Question
I repeatedly wake up during the night with my right hand numb.  It goes from light to severe burning at times and lasts anywhere from 5 min. to an hour. I am unable to fall back to sleep because it is so uncomfortable.  I have had adjustments my whole life, and I am a NYS licensed massage therapist, so I know how to stretch it and even crack my neck to get some relief, which does sometimes help.  My husband and I also just bought a new iComfort bed, which I thought would help. Other than my entire back feeling great upon getting up, the numbness in the hand has gotten worse.  I have been told by my chiropractor in the past that my cervical vertebrae are "straightening" and that the natural curve is all most gone.  What can I do to fix this problem?  I have tried side sleeping and back sleeping.  I have put the bed into the angled position to put my back in a better position and it still happens.  What is my next step?
Shelie

Answer
CTS, Carpal Tunnel Syndrome, Repetitive Stress, Staten Island Carpal Tunnel, Radiculopathy, pinched nerve, staten island pinched nerve, chiropractic, double pinch syndrome, staten island chiropractor,




Hello Shelie,

I am sorry to hear of your continued pain.  Thank You for your question.  If I do not answer fully, if you need further information, please do not hesitate to REcontact me here at AllExperts.com= your Staten Island Chiropractor Expert:  http://www.allexperts.com/ep/965-100794/Chiropractors/Victor-Dolan-DC-DACBSP.htm .

You say; ".....I repeatedly wake up during the night with my right hand numb.......", hmmmm sounds pathognomonic for CTS= Carpal Tunnel Syndrome ( http://medical-dictionary.thefreedictionary.com/pathognomonic ).
         Do you sleep upon your hands?  Do you sleep on THIS hand in particular?  Do you sleep with your hand underneath or over your head?
         Have you had an EMG/ncv test?  This test will look for a 'pinched nerve', and determine whether it ALL comes from your neck, or your wrist, or a combination of wrist/ elbow/ shoulder/ neck irritation of your nerves (particularly the median nerve:   http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001469/ ).

You state:  "..... It goes from light to severe burning at times and lasts anywhere from 5 min. to an hour. I am unable to fall back to sleep because it is so uncomfortable.......",
         look at these signs/ symptoms:  "......What are the symptoms of carpal tunnel syndrome?        Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell between hot and cold by touch.    http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm ........"

".......I have had adjustments my whole life.........", given my clinical experience, the adjustments have helped you, and you would be WORSE without them.  Usually CTS is a 'double crush' condition= irritation of a nerve in the NECK and WRIST.  SUCCESSFUL treatment means approaching BOTH ends of the neurological chain.  SUCCESSFUL treatment will also include nutritional support, and physical support (ie bracing)-- more on this later.

".........I am a NYS licensed massage therapist.......", sooooooo,,,,, I guess you work a lot with your hands,,,,,,,, could be overuse, could be a repetitive stress syndrome (see: http://www.ninds.nih.gov/disorders/repetitive_motion/repetitive_motion.htm ), I am sure you are familiar with this!

".........so I know how to stretch it and even crack my neck to get some relief, which does sometimes help.............."= these maneuvers are temporary.  Adjustment to the C-spine, shoulder, elbow, wrist may all be indicated; nutritional support may be necessary, PROPER SLEEPING POSTURE (do you have a firm bed (I hope so), do you have a cervical support pillow?), perhaps even bracing or a support.
    See:  http://www.youtube.com/watch?v=oEW4CBOeU6U  
    ESPECIALLY see:  www.MyCarpalTunnel.com , I have utilized this in my office.
    See:  http://www.footlevelers.com/products/cervical_support_pillows.php
( I have NO financial interest in any of these recommendations )

"........My husband and I also just bought a new iComfort bed, which I thought would help. Other than my entire back feeling great upon getting up, the numbness in the hand has gotten worse....." i hope you have bought a FIRM bed.  I hope you do not sleep upon your hands.  I hope you sleep on your back or side, cervical pillow, hands down.

