Case of the Month October 2009

October 26, 2009

Mrs. X presented to the office with bilateral carpal tunnel.

First a little background.  Carpal tunnel is a common term for pain in the wrist.  For many years it was assumed that because the pain was in the wrist, then the problem was originating in the wrist.  Chiropractors have worked to show there may be other factors that influence the pain in the wrist, including neck misalignment, muscle spasm and joint misalignment.

Back to the patient.  Mrs. X reported no significant history of trauma.  She did report that she spent between 8 and 1o hours at the computer, with about half of that on a laptop.  When asked to reproduce her work position I noted there was significant leaning forward with a lot of slumping of the shoulders.

Examination showed significant restrictions in the neck and muscle spasm in the shoulders and forearms.  X-Ray exam showed a 7 degree curve in the neck, where 45 is ideal and 36mm of forward head carriage.

After going through my findings with Mrs. X I suggested a 5 visit trial where I would get to see how she responded to the care and she would determine if this course of care was for her.  Care consisted of neck and midback adjustments, extension traction and trigger point therapy.  After evaluating the wrists, I made the decision to not mobilize the wrists as I judged they were already moving well.

On the first visit I asked Mrs. X to rate the pain in the wrists, it came in at a 7.  I adjusted Mrs. X, had her stretch and worked on the muscle spasm in the forearms.  This went on for 5 visits.

At the beginning of the fifth visit, Mrs. X reported her wrist pain had improved to a 3!!!  As excited as she was about this, her objective changes were what was getting me fired up.  The muscle spasm in the forearms was significantly better, the restrictions in the neck were clearing up and I was even seeing a change in her posture.

This is a classic example of the pain being in one area but the problem located in another area.

If you would like to see a research report that shows chiropractic as effective as taking a bunch of pain killers for carpal tunnel click here.  Please remember, what we did with Mrs. X involved no drugs, which for sure saved some wear and tear on the liver, stomach, etc.