates from the Hands into the Forearm
• Elbow Pain
• Loss of Sensation in the Fingertips

These are the classic signs and symptoms of CTS. True carpal tunnel syndrome is caused by pressure on the Median Nerve in the wrist. The Median Nerve which actually originates in the neck passes through the 8 carpal bones which form a tunnel in your wrist called the "carpal tunnel". There are also some tendons and blood vessels in the tunnel.

The tendons in the carpal tunnel can get over-worked and become inflamed which puts pressure on the Median Nerve. The carpal bones themselves can lose their proper alignment from trauma or repetitive trauma and put pressure on the Median causing CTS.

Women have a smaller carpal tunnel and are more prone to CTS. Carpal Tunnel is common in pregnant women because they take on water to build and protect the baby and this can cause swelling of the tendons in the tunnel and CTS. Smokers have a much higher incidence of carpal tunnel syndrome. High fat and high salt diets can cause water retention and CTS symptoms. Certain medications can cause CTS symptoms as well. Patients with Diabetes and other diseases (obesity) are more prone to CTS.

Then, there are the occupational risks of jobs that require repetitive motions such as office workers on a computer, hair cutters, meat cutters, assembly line workers. We work primarily with SF Financial District office workers.

Hobby's such as bowling, tennis, racquetball, knitting, golf, or anything that requires lots of hand motion will also predispose you to carpal tunnel syndrome.

But here's the deal. In spite of everything I outlined above...only a small percentage of patients that present with carpal tunnel SYMPTOMS actually have carpal tunnel SYNDROME.

Huh!...What do you mean?

Well, here's why...Pressure on the nerves in the neck that form the Median Nerve (see image above) causes the same symptoms as pressure on the Median Nerve in the carpal tunnel.

That's right. Just like pressure on a garden hose near the faucet will cause the same symptoms as pressure on the hose near the sprinkler (a decrease in water flow).

Pressure on the median nerve at the source causes the same symtoms as presure on the median nerve in the carpal tunnel.

And you are way more likely to have pressure on the nerves in the neck...what chiropractors call a "Subluxation" or Pinched Nerve, than you are to have true CTS. 

The reason for this is simple. As the nerves exit from the bones in the neck they are vulnerable to Subluxations. All the spills and falls we took as a child. Sitting at a desk at school for 12-18 years, sports injuries, car accidents, sitting at a desk all day at work...LIFE!

Yes, just being alive and having an active lifestyle predisposes us to Subluxations in the neck and carpal tunnel symptoms.

If your doctor does not know to look at the neck you may never get the right treatment. And, just because your doctor is able to identify the neck as the source of the problem does not necessarily mean they know how to treat it. This is why we get so many referrals from medical doctors and therapists...our chiropractors know how to treat subluxations and pinched nerves in the neck...and carpal tunnel syndrome. 

We use chiropractic adjustments to the neck, arms, and hands, deep tissue laser, Graston and Active Release Techniques, Kinesiotape, Exercises and more. We have perfected our methods over the years and have taught it to other chiropractors as well.

So, if you think you may have carpal tunnel syndrome and would like to find out if we can help...please call 415-392-2225 to schedule an appointment with one of our San Francisco Carpal Tunnel Doctors.

Dr. Eben Davis

San Francisco Chiropractor Weekly Health Update

Mental Attitude: Vitamin D and Alzheimer's Disease. Higher vitamin D dietary intake is associated with a lower risk of developing Alzheimer's disease. Women who developed Alzheimer's disease had lower baseline vitamin D intakes (an average of 50.3 micrograms per week) than those who developed no dementia at all (an average of 59.0 micrograms per week). Journals of Gerontology, December 2012

Health Alert: Pesticides and Food Allergies. Dichlorophenols are chemical compounds commonly found in pesticides and used for tap water chlorination. A recent study of 10,438 Americans showed 24.4% had dichlorophenols in their urine. Researchers found those with dichlorophenols in their urine were more likely to suffer from food allergies. Further research is needed to determine whether or not dichlorophenol exposure is a cause of food allergies.
Annals of Allergy, Asthma and Immunology, December 2012

Diet: Risks of Obesity! Being obese or overweight heightens the risk of diabetes, some cancers, high blood pressure, stroke, coronary heart disease, infertility, some forms of arthritis and respiratory problems.
British Medical Journal, December 2012