"..........I have been told by my chiropractor in the past that my cervical vertebrae are "straightening" and that the natural curve is all most gone. .........", Chiropractic Doctors (DCs) and probably LMTs (Massage Therapists) KNOW the importance of Mother Nature and Her Designs.  The normal, NATURAL curve is important (that is why posture and that cervical pillow is important) to PROPER functioning of this physical body.  Yes the loss of curve probably contributes to the neck portion of this 'double crush' phenomena.

"....What can I do to fix this problem?.....", which problem?- Carpal Tunnel?= read through this entire answer, it should help.  Straightening of the curve?= see the Chiropractic Doctor with some P->A C-spine adjustments, sleep with that cervical pillow!; this should help.

".......I have tried side sleeping and back sleeping.  I have put the bed into the angled position to put my back in a better position and it still happens......", I hope you are implementing all of my recommendations, if you are.... then progress should be made in the right direction!

"....What is my next step?....", I have jumped right on the 'Carpal Tunnel Bandwagon', perhaps I am WRONG!         Your next step?- I think is an EMG/ncv of the affected part(s); let us make sure it is a nerve.  IF it is NOT a nerve, then I would suggest a Vascular Doctor on the long shot that it is circulatory (vascular) in nature.  After that,,, perhaps a visit to the Neurologist MD or Neurologist DC again- to look within your Brain as a cause of the problem= the LONGEST shot, the remote possiblity.  You asked, I am giving you the long and short of it.
         I would bet on this complaint being Carpal Tunnel Syndrome.  Implement these recommendations and you SHOULD improve.  Different specialty types in Chiropractic:    http://www.acatoday.org/pdf/ApprovedChiropracticSpecialtyPrograms.pdf   perhaps you could find a specialist amongst these?

"....What is my next step?...." EMG/NCV, implement the above, get that 'mycarpaltunnel' support, get adjusted, sleep on side or back, cervical support pillow, and implement some nutritional supplements:

---------People with carpal tunnel syndrome have been noted to exhibit marginal B-6 deficiencies.  Vitamin B-6 should be combined with magnesium to enhance effect.
         NOTE:  VERY  HIGH dosages of B-6 (>250 mg daily) for long periods of time can create a nerve disorder called sensory neuropathy.

---------High potency B-complex may be helpful to provide extra B vitamin support.  Vitamin B-2 (riboflavin) supplemented for five months was shown to completely resolve a case of carpal tunnel syndrome in a women with a three year history of the condition.

-----------Proteolytic enzymes may be beneficial to aid inflammation.  Bromelain, an enzyme found in the pineapple stem, is effective in reducing swelling and healing time.

------------ Quercetin is a potent bioflavonoid and antiinflammatory nutrient.

---------Ginkgo biloba improves circulation, especially to the extremities.

----------Boswellia, curcumin and grapeseed extract are excellent antiinflammatory agents.

-------------Relaxing/pain relieving herbs including valerian, passion flower, kava kava, scullcap, chamomile and white willow bark may be beneficial.  Do not use kava kava if liver disease is suspect.

---------A whole foods diet is important.  Limit protein intake to 50 grams per day.  Avoid foods containing yellow dyes, as both inhibit metabolism of B-6.  Also avoid processed, refined foods such as sugar, caffeine and soda pop that deplete the body of essential nutrients, especially B vitamins.  Limit daily protein intake to a maximum of .75 g/kg of body weight.  Excess protein can deplete vitamin B6 since B6 is involved in protein metabolism.

-----------Rest the joint when possible.  Take a five minute break every hour when performing repetitive hand work.  Stretching may decrease the need for surgery.  Flex the wrists with the arms extended for five minutes during breaks and before starting work.  Stretching helps prepare the carpal tunnel nerve for repetitive movements.

----------Avoid antidepressant drugs because, in some cases, carpal tunnel is a known side effect of this type of therapy.

