“I feel like I have to shake out my hand in the morning”

I’ve been seeing in the clinic an increased amount of clients diagnosed with Carpal Tunnel Syndrome (CTS). It’s a diagnosis that many of heard of, but few understand the etiology of it and most importantly, what can a person do about it? What is CTS?!

CTS is the most common nerve compression disorder of the upper extremity. It falls under the category of repetitive strain disorders, which are the nation’s most common and costly occupational health problem (repetitive-strain.com). With CTS, the median nerve and tendons become compressed in the carpal tunnel.

Image result for carpal tunnel

What may be causing the nerve to be compressed in the carpal tunnel?

  • Swelling in the wrist (due to trauma or injury)
  • Repetitive gripping or wrist flexion
  • Repeated use of vibration (such as when using vacuums, power drills, etc.)
  • Fluid retention during pregnancy or menopause
  • Development of cyst or tumor in the carpal tunnel
  • External compressive forces (tight bracelets, watches, wrist rests for mouse)

Symptoms include:

  • Burning, tingling, or itching numbness in the palm of the hand and fingers
  • Fingers feel useless or swollen
  • Swelling in the hand or fingers
  • Needing to shake out your hand in the morning
  • Difficulty grasping objects
  • Atrophy of thumb muscles

The Bureau of Labor Statistics listed these occupations as having a higher incidence of CTS:

  • Assemblers
  • Cashiers
  • Secretaries
  • General office clerks
  • Bookkeeping, accounting, auditing clerks
  • Data-entry employees
  • Welders, cutters
  • Truck drivers
  • Janitors and cleaners

If you think you may have CTS:

  • Think about activities which requires repetitive motions, then take more breaks in between the task!
  • Ask your manager for an ergonomic assessment for your work station
  • Wear an appropriate night splint to avoid sleeping with your wrists curled in
  • See a hand therapist who will teach you how to protect your hand from activities that may be causing the symptoms, as well as teach you stretches and use modalities to treat the pain

If caught early, CTS does not require surgery! In fact…

According to the National Center for Health Statistics, approximately 260,000 carpal tunnel release operations are performed each year (repetitive-strain). However, 57% of the patients had a return of pre-operative symptoms (is that statistic for real?!), such as pain, numbness, and tingling beginning an average of 2 years after surgery. In addition  to the possible residual symptoms after surgery, patients also reported poor to fair strength and long-term scar discomfort post-surgery (Nancollas, 1995).

So, instead of opting for the knife, try a less invasive approach and see your local hand therapist who will treat your symptoms and, most importantly, teach you how to prevent further damage to your hand!

If you’re in Eastern WA, check out our hand clinic at therapy-solutions.us, where we will treat your hand for the full hour

Thanks again for checking out this site!

Claire, OTR/L

 

Resources

Nancollas, MP, Peimer, CA, Wheeler, DR, Sherwin FS. Long-term results of carpal tunnel release. Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand. 1995 Aug, 20(4): 470-474.

Carpal Tunnel Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke. July 2012. Retrieved from http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm#3049_5

National & International Statistics for Carpal Tunnel Syndrome and Repetitive Strain Injuries of the Upper Extremity. Balance Systems, Inc. Retrieved from http://repetitive-strain.com/national.html.

 

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That Touchy Subject…

Food has always been a very, VERY, important topic back at home. “What’s for ___” was a ubiquitous question. Particular family members were extremely picky eaters, and seemed to favor high saturated fat, high trans fat, and highly sugared foods, which led to health problems such as high blood pressure, high cholesterol, high triglycerides, diabetes, and high visceral fat, which in collection is called Metabolic Syndrome. Although this family member “knew” poor food choices were harming his body, he figured his 12+ pills, and shots of insulin, would reverse the effects of the unhealthy foods. Any attempt to suggest eating healthier would end with returned sarcasm and an awkwardly quiet and tense dinner table.

As part as a holistic occupational therapist, it is part of my job to educate clients on  nutrition and the damaging effects of poor food choices on our physical and mental selves.

