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.
What is Carpal Tunnel SyndromeCarpal 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. Better Patient Outcomes: Therapy VS SurgeryResearch 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:
What to Expect from Non-Surgical Carpal Tunnel TherapyIn 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:
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:
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:
What to Expect from Carpal Tunnel SurgeryWhile 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. Causes, Risk Factors and PreventionOveruse from repetitive strain injuries is the most common cause of CTS.
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:
Call to ActionPatient 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.
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Gardening is a wonderful way to calm your spirit but all the crouching, bending and lifting can take it’s toll. Check a few tips from Dr. Dukes to help you reduce your injury risks and while keeping you gardening with fewer aches and pains.
Gardening should be relaxing and rewarding , not painful. Perhaps the most important tip is to pay attention to your pain. Many of our patients report that they felt a little twinge but didn’t think it was much - only to figure out too late that they ‘over-did-it’. Severe and chronic pain isn’t normal. If you find yourself hurting, it may be time to seek help from Dr. Dukes. She'll help you determine the severity of your issue, work with you to ensure quick recovery and help you prevent ‘over-doing-it’ in the future. Call today (813) 752-2524. Are you searching for a non-invasive way to reduce or eliminate your chronic pain? If so, Dr. Dukes has helped patients with a variety of conditions through pulsed electromagnetic field (PEMF) technology. PEMF is a form of therapy that uses magnetic pulses to help reduce inflammation and improve circulation in the body. A number of studies have found that this technology can be helpful in relieving pain, especially for those suffering from conditions like fibromyalgia, arthritis, and sciatica. Let’s take a look at how PEMF works and why it might be beneficial for women seeking relief from chronic pain. Pulsed electromagnetic field (PEMF) technology works by using an electrical device to generate pulsating magnetic fields which are applied directly to the skin. These pulsating fields stimulates your cells, helping reduce inflammation and improving circulation. Dr. Dukes has found this to be a tremendous tool for pain relief with most patients also reporting increased overall energy level and a boosted sense of wellbeing. PEMF therapy is generally considered safe and effective. It's not for everyone. Certain types of medical implants may not be compatible with magnetic fields. Dr. Dukes will discuss potential risks along with the benefits prior to any treatment. PEMF therapy should only be performed as directed by a trained and experienced healthcare practitioner. Helping you better understand what is causing your health challenges is key to successful treatment and recovery programs. If you're struggling to find relief, ask Dr. Dukes is pulsed electromagnetic field (PEMF) technology is right for you. She'll take the time to discuss potential treatments without having to resort to dangerous prescription medications nor invasive treatments like surgery. That's why you'll find that Dr. Brenda Dukes and her team focus on communicating and educating throughout every course of treatment. Experience the difference for yourself. Call today! (813) 752-2524 Schedule your consultation with Dr. Dukes and experience the difference for yourself. Combine stress, repetitive activities and poor posture, and what do you get? Tension headaches. Dr. Dukes revealed the most common contributors: poor posture, constantly looking down at your cell phone, working on your laptop in your home office all day, driving for hours without rest, playing video games for hours, chronic jaw clenching, and poor sleep posture. Dr. Dukes explained that, “these activities overstretch the muscles on the back of your neck and weaken them, increasing your susceptibility to tension headaches. The second part of the problem is that using any muscle too much leads to pain and, often, results in tension headaches.” Episodic tension headaches come on quickly and are fairly painful. “They are usually associated with stressful events adn tend to be subside once the stressful event is over.” Chronic tension headaches can recur daily. They may come on as you