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Healthy Hints

Fall 1998 Newsletter

This Issue:

Treating Carpal Tunnel Without Drugs or Surgery

By Rick Allen, DC [ Wrist injury image ]
  • Do your wrists and hands ache from overuse?
  • Do you wake with your hands curled and stiff?
  • Do your hands burn, tingle or feel numb?
  • Do you fumble when lifting objects?
  • Do your hands have less than normal strength?

You may have carpal tunnel or a related repetitive strain injury/cumulative trauma disorder (RSI/CTD). Some form of repetitive stress disorder - mostly carpal tunnel - is now occurring in fully 15 percent of the U.S. workforce. According to Newsweek (6/26/95), claims for repetitive strain disorders cost employers some $100 billion annually. It is epidemic.

Warning Signs:

  • Occupational repetitive wrist motion - microtrauma - from hammering, typing, sewing, or assembly line work.
  • No major, overt trauma to the wrist - no macrotrauma.
  • Pain in the arm, wrist and hand - location and intensity may vary.
  • Altered sensation in the hand - may burn, tingle or feel numb.
  • Weak grip - may fumble or drop objects.
  • Tenderness when the carpal tunnel of the wrist is tapped vigorously (Tinel's Test).
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[ Tinel's Test graphic ]

Tinel's Test for RSI

Problems From Medical Treatment

Medical treatment focuses on the carpal tunnel, where the median nerve crosses the underside of the wrist. The most common medical treatment is a combination of wrist/forearm bracing and anti-inflammatory medication. If that doesn't help, surgery is suggested - cutting the flexor retinaculum across the wrist. While this gives dramatic short-term relief of the symptoms, it can create additional problems:

[ Cross Section of Wrist ]
  • While the arm, wrist and hand feel better when kept from moving, the underlying adhesions are still present and may be even worse when the brace is removed.
  • Anti-inflammatory drugs also block the pathways that heal connective tissue. With chronic use, this creates a cycle of incomplete healing and dependency on the drugs to reduce recurring swelling and pain.
  • Scar tissue often grows over the carpal tunnel.

Natural Conservative Care

A better route is conservative treatment: chiropractic, massage, myofascial release, neurolymphatic reflex points, acupuncture, nutrition, specific exercises, and correction of poor ergonomic working conditions. In addition to carpal tunnel, these treatments address related problems, such as trigger points in the muscle of the forearm and neck, vertebral subluxations of the neck, and chronic forward postural strain.

Having successfully treated a number people with carpal tunnel and other RSI/CTD (including myself), it is my experience that conservative, non-surgical, non-drug treatment is effective in most cases. It is certainly the route to follow first. Most importantly, it has no unwanted side effects.

[ Workplace Ergonomics chart ]

Beyond the Ability to Heal Naturally

In the unlikely event that your case is beyond the body's ability to repair itself with conservative care, the medical/surgical route is still available. If you do not experience some improvement within three weeks, your case may unfortunately be so severe that a neurological consultation is advisable and surgery may be necessary.

Ongoing, Preventative Care

Remember, though, that if you continue the same conditions that led to the injury in the first place, you will be back at square one - in pain and, perhaps, unable to work. Ongoing preventative care is necessary to stay healthy.

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[ Lisa and Sasha Santos ]

Why Wellness Care?

First of a Series

Last issue I introduced the concept of regular "wellness care tune-ups" to keep folks in optimum health. I owe a big "thank you" to the many patients who told me why they come for care.

Lisa Santo was a pregnant mom this summer when she told me, "I first began seeing Dr. Rick in April of 1997. I could barely move my head from side to side and had severe pain in my lower back. In the span of only a couple of weeks I was once again able to move freely. Since then I have had only occasional minor pain in my back and neck and I am currently in my 9th month of pregnancy! I really feel that a visit to Dr. Rick every few weeks has kept my back and neck in good shape. With some stretching at home and the chiropractic adjustments and massage I think I'm healthier than I've been in a long time!"

Lisa and her husband Brian gave birth to a healthy baby girl, Elly, on September 18th. Elly is off to a wonderful, healthy start - she had her first chiropractic checkup at age two weeks. Lisa and her older daughter, Sasha, are pictured above.

Wellness Care Options:

Chiropractic adjustment
Nutritional, exercise suggestions
Up to 45 minutes
Chiropractic adjustment
Brief massage
Brief self-care suggestions
Up to 30 minutes
Chiropractic adjustment
Up to 20 minutes

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[ Dr. Rick treating swimmer at Nike World Master's games]

Dr. Rick Leads Team Treating Nike World Masters Swimmers

Dr. Rick Allen organized and led a team of three chiropractors who treated swimmers and water polo players during the Nike World Masters Games August 9-19, 1998, at the Mount Hood Aquatic Center, in Gresham, Oregon.

The conditions treated were mostly over-use in nature. Rotator cuff injury to the shoulder was fairly common. It was greatly helped by conservative chiropractic care. There was excellent cooperation between the chiropractic, massage, EMT and Kaiser medical teams. In fact, Dr. Allen treated many of the medical team members!

[ Nike World Master's games 98 logo] [ Dr. Rick with medalists at Nike World Master's games]
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