Exercise: Memory. In this study, adults ages 50-85 years old (both with and without memory issues) looked at pictures of pleasant things. Afterwards, half rode a stationary bicycle for 6 minutes at 70% of their maximum capacity. An hour later, everyone took a surprise recall test on the images they viewed earlier. Outcomes revealed those adults in the group that rode the bike for 6 minutes were better able to remember the pictures they'd seen than the adults who did not, regardless if they suffered from memory issues. UC Irvine, December 2012

Chiropractic: My Degeneration. What causes the pain associated with spinal degenerative joint disease (DJD)? 1. The instability caused by disk degeneration. 2. The mechanical compression of nerve by bone, ligament, or the disk. 3. The chemical mediators of inflammation. Spine, 1997

Wellness/Prevention: Essential Oils. Essential oils, which form the basis of aromatherapy for stress relief, are reported to have a beneficial effect on heart rate and blood pressure following short-term exposure and may reduce the risk of cardiovascular disease. After 45 minutes of exposure, blood pressure dropped by 2.1 mmHg and heart rate by 2.2 beats per minute (bpm). However, after 120 minutes, blood pressure rose by 2.2 mmHg above baseline, and heart rate by 1.7 bpm above baseline. Because of these results, researchers believe prolonged exposure to essential oils may be detrimental to the cardiovascular health of spa workers. European Journal of Preventive Cardiology, December 2012

Quote: “It is no measure of health to be well adjusted to a profoundly sick society.” ~ Jiddu Krishnamurti

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To schedule an appointment with one of our San Francisco Chiropractors call 415-392-2225

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San Francisco Spinal Decompression Review

Introducing the Executive Express Chiropractic San Francisco "Patient of the Week"

Greg presented to our clinic with bothersome low back pain for which he could find no relief. The back pain was interfering with his home and work life and was making easy tasks difficult.

We have treated Greg with a series of nonsurgical spinal decompression treatments on the DRX9000. The decompression therapy also includes electrical stimulation, ice, and custom lumbar exercises.

Greg reports he is feeling much better and is able to work and play with much less pain. Greg is able to work a full day with more range of motion, less pain, and more energy. 

We are happy and excited for Greg to fully resume work duties and hopefully be symptom free soon. greg plans to continue with spinal decompression maintenance care and home exercises.

Many low back pain and sciatica patients have an underlying herniated or bulging disc as the cause. They are often times told surgery is the only option. Spinal decompression is a non-surgical solution that can deliver long lasting results without drugs or surgery.

To find out if you are a candidate for spinal decompression therapy in San Francisco call 415-392-2225. Mention this patient review for a complimentary consultation and office tour.

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Mental Attitude: Neuroticism and Post-Traumatic Stress Disorder. Many people experience traumatic events (such as the death of a loved one, witnessing violence, or physical assault) but only a small amount develop Post-Traumatic Stress Disorder (PTSD). A decade long study of 1,000 random residents in southeastern Michigan found those who scored higher on a neuroticism scale (chronic anxiety, depression, and/or a tendency to overreact to everyday challenges and disappointments) were more likely to suffer from PTSD following a traumatic event.
Psychological Medicine, November 2012

Health Alert: High Fructose Corn Syrup and Type-2 Diabetes. Researchers found a 20% higher proportion of the population has diabetes in countries with high use of High Fructose Corn Syrup (HFCS), like the United States, compared to countries that do not, like the United Kingdom. The United States has the highest consumption of HFCS at 55 lbs (~25 kg) per year per person. The United Kingdom consumes 1.1 lbs (~.5 kg) per year per person.
Global Public Health, November 2012

Diet: Food Advertising. Childhood obesity has tripled in the past 30 years. Food companies spend $10 billion a year marketing in the United States, and 98% of that is on foods high in fat, sugar, or sodium.
Journal of Pediatrics, November 2012
Exercise: Walk Much? The more moderate physical activity (like brisk walking) you do, the better. Compared to doing nothing at all, seventy five minutes of vigorous walking per week was linked to living an extra 1.8 years. Walking briskly for 450 minutes or more per week was found to provide most people with a 4.5-year longer lifespan. The longer people spent each week being moderately active, the greater their longevity. Heart, November 2012

Chiropractic: Keep Your Disks Healthy. In normal healthy disks, the nerves (sinuvertebral) only sense pain on the periphery or outer regions of the disk. In grossly degenerated disks, nerves may penetrate into the center (nucleus) of the disk and be more vulnerable to degeneration and/or inflammation. Lancet, 1997

Wellness/Prevention: Cell Phone Addiction. Cell phone and instant messaging addictions are driven by materialism and impulsiveness and can be compared to consumption pathologies like compulsive buying and credit card misuse. Cell phones may be used as part of the conspicuous consumption ritual and may also act as a pacifier for the impulsive tendencies of the user. Impulsiveness plays an important role in both behavioral and substance addictions.
Journal of Behavioral Addictions, November 2012

Quote: “The first wealth is health.” ~ Ralph Waldo Emerson

Want More?