wake up or after a long day of work or activity. “The muscles in your neck and scalp tend to stay contracted,” she says. “Pain and tightness develop on both sides of the head, in the forehead and at the base of the skull.” Dr. Dukes recommends minimizing tension headache contributing factors by: Minimizing stress: Try to avoid or limit stressful events. Taking breaks: Limit the time you spend looking down at your phone. Take breaks on long drives. Adjusting the way you sleep: Try sleeping on your back or on your side with a body pillow and your neck in neutral posture. Exercise and stretch: Use a therapy cane or a hard therapy ball to massage out or stretch your neck and shoulder muscles. Avoid clenching: If you have trouble avoiding this behavior, seek a dentist knowledgeable about temporomandibular joint (TMJ) syndrome. What about rubbing your temples when a tension headaches starts to build — does it help? “Muscle tension varies, so rubbing on your temples may not bring relief,” says Dr. Bang. “But rubbing on the tender spots, or trigger points, in your neck and shoulder muscles can help.” If tension headaches don’t go away after trying these suggestions, it may be time to seek professional help from Dr. Dukes and her experienced team of professionals. Call today (814) 752-2524. Reach out to Dr. Dukes. Schedule your consultation and learn how Chiropractic can help you. Did you know that water is part of every cell in your body? Good spinal health begins with good hydration. Dehydration can cause limited mobility, decreased flexibility, and pain. From the time you get up in the morning you are putting pressure on your spine, compressing and decompressing the discs that lie between each vertebra. If you don’t drink enough water, your body becomes dehydrated and your discs lack proper fluid pressure resulting in limited mobility, pain, and an increased risk of back injury. You may not even notice the typical signs of dehydrations such as headache and lethargy, but even lower levels of dehydration can cause serious problems in the body, especially if it is prolonged. Soda and other soft drinks do not supply the amount of water that is necessary for the body. Water is the best way to hydrate your body, but it isn’t the only way. Foods like watermelon, lettuce, spinach, and soups are great sources of hydration. Herbal teas can also provide the body with the right source of water as well. Drinks with caffeine are not as effective since the caffeine can have a diuretic effect. If you have constant or frequent back pain the answer could be dehydration and, you can change that. If you’re paying proper attention to hydration and find yourself still feeling aches and pains, reach out to Dr. Dukes. Schedule a consultation and learn how Chiropractic care can help you get back to living life on your terms. 813-752-2524 When injured, your body begins the healing process naturally through inflammation however imbalances in your immune system may cause your improperly stay ‘on’, continually creating more inflammation in response to the existing inflammation. Most patients are surprised to learn that left unchecked, chronic inflammation can lead to a host of issues exhibited through symptoms such as: joint pain, weight gain/inability to lose weight, complexion/skin problems, high blood pressure, respiratory conditions (asthma, allergies, congestion) or digestive issues (irritable bowel syndrome, indigestion). The good news is that you can reboot your immune system and find relief through non-drug / non-invasive treatment options. Many of my patients have found success by following a 3-step course of care: 1.Regular chiropractic adjustments are key to reducing cytokines that, left unchecked, cause inflammation to run rampant. 2.Pulse Electromagnetic Field Technology is cutting-edge technology that we use to help suppress inflammatory responses at the cell membrane level typically resulting in reduced pain symptoms and increased range of motion. 3.Lifestyle changes are the final step to preventing chronic inflammation from recurring. Regular exercise, proper sleep, good nutrition, hydration and smoking cessation Following this powerful course of care allows most patients to attain levels of wellness they never thought possible. If you feel that you may be suffering from chronic inflammation, make health your top priority and call Dr. Dukes at (813) 752-2524 to schedule your wellness consultation today. One positive outcomes from our pandemic is that more of us are walking more often. And, chances are that walking is something you've never really thought.
