Entrapment Neuropathy: More Than Just Carpal Tunnel!

Entrapment Neuropathy: More Than Just Carpal Tunnel!

An entrapment neuropathy occurs when a nerve is wedged or “pinched” against a bone, inflamed muscle, or other structure…

Most people have heard of carpal tunnel syndrome (CTS). What you might not know is that carpal tunnel syndrome is only one of a family of ailments in the upper limbs known as entrapment neuropathies. The other entrapment neuropathies are not as well-known in the mainstream as CTS, and so people who suffer from nerve symptoms in their forearms and hands frequently jump to conclusions. We are here to help set the record straight!

Diagnosis for compression neuropathies is usually straight forward…

An entrapment neuropathy, also called nerve compression syndrome, occurs when a nerve is wedged or “pinched” against a bone, inflamed muscle, or other internal mechanism in your arm. Aside from the median nerve (the one associated with CTS) there are two main nerves that help to control your arm and hand: the radial nerve and the ulnar nerve. Both are susceptible to compression, and the results can be painful!

Entrapment occurs under a number of conditions, most commonly:

  • When there is an injury originating at your neck or a disease of the cervical spine
  • When your elbow has been injured due to fractures or improper use
  • When your wrist has been injured due to fractures or Guyon canal alignment problems
  • Rarely, an aneurysm or thrombosis in your arteries
  • Factors commonly associated with peripheral neuropathy, such as diabetes, rheumatism, alcoholism, or infection

Your radial nerve runs the length of your arm, and is responsible for both movement and sensation. Radial neuropathy usually occurs at the back of the elbow, and can present itself with many of the common symptoms of neuropathy such as tingling, loss of sensation, weakness and reduced muscle control (in this case, often difficulty in turning your palm upwards with your elbow extended).

A number of palsies affect the radial nerve, such as:

  • “Saturday night palsy” where your radial nerve is compressed in your upper arm by falling asleep in a position where pressure is exerted on it by either furniture or a bed partner
  • “Crutch palsy”, where your nerve is pinched by poorly-fitted crutches
  • Tarsal Tunnel at the foot and Cubital Tunnel at the elbow.

Two main conditions affect the ulnar nerve: Guyon’s canal syndrome and cubital tunnel syndrome. Guyon’s canal syndrome is almost exactly the same in symptoms as carpal tunnel syndrome (pain and tingling in the palm and first three fingers), but involves a completely different nerve. Guyon’s canal syndrome is caused by pressure on your wrists, often by resting them at a desk or workstation, and is frequently experienced by cyclists due to pressure from the handlebars.

Nearly everyone has experienced cubital tunnel syndrome: it’s the “dead arm” sensation we’ve all felt when we wake up after sleeping on top of our arm! Sleeping with your arm folded up compresses the ulnar nerve at your shoulder, causing it to effectively “cut off” feeling to your arm. As you probably know from experience, this sensation is unsettling but temporary.

Diagnosis for all compression neuropathies is fairly straight forward. First, we will examine your arms for signs of neuropathy, and will likely ask you to perform several demonstrations of dexterity.  If  we suspect you may have an underlying condition, nerve (EMG/NCVs) or blood tests may be recommended. To pinpoint the specific location of a compression, we may also suggest MRI or x-ray.

Similar to carpal tunnel syndrome, most cases of compression neuropathy are mild. Treatment for these mild cases and commonly ice, rest, and a change in habits of motion or stress that are causing the symptoms. For more severe cases, possibly anti-inflammatories, and in extreme cases, a surgical solution is sometimes justified.

If you suffer from a compression neuropathy or have questions about this or any other kind of neuropathy, let us help! Contact us by calling the number at the top of the page and we can answer your questions.

Don’t wait! The sooner and accurate diagnosis is made, the more options for treatment you will have.

Do you or someone you know suffer from CTS? Join the conversation HERE!

 

References:

http://www.mdguidelines.com/neuropathy-of-radial-nerve-entrapment
http://emedicine.medscape.com/article/1285531-overview
http://emedicine.medscape.com/article/1244885-overview
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2599973/?tool=pmcentrez

 

Shoulder Pain? Maybe It’s Suprascapular Neuropathy

Shoulder Pain? Maybe It’s Suprascapular Neuropathy

You might not realize that you can develop some forms of peripheral neuropathy even if you’re perfectly healthy…

Diabetes, Lupus, Cancer and chemotherapy, Any of these conditions can lead to peripheral neuropathy…But what you might not realize is that you can develop some forms of peripheral neuropathy such as suprascapular neuropathy even if you’re perfectly healthy.