• To Receive The “Weekly Health Update” Every Monday Via Email,
Go To www.WeeklyHealthUpdate.com - Code: 94111DAVIS

• To Sign Up For Our Email Newsletter, Go To: www.InGoodHandsLetter.Com - Code: 94111DAVIS

To schedule an appointment with one of our San Francisco Chiropractors call 415-392-2225

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The Executive Express Chiropractic San Francisco "Patient of the Week" is Josie Morgado. Josie presented to the clinic with neck, back, and radiating pain into her leg (sciatica).

Josie was frustrated with not being able to work without feeling discomfort and nagging back and leg pain. The leg pain was also interfering with her home and social life. Through a series of chiropractic adjustments to the neck and lumbar spine, soft tissue therapy, and custom exercises and stretching, Josi has experienced significant relief from her symptoms.

We are happy that we could provide Josie with relief and are excited that will be 100% pain free soon. 

Often times, chronic back and neck pain sufferers feel they have nowhere to turn. They work through and live with the pain for too long risking permanent damage.

Our San Francisco Chiropractic Clinic has no waiting and appointments are not needed. This makes it super easy for patients like Josie who require multiple visits to incorporate her treatments into their busy lifestyles.

To schedule an appointment with one of our San Francisco Chiropractors please call 415-392-2225. Mention this chiropractor review for a complimentary ice pack.

Serving local 94111 for over 20 years

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More Whiplash Facts and Advice

We have been proving treatment for whiplash injuries in downtown San Francisco for over 20 years now.

Last month, we discussed car safety features, proper headrest position, how to prepare for a crash, and to seek immediate treatment as ways to minimize the chances of suffering from whiplash in the event of an accident. Here are four more ways to avoid or minimize whiplash:

PAY ATTENTION WHILE YOU DRIVE. Too often, we get distracted while driving. Any time our eyes leave the road, the potential for an accident increases significantly. This can occur when changing the radio to a different station, eating while driving, reading while driving, talking on the phone, texting (equals the effects of 2-3 alcoholic beverages), driving under the influence of certain prescription medications (pain killers for example), driving under the influence of alcohol or other chemical agents, and turning your head during conversation. We have a responsibility when we are driving to keep our eyes on the road, as many accidents occur within split seconds of time. If we are not paying attention, we will not be able to avoid a potential collision.

THE CONCEPT OF "NO CRUSH, NO CRASH INJURY" IS SIMPLY NOT TRUE. In fact, just the opposite is true. That is, the greater the amount of crushing metal at the time of collision, the greater the amount of energy absorption that occurs, resulting in less force transferred to the contents inside the vehicle (namely you or me). This is why, many times, people are injured in low speed collisions because there is no energy absorbed by crushing metal as noted by the absence of or, minimal damage to the car.

FOLLOWING YOUR DOCTOR'S ORDERS. It is very important that we do not inadvertently hurt or harm ourselves further by NOT following the advice of our health care practitioner. This means initially using ice to reduce inflammation and swelling, possibly wearing a soft cervical collar during the first few days after the injury to “rest” the injured structures, following proper nutritional advice for optimal healing benefits, and following exercise recommendations. This last treatment approach is vital in the prevention of long term, chronic neck complaints. Other ways you can REALLY help are to follow cervical traction orders. Cervical traction is a very effective method of reducing muscle spasm, separating the joint spaces, improving disk nutrient transfer and water content, reduce the pinching effect of the nerves, and as a result, speeding up the recovery process. Follow your treatment schedule; that is, DON’T SKIP APPOINTMENTS! During office visits, it is necessary to discuss not only what is working well, but also what may not be working so modifications to your care plan can occur on a timely basis. The primary goal of whiplash management is to prevent the condition from becoming chronic and long-term, and the first few weeks of treatment are critical!

ERGONOMIC MODIFICATIONS. An important part of managing whiplash injuries is preventing daily irritations from tasks that we have to do. Hence, we will discuss adjusting your work station for optimum positioning and avoidance of poor posture, such as using office chairs with arm rests, sitting posture modifications, and computer monitor positioning. Proper sleep positions and pillow design are also reviewed.

