Dr Trek 1

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Hey guys,

I have minor carpal tunnel syndrome that seems to only act up when I use my fingers strenuously with my wrist at a right angle, etc. Will doing OMM cause my carpal tunnel to act up? Just curious if anyone has any experience with this.

Thanks!
 

Buckeye(OH)

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i dont know, but anatomy definately will. My ex who wants to be a surgeon, has to wear braces when she works on a body because her wrists are shot.

Youd better ensure that you prevent it from worsening
 

DrMom

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I have a bad wrist that I'm not supposed to extend to a right angle or load. I had to make some adjustments to how I performed certain OMM techniques, but I discussed all of this with my OMM instructors. They were very understanding & taught me alternative methods to perform the techniques & allowed me to test this way.

Talk with your instructors and see if they'll work with you. Considering that carpal tunnel is a somatic dysfunction itself, they really should be understanding.
 
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Dr Trek 1

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DrMom said:
I have a bad wrist that I'm not supposed to extend to a right angle or load. I had to make some adjustments to how I performed certain OMM techniques, but I discussed all of this with my OMM instructors. They were very understanding & taught me alternative methods to perform the techniques & allowed me to test this way.

Talk with your instructors and see if they'll work with you. Considering that carpal tunnel is a somatic dysfunction itself, they really should be understanding.

Thanks for your reply. How was anatomy lab for your wrist though?
 

DrMom

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actually, my problem developed near the end of first year, so I didn't have to deal with it in anatomy.

I've learned to do everyday things without extending my wrist. The only time it seems to come up anymore is when I do chest compressions in a code. I was taught a one-handed chest compression method that is just as effective as two-handed, but I often get questioned by someone-or-other about why I'm doing them that way.
 

applicant2002

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DrMom said:
actually, my problem developed near the end of first year, so I didn't have to deal with it in anatomy.

I've learned to do everyday things without extending my wrist. The only time it seems to come up anymore is when I do chest compressions in a code. I was taught a one-handed chest compression method that is just as effective as two-handed, but I often get questioned by someone-or-other about why I'm doing them that way.
out of curiosity, could you describe the one-handed chest compression method?
 
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Dr Trek 1

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applicant2002 said:
out of curiosity, could you describe the one-handed chest compression method?
I was wondering this myself.


Also, what type of doctor would you suggest to diagnose/treat CTS? I am afraid an orthopedic surgeon would be too knife-happy and automatically suggest surgery.
 

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applicant2002 said:
out of curiosity, could you describe the one-handed chest compression method?

I only have one hand directly on the chest. In my case, it is my right hand. I then hold my right wrist with my left hand. This way I'm able to use both arms (and center my weight over both arms) without actually extending my left wrist.

I was taught this method when I was a CPR instructor with the Red Cross. It is as effective as two-handed compressions, but you need to practice it that way so that you can do it as well as someone else does two-handed.

Dr Trek 1 said:
Also, what type of doctor would you suggest to diagnose/treat CTS? I am afraid an orthopedic surgeon would be too knife-happy and automatically suggest surgery.
I ended up with a hand surgeon, but I also have a different wrist problem. He medically managed me. CTS should also initially be medically managed as surgery isn't first line. A decent family physician should be able to help you out, though. If it gets worse, they can refer you to an ortho.
 

cabinbuilder

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Have your OMM professor show you the technique to make your carpel tunnel better. There is a technique you can do on yourself that helps with the tingling and numbness. There is also a maneuver that is easy for someone else to learn to help you at home. Good luck. Remember that OMM is not about power or having strength in your hands, its about the position of the patient.
 

group_theory

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There are some OMM techniques you can use directly for symptomatic relief of Carpel Tunnel.

The great thing about manual medicine is that you can always modify a certain technique to what suits you best. You will learn the standard techniques in lab, but if you talk to the instructors outside of lab, they can show you their variation of the techniques taught that they found to be helpful. They might go "yeah, this is how you are suppose to do it in a lab, but for a 400 lb morbid obese lady with back pain, good luck holding her leg still with one hand while telling her to relax. I usually then do this."


For CPR, there's always the toilet plunger :). Some anecdotal evidence to show that it works, and it is the basis for the Active Compression-Decompression (ACD) Resuscitator, invented by several docs at UCSF.

A Comparison of Standard Cardiopulmonary Resuscitation and Active Compression-Decompression Resuscitation for Out-of-Hospital Cardiac Arrest
Plaisance et al.
NEJM 1999;341:569-575.
 

cardiotonic

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not too sure about this but, a UAAO guest lecturer that we had said that the vast majority of carpal tunnel that he treats (he has said no one during his career has required surgery :eek: ), is treated proximal to the wrist near the shoulder.
 

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To answer the speciic question, I agree with Dr. Mom, there are different ways to do pretty much every OMM procedure, there are plenty of variations. In fact, I would say that its actually quite rare to see 2 practitioners do procedures exactly the same. That being said, there are definitely ways you can do most any OMM so that you'll have minimal strain on your wrist, or so that you can keep your wrist straight.

Carpal tunnel is a realy interesting topic. Its definitely important to have it diagnosed properly, and determined whether or not its arthritis, inflammation, burisitis, tendonitis, writers cramp, etc since they're all slightly different and have different underlying causes. Carpal tunnel syndrome refers to the median nerve compression within the tunnel, however the causes can vary as well.

I've watched a few carpal tunnel release surgeries. The condition should definitely be managed medically first. Usually surgery is not indicated until the patient absolutely wants it, which is about 6 months of conservative therapy resulting in persistent pain and/or motor and sensory deficits. A combination of rest, strengthening excersies, anti-inflammatories, and good wrist management/technique can help control or reduce symptoms for most people.

The carpal tunnel release surgery is a very quick procedure. It only takes a few minutes, and its one of the most common surgical procedures. They basically just make a small slit on your anterior wrist and cut through sheath of the tunnel, the flexor retinaculum, and this frees up space for your 9 tendons (4 from felxor digitorum superficialis, 4 from flexor digitorum profundus, and flexor policis longus tendon) and median nerve. Its pretty cool.
 

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DrMom said:
actually, my problem developed near the end of first year, so I didn't have to deal with it in anatomy.

I've learned to do everyday things without extending my wrist. The only time it seems to come up anymore is when I do chest compressions in a code. I was taught a one-handed chest compression method that is just as effective as two-handed, but I often get questioned by someone-or-other about why I'm doing them that way.
I often worked a code using one-handed compressions on the ambulance, when you may only have 1-2 other personnel with you. I would do this almost always on smaller patients, or when I needed to be doing something with my other hand (i.e. bagging the patient or talking on the radio to the hospital.)

That whole trick where you rub your abdomen in circles with one hand and pat your head with the other hand paid off.

Personally, my wrist problems are related to weight-lifting, as I don't do CPR often enough to have problems.
 
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Dr Trek 1

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When teaching OMM they should be careful to teach good techniques to everyone that protect your hands and wrists. If people do OMM in a way that it harms their hands and wrists, it won't be long before everyone has CTS.
 

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I notice that if i type for more than an hour straight my wrists tighten up and hurt and i can't move to well. Hopefully get some of this next year. I have the weirdest combinations of disorders i swear.