Dr Davis' Back & Wrist Pain Blog

What causes carpal tunnel syndrome?

San Francisco Carpal Tunnel Doctor Comments:

We have been helping carpal tunnel syndrome (CTS) victims for 18 years in downtown San Francisco...for 17 years at Front Street Chiropractic (aka Carpal Tunnel Injury Center), and for about 7 months at our new clinic, Executive Express Chiropracticat the Embarcadero Center. 

I used to give a carpal tunnel seminar every week at our clinics...and there was usually a waiting list. CTS was a hot topic for a while...and it still is...even though it's not very well understood. What I mean by that is doctors and patients both tend to use CTS as a blanket term for hand pain...when in fact, only a small percentage of patients with hand pain have CTS.

So what exactly is carpal tunnel syndrome and what causes it?

I like this overview of carpal tunnel syndrome from www.mayoclinic.com. What I don't like are the treatment choices (wait...they now at least mention chiropractic...they never used to).

Anyway, if you jump to the "causes" section of the Mayo Clinic article you will see the following simple explanation:

The cause of carpal tunnel syndrome is pressure on the median nerve. The median nerve is a mixed nerve, meaning it has a sensory function and also provides nerve signals to move your muscles (motor function). The median nerve provides sensation to your thumb, index finger, middle finger and the middle-finger side of the ring finger.

Pressure on the nerve can stem from anything that reduces the space for it in the carpal tunnel.

The Mayo Clinic article goes into great detail about the signs and symptoms of CTS as well as risk factors. But the thing is...most patients that present with hand pain just have general pain vs. classic CTS signs & symptoms. 

In my experience, symptoms such as arm pain, hand pain, and numbness/tingling...even weakness, are usually caused by nerve pressure in the neck...as the nerves that control the upper extremities originate there.

I have written several blog posts about this in the past...here is one of the more recent:

Carpal Tunnel Syndrome? Could the problem really be in your neck? 

Helping patients with neck, arm, and hand pain has always been a specialty for us at our downtown SF Chiropractic Centers. And since so many people that work in the Financial District grind it out every day sitting at a desk working on a computer...it's been a good thing for both of us.

So...the moral of the story is this...Just because you may have some hand pain, numbness or tingling...does not necessarily mean you have CTS. In fact...chances are you don't. Your best bet is to find a doctor that treats CTS and related disorders on a routine basis and let them check you.

If you need help finding a doctor in your area send me an email at ebendavis@yahoo.com. If you live or work in San Francisco you can visit us at Executive Express Chiropractic. To make an appointment call 415-393-2225 or request an appointment online. 

Active Release Techniques (ART) works wonders for Sports Injuries-Repetitive Motion Injuries too

San Francisco Chiropractor Comments:

Dr. Adam Jacobs of Executive Express Chiropractic in downtown SF knows what it's like to have a sports injury, but still need to compete. "As a collegiate basketball player it was always one thing or another," says Dr. Jacobs. "But the game must go on."

This is when Dr. Jacobs was introduced to Active Release Techniques (ART). "The difference between regular deep tissue work and ART is night and day...ART would keep me on the court...regular massage was often a waste of time."

So it only made sense that when Dr. Jacobs decided he was going to be a doctor of chiropractic, that he would also become certified in Active Release Techniques. Chiropractic and ART are a winning combination.

There are many elite athletes that swear ART soft tissue methods are the missing link. Athletes such as Olympic Gold Medalist Donovan Bailey, who credits ART with helping him to win the Gold Medal.

There are also plenty of normal folks with sports injuries and repetitive stress injuries (RSI)  that credit Active Release Techniques with their speedy recoveries. Check out this article from the ART website entitled:

New treatment relieves pain of repetitive strain. Elite Athletes have been using it for more than a decade

So...whether you are a weekend warrior, a pro athlete, or you just sit at the desk a lot on a computer like most of us...Active Release Techniques (ART) just might be for you.