            We realize you have a choice in where you choose your health-care services.  If you, a friend or family member requires care for whiplash, 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.

To schedule an appointment for whiplash treatment in San Francisco call 415-392-2225.

Serving local 94111 since 1992

 

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San Francisco Chiropractor Review: Back and Ankle Pain

The Executive Express Chiropractic San Francisco "Patient of the Week" is Ousi Li. Ousi presented with severe ongoing tailbone, back, and ankle pain that was making life miserable and interfering with her active lifestyle. Ousi was recovering from an ankle injury and was wearing a boot cast that was throwing everything off. We have used a combination of deep tissue laser therapy, chiropractic adjustments, massage and exercises to help Ousi. So far so good. Ousi is getting better and better every day and looks forward to being back to normal soon. Check out her video review of us.

To schedule an appointment with one of our chiropractors in San Francisco call 415-392-2225

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Serving local 94111 for over 20 years

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Carpal Tunnel Syndrome: Diagnosis and Treatment

We have been providing treatment for Carpal Tunnel Syndrome in San Francisco for over 20 years.

Carpal Tunnel Syndrome (CTS) refers to the median nerve being pinched in a tunnel at the wrist. As the name implies, “carpal” refers to the 8 small bones in the wrist that make up the “U” shaped part of the tunnel and “syndrome” means symptoms that are specific and unique to this condition. As we learned last month, CTS can be affected by nerve pinches more proximal to the wrist, such as at the forearm, elbow, mid-upper arm, shoulder or neck. To make matters more complex, there are two other nerves in the arm that can also be pinched in different tunnels, and the symptoms of numbing and tingling in the arm and hand occur with those conditions as well. This is why a careful clinical history, examination, and sometimes special tests like an EMG/NCV (electromyogram/nerve conduction velocity) offer the information that allows for an accurate diagnosis of one or more of these “tunnel syndromes” in the “CTS” patient. Let’s look at these different tunnels and their associated symptoms, as this will help you understand the ways we can differentiate between these various syndromes or conditions.

            Let’s start at the neck. There are seven cervical vertebrae and eight cervical spinal nerves that exit the spine through a small hole called the IVF (intervertebral foramen). Each nerve, like a wire to a light, goes specifically to a known location which includes: the head (nerves C1, 2, 3), the neck and shoulders (C4, 5), the thumb side of the arm (C6), the middle hand and finger (C7) and the pinky side of the lower arm and hand (C8). If a nerve gets pinched at the spinal level (such as a herniated disk in the neck), usually there is numbness, tingling, and/or pain and sometimes, usually a little later, weakness in the affected part/s of the arm and hand (or numbness in the scalp if it’s a C1-3 nerve pinch). So, we as chiropractors can test the patient’s sensation using light touch, pin prick, vibration, and/or 2-points brought progressively closer together until 1-point is perceived and then comparing it to the other arm/hand. Reflexes and muscle strength are also tested to see if the motor part of the nerve is involved in the pinch. The exam includes compression tests of the neck to see if the arm “lights up” with symptoms during the test.

            Next is the shoulder. Here, the nerves and blood vessels travel through an opening between the collar bone, 1st rib and the chest muscles (Pectorals). As you might think, the nerves and blood vessels can be stretched and pinched as they travel through this opening and can cause “thoracic outlet syndrome.” Symptoms occur when we raise the arm overhead. Hence, our tests include checking the pulse at the wrist to see if it reduces or lessens in intensity as we raise the arm over the head. At the shoulder, the ulnar nerve is the most commonly pinched nerve, which will make the pinky side of the arm and hand numb, tingly, and/or painful. A less common place to pinch the nerves is along humerus bone (upper arm) by a bony process and ligament that is usually not there or resulting from a fracture. Here, an x-ray will show the problem.

            The elbow is the MOST common place to trap the ulnar nerve in the “cubital tunnel” located at the inner elbow near the “funny bone” which we have all bumped more than once. Cubital tunnel syndrome affects the pinky side of the hand from the elbow down. The median/carpal tunnel nerve can get trapped here by the pronator teres muscle, thus “pronator tunnel syndrome.” This COMMONLY accompanies CTS and MUST be treated to obtain good results with CTS patients. The radial nerve can be trapped at the radial tunnel located on the outside of the elbow and creates thumb side and back of the hand numbness/tingling.

