What is Carpal Tunnel?
The patients with carpal tunnel often complain of pain and/or tingling, weakness in the palmer surface of the thumb and radial two and one half fingers. The symptoms are worse at night or during the activity which aggravates it. The patient typically complains of clumsiness with precision gripping and pain. The cause is due to direct compression from ganglions, dislocations of carpal bones, narrowing of the tunnel due to thickening of the tendons there or fractures. These are usually a result of prolonged wrist use in full flexion or extension causing chronic micro trauma with inflammation. Additional factors may have to do with fluid retention, as in pregnancy, RA, diabetes, and connective tissue disorders. Patients deficient in B vitamins may be predisposed.
Classically, Phalen’s, reverse Phalen’s, and Tinel’s tests have been used clinically to provoke symptoms. These tests have variable responses. The pressure-provocative test appears to be more sensitive. Direct pressure is applied with the thumb over the carpal tunnel. Pinch and grip strength is usually weaker on the involved side. Thenar atrophy may be evident in chronic cases. Electrodiagnosic studies may indicate conduction delay at the wrist. Although symptoms of pain, numbness, and tingling are common in the general population, one study indicated the only one in five patients with these complaints meet the clinical and electrodiagnostic study criteria for carpal tunnel syndrome. Ironically, some studies have indicated that asymtpomatic patients demonstrate electrodiagnostic study findings of median nerve involvement, and many patients with carpal tunnel syndrome symptoms have no electrodiagnostic study abnormalities. It is important to examine other potential sites of median nerve entrapment.
Dr. Trabulsi has a 97% success rate utilizing this unique advanced smart stem therapy in combination with ultrasound to the carpal tunnel area which helps to reduce inflammation, edema, pain and stimulate the median nerve. This therapy is applied with a “smart head” probe that is capable of such mordality. Cold laser therapy is applied which was initially FDA approved for the treatment of carpal tunnel syndrome. Supplements such as B-complex are given to the patient adjustment to the lunate may also be helpful. Ergonomic advice regarding hand and wrist position or the use of split keyboard or rest pads may be of help. surgical release of the retinaculum is warranted if the patient is non responsive to treatment. it is important to know that one study indicated that 5 years following surgery, 30% of patients rated their satisfaction as poor or fair.
Rashad Trabulsi DC, Dip, Ac. and James Yu L.Ac have put together a group of highly trained and professional individuals that can work alone in the specific scope of their profession but best utilized in our integrative model of care which incorporates all their unique skills together to providing better care and faster relief. This model of care is comprised of a holistic Chiropractic approach that utilizes advanced physiotherapy modalities, therapeutic exercises, nutrition, traction decompression and joint manipulative techniques. Also, Oriental Medicine with over 40 years of family experience in Chinese herbs and Acupuncture specialized techniques for nerve problems or arthritic pain. Finally, Dr. Trabulsi selectively picks medical massage therapists that are highly skilled and they are trained to work closely with the doctor and acupuncturist to enhance their therapeutic approach and support the overall treatment plan. All services are provided at both the Brooklyn Heights and Midtown Manhattan locations.