We incorporate ART into all our treatment protocols at Executive Express Chiropractic at the SF Embarcadero Center. So if you are looking for a San Francisco Chiropractor that is certified in ART and really knows sports injuries and RSI...give us a call at 415-392-2225 or request an appointment online.    

  

San Francisco Chiropractor

Executive Express Chiropractic (formerly Front Street Chiropractic) is located at the downtown SF Embarcadero Center near the Ferry building. We offer walk-in, no-waiting, no hassles service.

Dr. Eben Davis is the clinic director. Dr. Davis has 18 years experience running one of the most successful chiropractic clinics in the country and writes daily on his award winning Back & Wrist Pain blog. 

Some of the conditions that Executive Express Chiropractic can help are:

• Low back pain
• Neck Pain
• Headaches
• Shoulder, arm and wrist pain
• Sports Injuries
• Whiplash
• Carpal Tunnel Syndrome
• Herniated cervical and lumbar discs

Clinic supervisor Dr. Adam Jacobs, DC is full body certified in Active Release Techniques (ART)...which is a high-tech method of isloted deep tissue massage with active participation by the patient.

 Executive Express also has a DRX9000 (lumbar decompression) and DRX9000c (cervical decompression) combo-machine which costs around $150,000. The DRX machines are used to help treat conditions such as herniated discs, bulging discs, spinal stenosis and degenerative disc disease (DDD).

This San Francisco Chiropractor clearly has an eye for flair (Executive Express Chiropractic photos) . The clinic is a remarkable combination of 100% eco-friendly building materials such as real leather scraps from shoes and furniture used for the curved leather entry wall, recycled marble chips for the countertop and shelves, and recycled resin materials (and silkworms from families in Nepal) for the dramatic privacy dividers between the chiropractic tables. 

Dr. Davis said "no expense was spared...we wanted to create a masterpiece that patients would talk about to their friends...but at the same time would be healthy for them, our staff...and our planet...even our patient processing, appointment making,  and record keeping systems are paperless.  And...our architects are the best in San Francisco...Martinkovic Milford Architects." 

To schedule an appointment at Executive Express Chiropractic...call 415-393-2225 or request an appointment online.    

   

    

Carpal Tunnel Syndrome? Could the Problem Really be in your Neck?

San Francisco Carpal Tunnel Doctor Comments:

We have helped thousands of patients with carpal tunnel symptoms over the past 18 years at our downtown San Francisco chiropractic clinics. The reason for this is mainly due to our Financial District location and the hundreds of thousands of office workers we service as our primary patient base.

Notice how I said carpal tunnel symptoms and not carpal tunnel syndrome(CTS).

Sure, we have helped hundreds of San Francisco carpal tunnel syndrome victims...but most patients don't have true CTS...they just have CTS symptoms.

I know this sounds confusing...but it really is simple...I know this because I have taught classes to 10 year olds that get it really quick. And, I have taught classes to hundreds of thousands of adults.

Here's the deal...The nerve involved in CTS is called the median nerve. When you get pressure on the median nerve in the wrist it can cause hand pain, numbness, loss of grip strength, night pain, tingling, forearm pain, and even radiating pain up to the neck. These are the SYMPTOMS of CTS.

Well...where does the median nerve come from? It comes from the neck. That's right...the median nerve originates in the neck and travels down the middle of the forearm and through a passage way in your wrist called the carpal tunnel. Pressure anywhere on the median nerve...even as it forms in the neck can cause the SYMPTOMS of CTS.

In fact...my clinical experience treating thousands of cases of carpal tunnel symptoms tells me that the neck is the main source of nerve pressure with CTS symptoms. And current research supports this.

This is why when we treat carpal tunnel symptoms or even true CTS we work from the neck to the fingertips. We seek to remove nerve pressure and re-establish nerve transmission from the neck to the hands.

To just focus on the hands when a patient presents with CTS symptoms (even if there are no symptoms in the neck) is sub-standard care. Wrist splints and Motrin for hand pain might be  good  enough every once in a while...but nothing beats a chiropractor that really knows CTS symptoms...and how to treat them.

