Aging is a natural part of life, and how we age depends significantly on the health practices we adopt throughout our lives. From infancy through older adulthood, maintaining healthy habits can lead to greater resilience and increased opportunities to thrive as we age. At Dukes Chiropractic Health Clinic, we recognize that the journey to healthy aging begins early and that health disparities experienced earlier in life can exacerbate as we get older. Chiropractic care plays a crucial role in promoting healthy living, ultimately contributing to wellness for life.

Chiropractic care focuses on the health of the musculoskeletal and nervous systems, which are vital for maintaining overall wellness. Regular chiropractic adjustments help keep the spine aligned, ensuring that the nervous system functions optimally. This, in turn, promotes better body function, enhances mobility, reduces pain, and supports the body's natural ability to heal itself.
Infancy and Childhood:Growth and Development: Proper spinal alignment is essential for children as they grow. Chiropractic care can address issues such as colic, ear infections, and poor posture, setting a strong foundation for future health.
Preventing Future Problems: Early intervention can prevent the development of chronic conditions and ensure that children grow up with healthy spines and nervous systems.
 
Adolescence and Young Adulthood:Sports Injuries: Adolescents often engage in sports and physical activities that can lead to injuries. Chiropractic care helps manage and prevent injuries, promoting faster recovery and long-term wellness.
Posture and Ergonomics: With increased use of technology, many young adults develop poor posture. Chiropractic adjustments and ergonomic advice help maintain good posture and prevent chronic issues.
 
Adulthood:Pain Management: Adults often experience back pain, neck pain, and headaches due to work-related stress, poor posture, and sedentary lifestyles. Chiropractic care provides non-invasive pain relief and improves quality of life.
Enhancing Mobility: Regular adjustments keep joints flexible and muscles balanced, making it easier to stay active and engage in regular exercise, which is crucial for overall health.
 
Older Adulthood:Maintaining Independence: For older adults, maintaining mobility and independence is crucial. Chiropractic care helps manage age-related issues such as arthritis, osteoporosis, and joint degeneration, improving balance and reducing the risk of falls.
Improving Quality of Life: Chiropractic care can alleviate chronic pain, enhance physical function, and promote a better quality of life, allowing older adults to stay active and engaged in their communities.

At Dukes Chiropractic Health Clinic, we understand that health disparities experienced earlier in life can significantly impact aging. Socioeconomic factors, access to healthcare, and lifestyle choices can all influence an individual's health trajectory. By providing comprehensive chiropractic care and promoting healthy living practices, we aim to address these disparities and support our patients in achieving healthy aging.
Education and Awareness: We educate our patients about the importance of maintaining a healthy spine and nervous system throughout their lives. This includes advice on proper posture, ergonomics, nutrition, and exercise.
Personalized Care: Our chiropractors provide personalized treatment plans tailored to each patient's unique needs and health goals, ensuring that they receive the best possible care at every stage of life.
Preventive Care: We emphasize preventive care to identify and address potential health issues before they become chronic problems, promoting long-term wellness and healthy aging.

Healthy aging is a lifelong journey that requires consistent effort and dedication to maintaining good health practices. Chiropractic care plays a vital role in promoting healthy living and supporting individuals at every stage of life, from infancy through older adulthood. At Dukes Chiropractic Health Clinic, we are committed to helping our patients achieve and maintain optimal health, ensuring that they can enjoy a higher quality of life as they age. By addressing health disparities and providing comprehensive, personalized care, we aim to empower our patients to thrive and age gracefully.

If you’re ready to give yourself and your family the gift of health, reach out to Dr. Dukes. Schedule your consultation and learn how regular chiropractic care will help you and your loved ones live their best life. Call ​​(813) 752-2524 today.

For mild to moderate carpal tunnel syndrome, therapy provides equal or better patient outcomes compared to surgery with no pain killers, significantly reduced risks, faster recovery, and vastly lower patient cost-of-care.