            Hence, you see the importance of evaluating and treating ALL the tunnels when CTS is present so a thorough job is done (which is what Chiropractors do). Try the LEAST invasive approach first – non-surgical treatment – as it’s usually all that is needed!

            We realize you have a choice in who you consider for your health care provision 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.

To schedule an appointment with one of our San Francisco Carpal Tunnel Doctors please call 415-392-2225.

 

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Fibromyalgia and Neurotransmission

Fibromyalgia and Neurotransmission

We have been providing treatment for Fibromyalgia (FM) in San Francisco since 1992.

Neurotransmission is the method by which nerves “speak” to each other so impulses can be sent from one part of your body to the brain and back. For example, when you touch a hot plate by accident, it doesn’t take long before you quickly let go of the plate. The reason you let go quickly is because of neurotransmission. Certain types of neurons or nerves (called afferents) bring information to the central nervous system where the information is processed and then signals are transferred back to the target site (such as your hand touching the hot plate) by different nerves (called efferents) telling you to immediately let go of that hot object. It’s like the flow of traffic into a city during rush hour. People work all day and then drive in the opposite direction on their way home (afferents in the morning going in the city or “brain” and efferents in the evening bringing new information home). This “give and take” process of information coming in, being processed and going out helps coordinate our bodily functions. This allows us to constantly adapt to surrounding changes in temperature, stress, noise, and so on.

            Each neuron has as many as 1500 connections from other neurons, but they don’t actually touch one another. Rather, there are “synapses” where nerve impulses stimulate the release of calcium and neurotransmitters, which either inhibit or excite another neuron and each neuron may be connected to many other neurons. If the total excitatory stimuli are greater than the inhibitory stimuli, that neuron will “fire” and create a new connection resulting in an action (like dropping the hot plate).

            Okay, sorry for the enthusiastic description and details of neurotransmission. More importantly, how does all this relate to fibromyalgia?  A new study (published May 14, 2012 in NATURE by scientists at Weill Cornell Medical College) discovered that a single protein (alpha 2 delta), “…exerts a spigot-like function controlling the volume of neurotransmitters and other chemicals that flow between the synapses of brain neurons.” This study shows how brain cells “talk to each other” through these synapses relaying feelings, thoughts, and actions and how this powerful protein plays a crucial role in regulating effective communication in the brain. They found that if they added or decreased this single protein (alpha 2 delta), then the speed of neurotransmission increased or decreased by opening or closing the calcium channels that trigger neurotransmission release.

            The relationship between calcium and neurotransmission has been known for 50 years, but how to “turn on or off” the volume is a new discovery. They hope this finding will help in the design of new medications that will help regulate the neurotransmission in the brain, thus help reduce the increased pain perception found in people suffering from fibromyalgia.

            Our aim in sharing this information with you is to keep you informed with what is on the cutting edge of research as we’ve said many times before, a “team” of health care provision is the BEST way to manage FM including chiropractic and primary care!

            If you, a friend or family member requires care for FM, we sincerely appreciate the trust and confidence shown by choosing our services!

To schedule an appointment with one of our Fibromyalgia Doctors in San Francisco call 415-392-2225.

Serving local 94111 for over 20 years.

 

Chiropractor San Francisco Review: Hand Pain

Our San Francisco Chiropractor "Patient of the Week" is Carol Martin. Carol came to our clinic searching for answers to her ongoing  wrist pain. Months ago she had broken her wrist and it never healed properly. 

Pain and swelling persisted even after the cast had been removed. Using a combination of chiropractic adjustments to the neck, arm, and wrist, icing, massage and laser therapy, we have significantly decreased her swelling and pain.

We are now helping her rehabilitate her wrist injury as she continues to improve and heal. As this new year has dawned upon us, we're excited for the progress that Carol has made and we are all looking forward to supporting her along the way.

We have been providing treatment for hand pain in San Francisco since 1992. After-all, the nerves the innervate and control the hand originate in the neck. Pressure on these nerves will cause pain and malfunction in the shoulders, arms and hands.

Many chiropractors such as ourselves specialize in the diagnosis and treatment of neck, arm, and hand pain. We can help conditions such as r tunnel syndrome, tendonitis, sprain and strains, repetitive stress injuries, and fractures that have not healed properly.

To schedule an appointment with one of our San Francisco Hand Pain Doctors call 415-392-2225. Mention this hand pain review for a complimentary consultation.

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