So there you go. If you or someone you know is suffering with CTS symptoms, your next move should be to find yourself a chiropractor that specializes in upper extremities and CTS...because not all of them do.

If you live or work near downtown San Francisco (some fly in from all over the world) you can visit us at Executive Express Chiropractic at the landmark Embarcadero Center near the Ferry Building.   We can be reached at 415-392-2225 or you can request an appointment online.  

Carpal Tunnel Symptoms and Cervical Disc Herniations

San Francisco Carpal Tunnel Doctor Comments:

We have been helping patients with carpal tunnel symptoms for many years now in downtown San Francisco. We have also successfully treated our fair share of cervical disc herniations.

In fact...some of the patients with carpal tunnel symptoms also had herniated discs in the neck.

Is there a connection between carpal tunnel symptoms and cervical disc herniations?

Great question...and the answer is YES. Here's how they are connected:

The nerves that exit from in between the bones in the lower part of the neck travel down the arm and into the hands. These cervical nerves are prone to pressure from herniated and bulging discs in the neck as they branch off the spinal cord.

When there is pressure on a cervical nerve root it can cause problems at the target cells...in this case the hands. Symptoms like hand pain, numbness and tingling in the hands, burning, weakness, loss of grip strength, and night pain are classic carpal tunnel syndrome (CTS) symptoms.

CTS occurs when there is pressure on the median nerve in the carpal tunnel...an opening in the bend of the wrist. The median nerve is one of the branches of nerves that originates in the neck.

So how can I tell if my carpal tunnel symptoms are from the neck or hand?

It's really hard sometimes to make this determination yourself...it's best to see a carpal tunnel expert...a doctor that treats lots of CTS, like we do at Executive Express Chiropractic in the SF Financial District.

Honestly...true CTS is rare...but CTS symptoms are common and are usually the result of pressure on the cervical nerves from misaligned vertebrae (Subluxations), tight muscles, degenerated discs, bulging discs, and cervical disc herniations.

I know it sounds complicated, but it's not...and neither is the treatment. Sometimes we can fix a problem in a few sessions...sometimes it takes months...it just depends on the severity.

Sometimes we can't help at all...but that's rare. The moral of the story is to go see someone that treats CTS day in and day out...it will be worth the effort (sometimes an expert is hard to find).

If you have CTS symptoms and would like to find out if you are a candidate for care at Executive Express Chiropracticat the SF Embarcadero Center...call 415-392-2225 or request an appointment online.

 

Hand Pain:Why Don't More Doctors Check The Neck?

San Francisco Chiropractor and Carpal Tunnel Doctor Comments:

I have been getting hit with a lot of emails regarding my recent post: 

Throbbing Hand Pain? Can It Be Caused By The Neck?

Basically, these people want to know if there is a doctor near them that does what we do at Executive Express Chiropractic in downtown San Francisco. They say none of the doctors they have seen for hand pain have checked the neck. Or, they are going to a chiropractor that does not work on the hands.

Here's the deal...Not all chiropractors work on the extremities. Most will be able to work on the neck...which will probably help many upper extremity pain syndromes. But...sometimes that's not enough...you need a chiropractor that can adjust the neck, shoulder, elbows and wrists...as  well as the rest of the spine. Our CTS protocols include full spine adjusting as well as extremity adjustments.

So when you are trying to find a Chiropractor for your arm or hand pain...ask if they adjust the extremities (shoulders, elbows, wrists). 

While you are at it...you should find out if the chiropractor offers nonsurgical spinal decompression of the cervical spine with the DRX9000c...just in case you need it.

Yeah, sure...my opinion is biased...but if you are trying to find a chiropractor in your area that does what we do...you might as well know everything.

Whoops...I almost forgot...we incorporate Active Release Techniques (ART) into our neck, arm, and hand pain protocols.  ART is a very advanced (high-tech) form of massage. It is very specific...and quick. Add this to the list too.

To find a doctor near you that has cervical spinal decompression, go to www.axiomworldwide.com.

To find an ART doctor go to www.activereleasetechniques.com.