Oh, and FYI, I am not supportive of diets. Growing up, I struggled with my weight and body image which led me to live a life of restrictive diets, binges, and eating disorders. But now that I’ve begun working at TherapySolutions, and can make my own food choices since I am only cooking for myself, my approach to food has changed. Rather than worrying about choosing only low calorie, low-fat foods–which ended up being high in sugar–I now focus on eating anti-inflammatory foods, even the ones high in fat…the good ones though! Think monosaturated or polysaturated fats.

It’s still uncomfortable to talk about food with clients, in fear that I’ll hit a vulnerable spot, or they’ll perceive me as judging them. But it would be a disservice to them, and failure on my part as an occupational therapist, if I didn’t educate clients on the role of food on our bodies, and the consequences of eating inflammatory foods.

In my last post, I discussed an article that came out by the NY times on the causes of arthritis. It was suggested that arthritis is more than a “wear and tear” condition. Rather, it’s a combination of “wear and tear” as well as exposure to chronic, low-grade inflammation from food sources such as sugar, trans fat, saturated fat, alcohol, and processed foods. In follow up, I want to discuss about what you can and should be eating to avoid conditions like arthritis, Alzheimer’s, and chronic swelling…the ANTI-INFLAMMATORY FOODS.

I am a strong supporter of Dr.  Weil’s Anti-Inflammatory Food Pyramid. Here he lists anti-inflammatory foods, as well as their nutrition description. You can check out his website at http://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/dr-weils-anti-inflammatory-food-pyramid/

anti-inflammatory-food-pyramid

Rather than talk about each anti-inflammatory food listed, I just want you to take away the message that food does contribute to swelling, inflammation, pain, “foggy brain”, and the like! I’ve personally experienced it myself, but see it in the clinic all the time!

Dr. Weil’s site also has a list of recipes which look pretty quick and simple to make. I’ll be making this Bento Box Soup this week since the fall weather has been settling in! http://www.drweil.com/diet-nutrition/recipes/bento-box-soup/

Comment if you were able to try any of his recipes, or have ones to share yourselves. Eat well my friends!

Claire

 

Keep Osteoarthritis at Bay!

“There are few things more pathetic than those who have lost their curiosity and sense of adventure, and who no longer care to learn.” -Gordon B. Hinckley

In everything, there will always be that “first.” First job, car, house, boyfriend/girlfriend, pet, time trying out ___, time seeing ___, etc.

How exciting/scary was it when you experienced that first?  Yesterday, one of my close friends from grad school called me in distress regarding her first three weeks at her job outside of school. She graduated a year later than me in order to obtain her doctorate of occupational therapy rather than just her masters, and although she had a higher degree than me, she began venting about the same struggles I experienced when I began working…

  • I don’t know everything!!!
  • My boss, colleagues, and clients think I’m incompetent!
  • People think I’m younger than I actually am!
  • School didn’t prepare me for this!
  • My clients would receive much better treatment from the other therapists!

All these thoughts I lived through and occasionally come across now.

My words of advice to her: “Not going to lie, there will be A LOT of moments when you feel like you don’t know anything. It’s going to be tough these next few months, but it will get better. Ask a lot of questions.”

Thank goodness that we are capable of learning something new each day! Both of my mentors, Sara and Nancy, remind me that one can never know everything. As a therapist, it’s not a matter of knowing how to treat every diagnosis, but to learn about the person–their postural tendencies, activity involvement, past medical histories, readiness for change, etc.–as well as to integrate compassion, curiosity, and skill into the development and application of the treatment plan. I absolutely love that opening quote: “There are few things more pathetic than those who have lost their curiosity and sense of adventure, and who no longer care to learn.” What are your feelings on it?

Now on to our hands!

As a younger practitioner, I’m still learning to correct my body mechanics in the clinic and at home in order to prevent my hands from becoming sore! I’ve learned some joint protection principles, but this NY times article on osteoarthritis (OA) does a fine job of outlining the causes of OA and some lifestyle modifications we can make to prevent OA or decrease the symptoms of it.