Walking offers tremendous health benefits. But, if it's been a while since you've been active, it's important to take a look at how you walk. After all, it’s a repetitive motion and thousands of steps per day can put a lot of stress on your entire body resulting in aches and pains that may keep you from realizing those benefits. Chances are, you learned to walk when you were just a toddler and you haven’t really thought about it much since. But life and activity levels change so it's important to learn how to walk correctly. Here's how to make the most of your daily strolls step-by-step. Understand the mechanics Having a clear idea of what a step actually involves can help you visualize how to walk correctly. Every step happens in two phases: stance and swing. A single gait cycle of stance and swing typically lasts about 1-second.” Your brain does all of that instinctually. Understanding the parts can be valuable in assessing where you might have weaknesses and can help assess any pain you’re having. Pick the right shoes Choosing poorly fitting or unsupportive shoes can lead to serious health problems. While symptomatic aches and pains may begin at your feet, the core problem often creates spinal mis-alignments that wreak havoc all over your body. There’s no perfect shoe for everyone. Stability is crucial. Avoid walking in sandals or other footwear without arch support. Many shoe stores offer options with corrective structures designed to provide support in specific areas or even correct problems. I recommend starting with an established local running store or show store that specializes in corrective shoes. They'll look at the sole of your current shoes to determine wear patterns. If your shoes are wearing too much on the inside, then you might need something that gives you a little more arch support. If they’re wearing more quickly at the heel and causing pain, then you might need a little more cushioning. If you’re unsure about the shape of your step, sticking with a neutral shoe is a good place to start unless you’re having specific pain or are getting a personal assessment. Pay attention to posture It’s possible for your body to have an injury that you haven't noticed which is causing you to over-compensate and walk imbalanced. The obvious sign of this is poor posture. Poor posture often indicates weakness, pain or injury. When this happens we lean over to the weak or painful side, shifting the center of our mass to alleviate forces on that limb. That imbalance will cause of host of problems throughout the body. If you start to recognize that you're imbalanced, seek professional help. Avoid attempting to force yourself into the right position because that often makes issues worse and accelerates health problems. Rather, call to schedule a consultation. We'll work together to find the underlying cause then use treatment to help eliminate the source of the problem rather than simply addressing the symptom. Sometimes the treatment solution is as simple as a combination of massage and learning proper walking technique and posture. Stand up straight Slouching is never healthy and that’s especially true while walking. Pull your shoulders back, keep your bum tucked underneath you, and your head parallel to the ground. As you lift your chin up, you'll automatically help bring your head in line with your pelvis and eliminate slouching. If you have a habit of slouching at a desk all day, it's normal that your back, neck, and shoulder muscles may feel sore after a long walk. Keep at it, the soreness will soon be replaced with a feeling of vitality. Avoid over-striding Once you’re a more experienced walker, it’s tempting to try and up your pace and distance. But doing too much, too soon can cause problems with your stride and limit your workout capabilities. Taking too big of a stride will require your pelvis to rotate too far to step out in front of you. This puts stress on your lower back and a lot of stress on your heel as it impacts the ground. If you're looking to put a 'little more umpf' into your walking, I recommend increasing the pace of your steps rather than compromising your health by overstretching your stride. Custom Orthotics A variety of problems ranging from joint pain, foot discomfort, and posture issues, and especially lower back pain can be alleviated through custom orthotics. These are insoles that slip into shoes. They are custom-crafted especially for your unique foot shape and biomechanical needs. Dr. Dukes has helped many patients struggling with low back pain, knee pain, plantar fasciitis, and even neck and shoulder pain find relief through custom orthotics so they can achieve their health and fitness goals. When you're ready to live your best life, call me. Schedule a consultation. The team at Dukes Chiropractic is here for you. (813) 752-2524 What Is Inflammation? Inflammation is your body’s natural immune response that helps the healing process begin. Chronic inflammation occurs when an imbalance in your immune system causes your immune response to ‘stay-on’, continually creating more inflammation in response to the existing inflammation. Most patients are surprised to learn that almost everything we do can diminish or exacerbate the conditions that foster chronic inflammation. Stress, diet, exercise and sleeping habits can be major contributing factors. Left unchecked, chronic inflammation can lead to diseases as well as impacting your whole body via symptoms such as: joint pain, weight gain/inability to lose weight, complexion/skin problems, high blood pressure, respiratory conditions (asthma, allergies, congestion) or digestive issues (irritable bowel syndrome, indigestion). Treatment Options The good news is that you can reboot your immune system and find relief through non-drug / non-invasive treatment options. First, regular chiropractic adjustments have been shown to reduce the chemicals in your body (cytokines) that cause inflammation to run rampant. Adjustments also align your spine ensuring proper nervous system function so that your immune system can function properly too. Second, lifestyle changes are critical to successfully treating chronic inflammation. Regular exercise, proper sleep, good nutrition, hydration & PH balance and eliminating smoking will allow you to reach a level of wellness you never thought possible – without drugs or invasive procedures. If you feel that you may be suffering from chronic inflammation, Call Dr. Dukes today. She’ll help you understand your challenges, learn your options and find lifelong health and wellness. |
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