A Subject That Has Been Milked for Decades – Carpal Tunnel Syndrome

By  Dr. Dennis Antoine

Guest Writer for Wake Up World

Throughout history, our occupations have required us to perform certain body movements over and over. Automobile assembly lines and their mass production of automobiles made this a common occurrence.  Many other occupations require repeated movements as well.

It’s not a good idea to do one certain movement in a job without taking care to prepare the area being used. Stretch the muscle. Get the right treatment. Talk to your boss about a worksite change, if you have one in mind that will make your job easier. Just don’t work yourself into a problem.

If an individual performs the same exact task every minute or so, every hour of a five day work week, they will develop some type of strain or sprain to their body.  This is known as a repetitive strain disorder. Carpal tunnel syndrome can sometimes  be a type of repetitive strain disorder.

*Olmstead County, Minnesota, using the medical records from the Rochester Epidemiology Project and data from the Minnesota Department of Labor and Industry.

A total of 10,069 individuals were diagnosed with carpal tunnel syndrome in the study period. After accounting for the influence of age and gender, the incidence carpal tunnel syndrome was 376 per 100,000 persons per years. The incidence was significantly greater among women vs. men (491 vs. 258 per 100,000 persons per years. Overall the annual rates increased nearly twofold over the study period, from 258 per 100,000 in the earlier period (1981 to 1985) to 424 per 100,000 people in the later period (2000 to 2005.)
Read more:  Carpal tunnel syndrome incidence rising – Neurology

There has been a continued increase in cases of carpal tunnel year after year. Why should that be? Is the wolf guarding the henhouse?

We do 2 things to a muscle. Exercising  the muscle, we make it  larger.  Stretching  takes a compact muscle and smoothes it out, making it  longer.

Repeated motions from a job can make a muscle enlarge. Such is the case with occupations requiring use of the pronator teres muscle. Professional hairstylists, mechanics, surgeons, waitresses all overuse specific muscles in their forearm, one of them being specifically the pronator teres muscle.

Let’s use a foot blister from walking, as an example. The irritant is either the shoe itself, where the skin of the foot is being rubbed upon repeatedly, or an object is lodged in the shoe. Either situation can cause a blister to form. The body’s way of dealing with this is to form protection over the damaged skin and does so, forming a water filled sac with underlying sensitivity. This is a blister.

Inside the body we have these same types of overuse or irritating situation, yet an inability to form a blister. The body knows when a muscle is slowly being overused. For this reason it causes pain. And if it can’t cause pain directly at the site, it will refer the pain or send it somewhere else. This is termed  ‘referred pain”. Just like when a gall bladder has a problem it “refers ” pain to the scapula.

You want to get to the cause of the problem. Decompression surgery decompresses the wallet mostly. Opponensotomy or cutting of a thumb muscle? Really? That’s pretty radical for a fairly easy to treat condition. You want to treat the problem, and then make an evaluation and perhaps change in the duration/frequency of the job causing the problem in the first place.

The following video explains concisely how and  why  you want to seek the most effective first line of defense.    Active Release Technique  is a patented treatment program founded by  Dr Michael Leheay,  a  certified sports physician. This treatment is also very effective for plantar  fascitis, sciatica, and frozen shoulder. The rest of this offering will center on wrist problems.

There are many highly skilled and advanced practitioners who, through utilizing anatomical and practical manual applications with their hands alone, can give great relief to those who suffer from repetitive strain disorders or rsd’s. This treatment is called  Active Release Technique

This type of attention should always be done instead of “throwing the baby out with the bath water” approach of automatically and systematically delivering the same treatment over and over– drugs and surgery, instead of denying the origin and development of the condition in the first place.

There is a muscle in the forearm called the Pronator Teres muscle. There is also a nerve in the forearm that travels through this muscle.  This nerve is the median nerve.

Many occupations enlist the use of this muscle  repeatedly.  Waitresses, hair care professionals, butchers, mechanics, even surgeons,  as a result of overuse, their pronator teres muscle becomes larger, and  it pulls upward on the median nerve.  As a result of the nerve becoming taut and tight, it “rubs” in the tunnel created by the carpal bones which is known as the carpal tunnel. if you pull a  garden hose very tight around the corner of a home, you will impede or stop the flow of water. You don’t need to open up the wall in the home-you need to let out more hose or let the hose relax, to normalize flow.

The medical treatment? Splint/brace the area and give anti-inflammatory drugs. Of course, over a week or two, the area will be calmed down, and the person will think their problem has gone away, because the symptoms have stopped.

The injured person  begins doing their job again and the pain returns. And why wouldn’t it? So now, surgery is recommended.

Surgery is performed and decompression is performed. What is actually being decompressed, if the problem is not compression to begin with? In some cases, the  problem is in the muscle above (pronator  trees) pulling up on that nerve. This can be quite painful.

True carpal tunnel syndrome is characterized by a shrinkage of the actual carpal tunnel. This occurs from a genetic cause (birth), unknown (idiopathic) or trauma (a fall, auto accident).

There is a lot of  profit generated from pre-op treatment, NSAIDS, operation, and then post op care. Quite lucrative for the drug companies and surgeons as well.  After all, business is  business. Health care costs are a big chunk of change for families, and we need to find ways to lower costs for care, since so many are experiencing challenging financial times.

Many CTS cases can be treated effectively through non-surgical methods at a fraction of the cost. Find an  Active Release Practitioner  in your area and he will be happy to speak with you about your options and alternatives.

Yours in health,

Dr. Dennis Antoine

About the Author

Dr. Dennis Antoine graduated New York Chiropractic College in 1983. He opened his office in Ft Lauderdale to treat patients with chiropractic care and nutritional guidance, and  started Prevention@Work which focused on helping industry reduce injuries in the workplace. Using ergonomics, or the study of a person in the workplace, he assisted large companies in south Florida reduce their injuries, thereby helping companies save millions of dollars in health care costs. He has been a contributing editor for the Florida Sun Sentinel, The South Florida Business Journal, and ACA Journal of Chiropractic. He has also been a presenter for the American Chiropractic Association, the Florida Dairy Products Association, and Prevention Magazine. He now helps other doctors market their practices, and get the word out about options and alternatives that are safe and effective in the treatment of musculoskeletal conditions.

He plays a mean guitar, rolls sushi, and is crazy about anything that can be grown and is nourishing !


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