My Staten Island Chiropractic patients get this information:
    揅arpal  Tunnel  Syndrome?CTS- (Also Known As- repetitive stress syndrome) Sometimes  we  wake  up  with  pain and tingling in our hand, fingers  and/ or wrist. Sometimes working can cause the same symptoms,,, especially any REPETITIVE motions/ postures.  .... sometimes a slip, trip, fall, heavy lift, or even a motor vehicle accident can cause CTS (carpal tunnel).


 Ultimately-  the true    c a u s e   of  the CTS (  = pain in the fingers, hand, wrist, sometimes even UP the forearm) is a 揇ouble Crush?  


CTS is, in part, pressure on the median nerve in the wrist.  BUT,    CTS  usually has pressure somewhere else along the same nerve as well.  If both 慹nds?of the double crush are not properly treated, the CTS will not properly heal.  Besides nerve pressure in the wrist, perhaps there is a  慿ink?in the neck- more properly termed a Vertebral Subluxation.   Do not go just 1/2 way (and only treat the wrist) , treat the whole nerve to beat your CTS.
         
         Vertebral   Subluxation   Complex    (a.k.a.  憇ubluxation?
The vertebral subluxation complex is often contributes to CTS and many other healthcare problems.  A subluxation interferes with the proper functioning of the nervous system (the master system which controls and coordinates all function within the body) and may cause various other conditions, symptoms and problems.

This   (subluxation)  is a serious condition identified by its five parts:
         Spinal   Kinesiopathology:
This is fancy way of saying the bones of the spine have lost their normal motion and position. It restricts your ability to turn and bend. It sets in motion the other four components.
         Neuropathophysiology:
Improper spinal function can choke, stretch, or irritate delicate nerve tissue. The resulting nerve system dysfunction can cause symptoms elsewhere in the body.
         Myopathology:
Muscles supporting the spine can weaken, atrophy, or become tight and go into spasm. The resulting scar tissue changes muscle tone, requiring repeated spinal adjustments.
         Histopathology:
A rise in temperature from an increase in blood and lymph supplies result in swelling and inflammation. Discs can bulge, herniate, tear, or degenerate. Other soft tissues may suffer permanent damage.
         Pathophysiology:
The VSC contributes to OsteoArthritic degeneration. Bone spurs and other abnormal bony growths attempt to fuse malfunctioning spinal joints. This spinal decay, scar tissue, and long-term nerve dysfunction can cause other systems of the body to malfunction.
The Vertebral Subluxation Complex describes what happens when spinal bones lose their normal movement patterns and position.

         Automobile accidents, improper lifting, improper posture, alcohol, emotional stress, chemical imbalances, and long periods of sitting can cause the Vertebral Subluxation Complex.
         Vertebral  Subluxation   cannot   be corrected through chemicals (medicine), stretching, yoga, vitamins or physical therapy alone.  Subluxation- a neuro/skeletal/muscular- mechanical- problem requires a mechanical correction-  -  -    a manipulation,     best performed with the chiropractic adjustment.  For good health- Treat the   Cause,  not just the Symptoms.

Dr. Victor E. Dolan, Doctor of Chiropractic; Diplomat, American Chiropractic Board of Sport Physicians;  Diplomat, American Academy of Pain Management; Certified Clinical Nutritionist (IAACN); FIRST  Chief of Chiropractic  in  a  Hospital  in  New York State (DHSI);  As  Seen  in  PREVENTION  Magazine ; Invited to Colorado Springs (Olympic Training Center) to  Care for USA Olympic Athletes ; Chiropractor to the NYPD Football Team

+++++++++++++++++++++++++++++++++++++++

I have tried to be exhaustive in my answer.  I hope this helps.  Do not hesitate to REcontact me for further if needed.

I wish you Good Health, Naturally,
Your Staten Island Chiropractor Expert,

Dr. Victor Dolan, DC, DACBSP
www.DrVictorDolan.net