For many people with CTS, conservative therapy relieves symptoms and restores function - without the use of dangerous drugs or risky surgeries. Non-surgical therapy is universally recognized as the first-line CTS treatment modality. The AAOR cautions that surgery should be used only as a last resort advising that surgery is only appropriate for severe cases that interfere with daily life with symptoms lasting over 6 months where non-surgical intervention has not resolved the issue.

Chiropractors are experts at restoring wellness by treating the root cause of CTS with hands-on care and patient education without risks associated with surgery.

Symptoms typically include tingling, pain, numbness or weakness in the fingers and thumb. Some patients may also experience radiating pain in the forearm.

Dr. Dukes usually resolves CTS within a few weeks through therapeutic, non-surgical therapy. Many patients start feeling better after the first treatment. Symptoms normally improve gradually. Within a few weeks, most patients report significantly reduced pain, tingling and numbness as well as normal hand function.

• Women get carpal tunnel syndrome three times more often than men.
• Carpal tunnel syndrome is a progressive condition that can worsen without proper care.
• CTS symptoms often present during pregnancy and can be alleviated with nonsurgical treatments. Symptoms often improve after delivery, but such patients are at higher risk of developing carpal tunnel syndrome later in life.
• Most people first experience symptoms in their dominant hand.

Carpal tunnel syndrome (CTS) is typically a constriction of the median nerve as it runs through the carpal tunnel in your wrist. The root cause is most often irritation or damage that causes inflammation with use which compresses the carpal tunnel on your medial nerve.

Symptoms of this common hand condition include numbness and/or tingling exhibiting in the thumb and fingers which often results in pain, discomfort, weakness and reduced mobility over time.

The carpal tunnel is a narrow passageway through your wrist. It is made of tendons, ligaments and bones located on the anterior (palm) side of your hand. It protects the median nerve and allows it to pass through your wrist and into your hand.

The median nerve provides sensory feeling to your thumb, index finger, middle finger and the thumb side of the ring finger and controls motor (movement) functions to the forearm, wrist and hand. It also sends touch, pain and temperature sensations from the lower arm and hand to the brain.

Research shows that, in most cases, non-surgical therapy provides equal to or better outcomes when compared to carpal tunnel surgery. In fact, the American Academy of Orthopedic Surgeons (AAOS) recommends non-surgical therapy as the primary CTS treatment modality and cautions that surgery should be used only as a last resort further advising that surgery should be recommended only if ALL of the following criteria are met:

1. Severe symptoms present for at least 6 months. 60% of patients carpal tunnel symptoms resolve on their own with rest. For 40% of patients, symptoms will last for months and intensify without intervention.
2. Symptoms are so severe they interfere with daily life. Symptoms typically advance within 6-12 months of the first symptoms. Severe symptoms may include weakness and radiating pain that limits dexterity and functionality.
3. All nonsurgical remedies were tried without success. The vast majority of patients typically experience complete relief using non-surgical therapies to treat CTS.
   
   

Research published in the Journal of Orthopaedic & Sports Physical Therapy revealed that at the 3, 6, and 12 month post-treatment follow-up examinations, patients in both the therapy and surgery groups showed similar improvements in function and grip strength. Pain also decreased similarly for patients in both groups. The researchers concluded that therapy and surgery for carpal tunnel syndrome yield similar patient benefits.

In most cases, non-surgical therapy treatment is effective in reducing CTS symptoms and often helps patients get back to everyday activities within 8-12 weeks depending upon the symptom severity.
Typically patients are referred by their primary care physician or a hand specialist after a examination results in a CTS diagnosis. Patients may also self-refer to avoid delaying the process and mitigate cost of care.

