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Carpal Tunnel Pain Relief without Surgery

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Carpal Tunnel Pain Relief without Surgery
Carpal Tunnel Pain Relief without Surgery

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Carpal tunnel syndrome (CTS) is a debilitating disorder caused by irritation or pressure to the median nerve. The median nerve originates in the neck, runs through the shoulder, arm and forearm into the wrist and hand. It is one of the major nerves in the hand that provides sensation and movement for the thumb, index and middle fingers. CTS often is described as an aching pain with burning, tingling, and numbness in the wrist or hand and, occasionally, in the forearm. In some cases, muscle weakness, swelling and loss of temperature sensation may be present. Patients may begin to drop objects or have difficulty lifting small items or turning door knobs.

It is thought that jobs that require workers to use their hands, wrists, or arms in a repetitive manner tends to have a higher incidence of CTS. But renowned hand surgeon Dr. Charles Eaton says that there is no scientific evidence that shows such activities actually cause carpal tunnel syndrome.

Medical Treatments

The standard medical treatment for CTS may include braces, splints, over-the-counter or prescription non-steroidal anti-inflammatory drugs (NSAIDs), vitamin B6, cortizone injections, or surgery. Unfortunately, drugs have potential side effects and surgery is not always successful.

In fact, three separate studies published in the Journal of Hand Surgery followed the failure rate of some of the common treatments for CTS. One study revealed that wrist splints and NSAIDs had an 82% failure rate while another showed steroid injections has a 72.6% failure rate. The third study showed an average failure rate of 57% in patients that underwent carpal tunnel release surgery.

These failure rates support the idea that the actual cause of CTS in the majority of the patients might be nerve irritation at a site away from the wrist, as is the cause with Double Crush Syndrome.

Double Crush Syndrome

Stress to the median nerve commonly begins in the neck, where the median nerve begins. The nerve is then aggravated by added pressure or irritation anywhere from the neck to the wrist, which can then cause symptoms in the hand and fingers. This is called “Double Crush Syndrome” and is widely referenced in the scientific and medical research journals as a consistent finding in patients with carpal tunnel. Pressure or irritation to the nerve roots as they exit the neck makes the median nerve more vulnerable to injury at the wrist.

A growing number if studies suggest that the Double Crush phenomenon is one of the most common causes of CTS. The prestigious medical journal The Lancet found that nearly 7 of every 10 CTS patients had nerve irritation in the neck. Another study found that 89% of carpal tunnel sufferers also had arthritis in the neck. Both studies suggest the vast majority of CTS patients actually have Double Crush phenomena.

This would explain the high failure rates when it comes to medical treatments directed solely at the wrist neglect possible nerve irritation and/or compression in the neck, which renders the lower nerves in the wrist more susceptible to injury. In this case, it is essential to first correct the cervical problem to allow the wrist condition to fully heal.

A similar phenomenon can also occur with Thoracic Outlet Syndrome (TOS) and cervical radiculopathy (tingling, pain down the arms).

CTS & The Cervical Spine

Problems in the neck or cervical spine can be a simple as poor posture and muscle tension, or as serious as disc bulges, arthritis, or spinal misalignmens, also referred to as subluxations.

A proper evaluation for CTS should include an exam of the entire length of the median nerve, starting at the neck and working down to the hands, wrists, and fingers. Since the neck is the most common site for Double Crush to occur, a consultation with an upper cervical doctor would be in the best interests of any CTS sufferer, especially if they have been recommended for carpal tunnel surgery.

Upper Cervical Health Care of Orange County

Upper Cervical Health Care of Orange County is the clinic of Dr. Jerome Ri, DC servicing the greater Los Angeles and Orange Counties. He has extensive education, training, and experience with carpal tunnel syndrome and the upper cervical spine.

If you suffer from carpal tunnel syndrome and would like to schedule a consultation with Dr. Ri, call (714) 848-8122, visit the Contact Form or use the Appointment Request Form at the top of the page.

Upper cervical care has helped countless CTS sufferers. Dr Ri knows how to develop a program specific to your needs. Most health insurance companies recognize the benefits of upper cervical care and include it among the services they cover.

Carpal tunnel syndrome (CTS) is a debilitating disorder caused by irritation or pressure to the median nerve. The median nerve originates in the neck, runs though the shoulder, arm and forearm into the wrist and hand. Don’t wait. Seek help Today!