What causes OA?

School and textbooks have taught me that OA is a “wear and tear” condition–we wear down the cartilage between our joints which then causes the bones to grind against one another, causing pain. However, recent evidence shows that OAmay be promoted, and perhaps initially caused, by chronic low-grade inflammation that is now also linked to major chronic ills, including heart disease and Alzheimer’s disease, in which diet and exercise may play a protective role.”

The following also increases your risk of developing OA:

  • Those who undergo surgery develop arthritis at a rate of 5-10x greater than people who don’t undergo the knife
  • Body-wide inflammation, caused by poor diet, may explain why some people get arthritis in the joints that are not weight-bearing, like the fingers
  • Foods that causes inflammation:
    • Sugar, saturated and trans fats, refined carbohydrates, and alcohol

What can help decrease/prevent arthritic pain?

  • Assisted devices (jar openers, keys with levers, button hook, built-up handles) can help to prevent further joint damage
  • Tai chi improves balance and helps relieve arthritic pain and stiffness
  • Strength training (cycling, floor-based exercises) can support compromised joints
And some insight from the clinic, a hand therapist could:
  1. Teach you joint protection techniques for your daily activities
  2. Guide you through stretches/exercises for the hands
  3. Recommend and/or create an appropriate splint to rest the joint
  4. Treat the hand pain with modalities in the clinic
  5. Apply manual therapy techniques to decrease swelling and tension in the hand

I highly recommend you read through this article if you or a loved one has arthritis, or if you use your hands often (which I would like to know who doesn’t?!) The link wouldn’t copy onto this page for some reason, so you can Google “Don’t Take Osteoarthritis Lying Down” and it will pop up.

Again, if you have any questions, please comment below, or email me at Claire@therapy-solutions.us.

Keep on learning!

Claire

 

 

On the Learning Curve

Hi there! Thanks for checking out my blog! My name is Claire and I am an occupational therapist (worked 10.5 months now!) on pursuit to become a Certified Hand Therapist (CHT). I’m originally from Los Angeles, but was so fortunate to find TherapySolutions, a small, privately-owned physical therapy clinic in Richland, WA. I decided to move to an area where I knew not a soul because there really was, and is, no other clinic like TherapySolutions. Here we have occupational therapists (OT), physical therapists (PT), massage therapists, a counselor, a nutritionist/personal trainer, as well as an acupuncturist! Our specialties include hand therapy, Women’s Health, and Manual Lymphatic Drainage. Tell me, where else can you find a place that uses this kind of holistic approach + treats their clients for the full hour, one-on-one? Pardon if it sounds like I’m bragging, but I kind of am 🙂 If you want to learn more about our clinic and how we can assist you with your aches, pains, and overall well-being, check us out at http://therapy-solutions.us/.

Anyways, a little more about this blog. I’ve decided to start this blog as a way to share clinically relevant information that I come across in the clinic, as well as in the literature. Not only is it my responsibility as a health care professional to stay up-to-date on the latest research on treatment and prevention methods, but I also strongly believe in educating others on how to live healthier lives. Even though I received my bachelors degree in Exercise Biology and masters in Occupational Therapy, I still was completely oblivious on subjects such as the effects of body positioning on our nerves, the damaging effects of swelling, the benefits of eating an anti-inflammatory diet…things which every person should be taught in high school because, quite frankly, our bodies aren’t getting any younger and we should know how to take care of it! Ever since I’ve began working at TherapySolutions, my own health has significantly improved, and I want others to at least have the knowledge on how to take care of their bodies.

Since I’ve learned the value and significance of treating the body holistically, I’ll also share articles on nutrition, exercise, meditation, and such–all which can significantly affect the condition of our hands. If you have suggestions, questions, or anything of the like, please feel free to comment or send me an email.

They say you’re on the learning curve the first few years of working. So join me, as I climb up this curve and take on this journey to become a CHT, where we can both learn hand in hand, how to treat and maintain, healthy hands and healthy lives.