Therapy for mild cases of early-stage CTS typically involves an initial consultation, testing and 1-2 therapy sessions over 4 weeks. Treatment may include: 

• Resting the affected hand and wrist. 
• Avoiding activities that may worsen symptoms.
• Education on proper workplace rest breaks, ergonomics, on-the-job stretching and light exercises. 
• Immobilizing the wrist in a splint to avoid further damage from twisting or bending – especially while sleeping.
• Applying cool packs to help reduce swelling from inflammation.
• Inflammation and swelling treatment through PEMF and/or Cymatic Therapy.

Patients with moderate or severe CTS treatment begin with the same process used to treat mild CTS symptoms along with specialized therapy techniques such as myofascial release or fascial stretch therapies that gently manipulate the joints and soft tissues of the wrist, hand, and arm releasing restrictions and tissue adhesions to alleviate pressure on the median nerve. These techniques reduce symptoms and improve electromyographic test results by naturally releasing the transverse carpal ligament which "opens" or dilates the canal. People on blood thinners, with metabolic conditions, deep vein thrombosis, open wounds, burns or bone fractures are not candidates for myofascial therapy.

Myofascial release is the primary treatment modality used to break-up restrictions and tissue adhesions in and around the tendons inside the wrist joint. Specifically, this technique breaks fascia restrictions and adhesions that cause tendon inflammation and swelling. This inflammation and swelling is the underlying condition that causes carpal tunnel symptoms. 
Two primary techniques used:

• Friction: This is a glide technique that involves applying pressure to the base of the wrist with both thumbs and then gliding the thumbs toward the elbow with sustained pressure to break up tissue adhesions.
• Petrissage: Utilizes movements like kneading, wringing, skin-rolling, and deep squeezing to help stretch and loosen tight muscles that may be contributing to CTS.

After myofascial release therapy, you may feel soreness. This should go away within 12-24 hours and your arm, wrist and hand should feel more relaxed.
Fascial stretch therapy is another type of manual therapy where therapists don’t apply pressure to certain areas of your body. Instead, parts of your body (such as your arms and hands) are manually moved to stretch your fascial tissues.

Treatment may be recommended every one to three days over several weeks or a few months. Therapy sessions will last 15 to 50 minutes.  Session frequency and intensity will depend on the cause and severity of your condition. Most patients report numbness and pain subsiding within 12 weeks.
Once your symptoms have subsided, your practitioner will likely prescribe self-care stretching, strengthening exercises, and wearing a splint at night until full hand strength returns. Length of time required for full strength to return varies by patient, but most can expect complete recovery in 6 months. Patients should consider:

• Risk. Because therapy is non-invasive and drug-free, there are few risks. Short-term soreness is the most common risk. Rare cases of myofascial release causing internal bleeding, nerve damage and/or short-term paralysis have been reported.
• Complications. Ineffective or incomplete release resulting in recurrence. In severe (Stage 4) cases not responding to therapeutic approaches, an assessment for surgical intervention may be indicated.
• Cost. Therapy provides affordable, first-line treatment of CTS symptoms.

• Recovery. Most patients report symptom resolution within 12 weeks.
• Return to work time. Most patients choosing non-surgical therapy to treat CTS return to normal activity within 8 weeks of treatment.

While each patient’s experience is unique, in most cases the process takes 16-24 weeks from the initial PCP appointment, specialist consultation, surgery and primary recovery. Full recovery may take 4-12 months depending.

In most cases patients are referred to a hand specialist after a general exam performed by their primary physician indicates the potential for CTS.  A specialist provider will normally use a combination of physical and imaging tests to diagnose your condition. These may include: Tinel’s sign, Phalen’s test, Wrist X-rays, Electromyography (EMG), Ultrasound, and/or Magnetic resonance imaging (MRI).
Surgery for carpal tunnel syndrome is usually done as an outpatient procedure using local or general anesthesia. Two types of carpal tunnel surgery are typically performed:

Open surgery involves the surgeon making an approximately 2-inch long cut on the wrist, then cutting the carpal ligament to make the carpal tunnel passageway larger.