Good luck putting it all together...but if you do, it will most likely be worth the effort.

If you live or work in the SF Bay area...you can visit us at Executive Express Chiropractic. We are downtown at the Embarcadero Center. Simply call 415-392-2225 or request an appointment online.

Throbbing Hand Pain:Can it be Caused By The Neck?

San Francisco Chiropractor Comments:

I have been helping patients with neck, arm, and hand pain in downtown San Francisco for many years now. I can tell you this...sometimes hand pain is not what it seems. What I mean by that is...we are conditioned to think the cause of pain (when we feel it) is at the site of the pain...and it usually is...but not necessarily when it comes to the spine.

Here's the deal...the nerves that exit from the spine control all the body parts. The nerves that exit from in-between the bones in the neck travel down the arm and into the hand. The nerves that exit from the low back travel down the leg. If one of these nerve roots has any pressure on it from a bone out of place (subluxation), which is very common...it can cause pain to be perceived at the target cells...the hands or the feet.

Now if you work on the computer a lot using your hands...and all of the sudden your hands start to throb with pain...the first thing you are going to think is do I have carpal tunnel syndrome (CTS) or a problem in my hand, and you might. But chances are...you are not going to think, Gee...I wonder if I have Cervical Radiculopathy (radiating pain from nerve root compression) from the neck?...especially if there is no neck pain...and there doesn't need to be. 

Seems strange...but it's true. In fact...my 17 years treating back, neck, and wrist pain has taught me that...more often than not...hand pain is from the neck...especially with office workers...and they make up the majority of our patient base in the SF Financial District.

So the moral of the story is this...If you have hand pain, and you spend a lot of time on the computer...don't just assume the problem is in the hand...because it might be in the neck. Find yourself a good chiropractor and get checked out.

To find out if you are a candidate for care at Executive Express Chiropractic at the SF Embarcadero Center...call 415-392-2225 or request an appointment online.  

Headaches and Hand Pain: Is There a connection?

San Francisco Chiropractor Comments:

I have been practicing chiropractic in downtown San Francisco for 17 years. I have always had a special interest in helping patients with headaches because I myself was introduced to chiropractic because of my own headaches.

A while later I became an expert on the causes, prevention, and cures for Carpal Tunnel Syndrome (CTS). In fact...it is not likely that between 1995-2005 that there is a single chiropractor in the world who treated more cases of upper extremity disorders. A lot of this had to do with the Dot-com boom and our proximity to the epicenter.

One thing I knew first hand, but confirmed during this period...headaches and CTS symptoms are often times connected...connected at the neck...here's how:

The nerves that exit from in between the bones of the cervical spine, travel down the arm and into the hand. Pressure on these nerves in the neck (cervical radiculopathy) can cause signs and symptoms of CTS. Some of the most common sources of pressure are vertebral subluxation, cervical disc herniations, disc bulges, stenosis, and disc degeneration...the same conditions that can cause headaches.

Believe me, I know. When I was having my headaches I tried everything. I tried muscle relaxers, pain pills, massage, acupuncture, physical therapy, biofeedback, migraine medication...everything...and none of it worked.  And...I also had hand pain which made my condition seem like it was from Mars to all the doctors that treated me...or tried to.

So I know first hand there is a connection between headaches and hand pain. This really helps when it comes to treating CTS symptoms and migraine headaches. And, I also know it can seem like an endless loop when none of the doctors you go to have a clue about what to do.

So anyway...I guess the moral of the story is chiropractic can help. Not just any chiropractor though. The chiropractor must be proficient at doing chiropractic adjustments to the neck, shoulder, arm and hands...not all of them are.

So do some homework...go online and talk to people you know. There is a chiropractor out there for you...you just have to flush them out.

For a complimentary headache or CTS consultation at Executive Express Chiropractic in downtown San Francisco...call 415-392-2225 or request an appointment online.

Osteoarthritis study shows cause more than just wear and tear

San Francisco Chiropractor Comments:

I just read an article on the excellent www.medicalnewstoday.com. The article is entitled:

Pain is not a Symptom Of Arthritis, Pain Causes Arthritis: New Study

The article gets a little bit technical, but it's still easy to read if you pass over some of the mumbo-jumbo.