References & Case Studies

Critelli N. Head injury-cervical strain-carpal tunnel syndrome- a videotaped evidence deposition of plaintiff’s neurosurgeon-direct and cross-examination. Med Trial Tech Q 1982 Summer; 29(1): 114-36.

Eaton, C. eHand, The Electronic Textbook of Hand Surgery. 2006.

Herczeg E, Otto A, Vass A. Significance of double crush in carpal tunnel syndrome. Handchir Mikrochir Plast Chir 1997 May; 29(3): 144-6.

Hurst LC, Weissberg D, Carrol RE. The relationship of the double crush to carpal tunnel syndrome: an analysis of 1,000 cases of carpal tunnel syndrome. Journal of Hand Surgery 10B(2): 202-204, 1985.

Ide M, Ide J, Yamaga M. Symptoms and signs of irritation of the brachial plexus in whiplash injuries. J Bone Joint Surg Br 2001 Mar; 83(2): 226-9.

Irwin, LR, Beckett R, Suman RK. Steroid injection for carpal tunnel syndrome. J Hand Surg [Br]. 1996 Jun; 21(3): 355-7.

Kaplan SJ, Glickel SZ, Eatin RG. Predictive factors in the non-surgical treatment if carpal tunnel syndrome. J Hand Surg [Br] 1990 Feb;15(1): 106-8.

Kuntzer T. Carpal tunnel syndrome in 100 patients: sensitivity, specificity of multi-neurophysiological procedures and estimation of axonal loss of motor, sensory and sympathetic median nerve fibers. J Neurol Sci 1994 Dec 20; 127(2): 221-9.

Mariano KA, McDougle MA, Tanksley GW. Double crush syndrome: chiropractic care of an entrapment neuropathy. J Manipulative Physiol Ther 1991 May; 14(4): 262-5.

Massey EW, Riley TL, Pleet AB. Coexistent carpal tunnel syndrome and cervical radiculopathy (double crush syndrome). South med J 1981 Aug; 74(8): 957-9.

Morgan G, Wilbourn AJ. Cervical radiculopathy and coexisting distal entrapment neuropathies: double crush syndromes? Neurology 1998 Jun; 50(1): 78-83.

Murray-Leslie CF, Wright V. Carpal tunnel syndrome, humeral epicondylitis, and the cervical spine; a study of clinical and dimensional relations. Br. Med J 1976 Jun 12; (6023): 1439-42.

Narakas AO. The role of thoracic outlet syndrome in the double crush syndrome. Ann Chir Main Memb Super 1990; 9(5): 331-40.

Nancollas MP, Peimer CA, Wheeler Dr, Sherwin FS. Long-term results of carpal tunnel release. J Hand Surg [Br] . 1996 Apr; 21(2): 286-7.

Niwa H, Yanagi T, Hakusui S. Double crush syndrome in patients with cervical spondylosis or ossification of posterior longitudinal ligament-a-clinicophysiological study. Rinso Shinkeigaku 1994 Sep; 34(9): 870-6.

Osterman AL. The double crush syndrome. Ortho Clin North Am 1988 Jan; 19(1): 147-55.

Pierre-Jerome C, Bekkelund SI. Magnetic resonance assessment of the double-crush phenomenon in patients with carpal tunnel syndrome: a bilateral quantitative study. Scand J Plast Reconstr Surg. 2003: 37(1): 46-53.

Roquer J, Herraiz J, Maso E. Carpal tunnel syndrome and cervical whiplash. Neurologia 1988 Sept-Oct; 3(5): 202-3.

Upton AR, McComas AJ. The double crush in nerve entrapment syndromes. Lancet 1973 Aug 18; 2(7825): 359-62.

Valente E, Gibson H. Chiropractic manipulation in carpal tunnel syndrome. J Manipulative Physiol Ther 1994 May; 17(4): 246-9.

Wood VE, Biondi J. Double-crush nerve compression in thoracic-outlet syndrome. J Bone Joint Surg Am 1990 Jan; 72(1): 85-7.

SahirKS, Zahir FS, Thomas JG. The double-crush phenonmenon- an unusual presentation and literature review. Conn Med 1999 Sep; 63(9): 535-8.

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About the author


Dr Jerome Ri, DC is the owner and operator of Upper Cervical Health Care of Orange County. He has dedicated his life to helping those in pain to regain their health and livelihoods through the use of the Blair and Knee Chest Upper Cervical Chiropractic techniques. In his free time, he enjoys working out, cooking, and building computers.

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