Question
I suffered a nasty fall onto a concrete floor in 1997 and damaged my left (dominant) hand and wrist. X ray showed no bony injury. Symptoms did not improve and 6 weeks later sent for extensive physiotherapy lasting 6 months. After no improvement I was sent to orthopaedic surgeon who ordered nerve conduction studies. These showed compression of median nerve and carpal tunnel operation was done in Feb 99. The surgeon said after the operation that he expected the compression to be worse than it was as symptoms were excessive in comparison to compression. There was still no improvement and in fact things got worse and I experienced neck pain and stiffness. Told that this was due to the awkwardness of having dominant hand out of action. The 3 months after the op my neck went into really severe spasm and stayed tilted to the right side slightly. This was diagnosed as secondary cervical dystonia caused by the trauma however research was still ongoing into dystonia causation. Since then I have received regular botox injections into dystonic muscles. Over the years things have just continued to deteriorate. After being offered a second carpal tunnel op which I turned down it was decided I had fibromyalgia again through the trauma. As the pain has increased more and more over the years affecting my mobility and all other aspects of life including care needs I was once again sent for more tests to see if anything else was causing the pain (recent pain management consultant scored level at 9/10). I was diagnosed as now having crps in left hand and also sent by neurologist for more nerve conduction studies with the addition of EMG studies which had never been done previously. The EMG tests show I have chronic cervical radiculopathy and this has caused the problems in my left hand/wrist. I am now waiting to see if this is able to be treated but been told that it will not cure but could help. My dystonia practitioner is in no doubt that the median nerve was most definitely crushed at the same time as the fall as it was a particularly bad fall and the consequent pain level and disability are a direct result of the original damage to the median nerve after the fall that has not been detected until now as no EMG tests were carried out initially. I would just like another opinion on this. Previous to the fall I was an extremely fit sports fanatic and now a wheelchair user for any walking other than distance from house to car. Many thanks in advance for your time. Regards Lesley

Answer
Lesley,

I am very sorry to hear of your health situation. I opine that you have pretty much exhausted anything that medicine has to offer. I highly suggest you get to an upper cervical chiropractor as as fast as possible. I would like to explain why:

The fall/accident you describe could have caused the wrist problems and that is the easiest part of your situation to understand. Most chiropractors would have assessed your wrist , elbow, shoulder and your neck on the very first day that you entered services with them. let's look at the mechanics of your fall. As you fell you struck the wrist on the cement.( This is a natural response to break your fall) The shock of the trauma directly insulted the integrity of the wrist. This shock then traveled up the arm going through the elbow, shoulder and neck area. Now before the event was over you more than likely suffered a whiplash to your neck ( I hate to use the term whiplash but when I do everyone seems to be able to picture the mechanism of injury to the neck). I this this is a very simple scenario that I see on a weekly basis in my clinical practice. The trauma to your neck was predicated by the trauma but it is important to assess which way your head actually "torqued".

In your case it is my opinion that you have to have an assessment of the wrist, elbow, shoulder and especially your neck. I would bet my last dollar that you have Subluxation through out your neck with a propensity for the upper cervical vertebrae C1 and C2 as the major areas of concern.

The nerves down to your wrist emit from the neck and upper back and travel all the way to your finger tips. The nerves have to be assessed in their entirety. Makes sense doesn't it? If you had seen a competent chiropractor he more than likely would have been adjusting your neck shoulder elbow and wrist on the affected side and sometimes on the non affected side because you more than likely have had to use your other side to get along with the activities of daily living.

I would like to clarify a few things at this point. To be blunt you have been surgically altered. I am not trying to be crass but there is only so much that any chiropractor can do with any condition where surgery has been involved. I suggest you start looking for a chiropractor who has spinal decompression. I would ask if they can also preform decompression to the writs. I also think you would need to have chiropractic adjustments to the wrist, elbow,shoulder and especially the neck. I do feel that you are a chiropractic candidate and even though you have had wrist surgery there is help. You will need to set realistic goals with your chiropractor.

I also agree that you could have Fibromyalgia set in motion by your trauma and ever progressing health issues. This is usually a problem with the brain it's neurotransmitters and the balance and check systems within the brain that actually can be reset. There is a group of chiropractors that practice brain based Therapy. Brain Based therapy protocols actually involve resetting these brain based problems. Try checking www.lifechangingcare.com to find one of these Chiropractors. If you do find one that is close let them know I sent you!!!

In conclusion don't walk to a chiropractor....run to one! I am sure you will thank me in the future. Also if you have any other questions for me please resubmit.

Sincerely,
Dr John Quackenbush
www.drqdc.com