The bottom line is this: Pain is a perception in the brain. In order for the brain to perceive a pain signal it has to travel from the joint (in the case of arthritis) or site of damaged tissue, over nerves and into the spinal cord...then up to the brain. The nerves that carry the pain signal appear to become more sensitive to pain signals the more they carry them (a survival instinct).

In addition, the nerves appear to carry inflammation to the spinal cord which can find it's way to other joints in the body causing even more arthritis (inflammation of a joint).  

Very interesting stuff. Now of course since this is a medical website...the solution is a potential drug that can block this process. But from a chiropractic point of view...this is old news. I have always known this process occurs and refer to it as "axoplasmic transportation"...whereby chemicals from a distal site of injury travel over the nerve to the spinal cord predisposing the spinal joints and connecting nerves to injury and inflammation.

Because of my extensive work with carpal tunnel syndrome (CTS), I know first hand that inflammation from the hand can travel to the neck....and inflammation from the neck can travel to the hand. This is called "double crush syndrome". The reason we are so successful treating CTS and related disorders is because we treat the neck to fingers on both sides...on everyone...and usually the rest of the spine also (think about how this ties into this study).

Anyway...I don't think we need to figure out new drugs to treat these problems...we need to figure out how to (teach people) maintain a healthy context to minimize inflammation....which can trigger more inflammation.

Proper spinal care and alignment can also help reduce the transmission of inflammation and toxic chemicals from damaged tissue through the spine.

We don't need to over-think this...just eat right (preferably plant foods), exercise, use proper ergonomics, get plenty of good sleep, stay away from drugs, alcohol, and tobacco...and get your spine adjusted on a regular basis...Thats my prescription.

Well...this is good stuff...I hope you found it interesting.

If you would like to find out if you are a candidate for care at Executive Express Chiropractic in downtown San Francisco...please call 415-392-2225 or request an appointment online.

Carpal Tunnel Syndrome Treatment Options

San Francisco Chiropractor Comments:

I have been treating Carpal Tunnel Syndrome (CTS) and related disorders in downtown San Francisco for 17 years now with great success. I guess I should say I have been treating carpal tunnel symptoms.

I say this because most of the time when a patient presents with wrist, hand or arm pain at my SF Chiropractic Clinic...it turns out NOT to be true CTS. In fact...most of the time the CTS symptoms are the result of pressure on the nerves in the neck. 

Carpal Tunnel Syndrome by definition is compression of the Median Nerve inside the carpal tunnel. The carpal tunnel is an opening in the wrist that is created by the wrist bones and the transverse ligament which holds them together. There are also nine flexor tendons crammed in the carpal tunnel...so there is no extra space.

So...either the diameter of the tunnel narrows or the contents of the tunnel expand, putting pressure on the median nerve, which causes CTS symptoms. The classic signs and symptoms of CTS are as follows: 

• Hand and Wrist Pain
• Numbness & Tingling in the Hand
• Weakness of Grip
• Night Pain

In addition there can be arm pain, elbow pain, and neck pain. There can be pain that travels from the wrist up the arm...pain that travels from the neck to the hand...even headaches.

But the thing is...the Median Nerve originates in the neck. It is formed by branches of nerve roots from the bottom part of your neck. When these nerves become irritated from herniated or bulging cervical discs...or vertebral subluxations, or degenerative disc disease...it can cause the same signs and symptoms of carpal tunnel syndrome.

This is why we always check the neck at Executive Express Chiropractic. And our treatment protocols include the neck to the fingertips...on both sides. Sure, we can't help every case...but I can't remember the last CTS patient that did not respond.

So consider chiropractic for CTS symptoms...and consider chiropractic care at Executive Express Chiropractic at the downtown SF Embarcadero Center if you live or work in San Francisco.

Because chances are...you will be glad you did.

For a complimentary CTS Consultation call 415-392-2225.