Endoscopic surgery is performed with the surgeon making one half-inch long cut on the wrist. Then a small probe is attached to a narrow tube which is then inserted into the cut. The small probe may or may not have a camera. The surgeon inserts surgical instruments through the narrow tube and cuts the carpal ligament through the other incision. The surgeon uses the camera to locate and cut the carpal ligament. When there is no camera, an ultrasound device guides the surgeon to the correct probe placement before cutting the carpal ligament.

Post-operative care can be intensive for some patients and mild for others. After surgery, your hand and wrist will be splinted for several weeks or more. The surgeon may also have you keep the affected hand elevated above your heart while sleeping at night to decrease swelling. You'll likely begin a physical therapy program once the stitches have healed and the splint is removed. Use of a splint or brace may be recommended for 4-6 weeks after surgery.

Risks. Carpal tunnel release surgery potential risks include bleeding, infection, injury to the median nerve or nerves that branch out from it, injury to nearby blood vessels, sensitive scaring, the need for more surgery.

Potential complications. According to a 2023 NIH report,” the most frequent complication of carpal tunnel surgery is the development of a neuroma in the palmar cutaneous branch of the median nerve. Patients may also experience hypertrophic scars, joint stiffness, dysesthesias, and incomplete resolution of their symptoms.”

Cost considerations. According to the NIH, the median cost of carpal tunnel surgery was $10,273 as of April 2023. The estimate does not include pre-surgery examinations, testing, post-surgery care, therapy nor follow-up examination costs.

Recovery time. Carpal tunnel surgery recovery time varies. Most patients report numbness and pain subsiding within 4 months. Hand strength will return within 1 year – how much strength returns can vary.

Pain medication. Prescription pain-killers and drugs are typically prescribed to control post-surgery pain and inflammation.

Return to work time. Surgery recovery takes longer for a significant number of patients. The majority of patients choosing therapy to treat CTS return to normal activity within 8 weeks of treatment. However, over 30% of CTS patients choosing surgery do not return to work within 8 weeks.

Overuse from repetitive strain injuries is the most common cause of CTS.

• Frequent, repetitive movements with the hands.
• Extending or flexing the wrist for long periods of time.
• Inflammation in the joints.
• Rheumatoid arthritis and other related conditions.
• Hormonal or metabolic changes (menopause, pregnancy or thyroid imbalance, etc.).
• Wrist anatomy/scar tissue from previous injuries.
• Poor health due to smoking, obesity and/or poor nutrition.
• Nerve damage from diabetes, high-blood pressure, etc.
• Health conditions such as Gout, Hypothyroidism, Amyloidosis, or Rheumatoid arthritis.
  

It can be hard to prevent carpal tunnel syndrome, especially with a contributing health condition or activities contributing to the condition cannot be avoided. Professional healthcare associations including The American Chiropractic Association and the American Academy of Orthopedic Surgeons suggest the following CTS prevention strategies: 

• Stop smoking.
• Maintain a healthy weight and fitness level.
• Eat healthy, nutritious food. Avoid processed, high-sodium foods.
• Stretch your wrists and hands before and after intense physical activities.
• Wear proper protective equipment for all work or activities.
• Take frequent rest breaks when working with your hands.
• Perform on-the-job conditioning, such as stretching and light exercises. 
• Use correct posture and wrist position. 
• Use proper workplace ergonomics.
• Wear splints to help keep the wrists straight – especially at night. 
  

Patient education is key to positive patient outcomes. We hope that this article arms those suffering from CTS with the facts they need to make informed health conditions.

Early diagnosis, treatment and intervention will help avoid more extensive damage as well as improve healing trajectory.

If you've been told that drugs or surgery are your only options, Dr. Dukes encourages you to learn the facts and get a second opinion. Dr. Dukes can help get you back to living life on you terms, naturally.

Call ​​(813) 752-2524 today to schedule your consultation with Dr. Dukes.