Athletes who take part in sports that require consistent overhead movement of the arms (like tennis, baseball, kayaking, volleyball) place a lot of strain on their shoulders. That places them at a much higher risk of overuse injuries.

And that can lead to a very specific type of neuropathy – suprascapular neuropathy.

What is Suprascapular Neuropathy[1]?

Suprascapular neuropathy- that’s a real mouthful isn’t it?  It may sound complicated but it really isn’t.

Suprascalupar neuropathy is nerve damage to the suprascapular nerve – the nerve that runs from the brachial plexus (a group of nerves in the neck and shoulders) to nerves that help the body fully rotate the arms.  Suprascapular neuropathy causes shoulder pain and weakness and can lead to career ending pain for professional athletes or stop weekend warriors from doing what they love.

The most common symptoms of suprascapular neuropathy are[2]:

–   Deep, dull aching pain in the shoulder

–   Weakness or muscle pain

–   Frozen shoulder (inability to move the shoulder)

–  Numbness and tingling

If any of these symptoms are keeping you sidelined, talk to your doctor or your local NeuropathyDR® clinician today.

Exactly What Causes Suprascapular Neuropathy?

As the suprascapular nerve passes over the shoulder blade, it can be compressed and stretched.  When that happens repeatedly over a period of time, the nerve can become damaged and neuropathy develops. The first symptoms are usually pain and weakness when you try to rotate the shoulder.  More than just being uncomfortable, the pain can disrupt your life on a daily basis.

Imagine trying to put on a t-shirt or reach for a can on the top shelf of your pantry with a frozen or extremely painful shoulder…

If your experiencing any of the above symptoms, contact your doctor or your local NeuropathyDR® clinician immediately to determine if you have nerve damage.  You’ll need to start treatment immediately to prevent permanent damage.

What You Can Expect From Treatment

Your NeuropathyDR® clinician will start with nerve conduction studies to find out exactly where the nerves are damaged.  Electromyography will show exactly how severe the damage is.

Once you know for sure you have suprascapular neuropathy, the first step will be stop participating in the sport that caused the injury (until the damage is repaired).

Next, you’ll start a course of physical therapy and prescribed exercise.  Therapy will concentrate on maintaining your full range of motion and strengthening your shoulder muscles.

Your NeuropathyDR® clinician will employ a very specific treatment protocol depending on

–          The location of your injury and how severe it is

–          Your age, general health and typical activities

–          How long you’ve had your symptoms and whether or not they was caused by overuse or a specific injury

If your shoulder pain is keeping you on the bench and stopping you from participating in the sports you love or even from living a normal life, call your doctor or your local NeuropathyDR® clinician today.   Early intervention is one of the best ways to minimize the damage caused by suprascapular neuropathy and repair any nerve damage you may have suffered.

For more information on coping with autonomic neuropathy, get your Free E-Book and subscription to the Weekly Ezine “Beating Neuropathy” at http://neuropathydr.com

 

Neuropathy Foot Wear – Your Shoes Could Be Killing You

Neuropathy Foot Wear – Your Shoes Could Be Killing You

Have you been diagnosed with peripheral neuropathy?

Do you have peripheral neuropathy in your feet and/or legs?

Has your doctor told you how important it is to take proper care of your feet?

Now, for the $25,000 bonus question…

Are you doing what your doctor tells you to do?

Many patients with peripheral neuropathy don’t take proper care of their feet and don’t follow their doctors’ instructions on foot care.

If you have peripheral neuropathy in your feet, not following your doctor’s instructions about the type of shoes you should wear and how to care for your feet can lead to amputation…

Ultimately, it could cost your life.

You’re Not Alone

If you’re not listening to your doctor and doing everything he tells you to do to care for your feet, you’re not the only one.[1]

A recent study that followed 41 patients with type 2 diabetes found that

  • 90% of the patients had been educated about proper footwear
  • 83% washed and dried their feet properly every day
  • 51% actually foot self-exams recommended by their doctors

But more than half the patients admitted that they walked around the house and even outside with no shoes.  And more than two thirds of them were not wearing appropriate footwear.  They were wearing shoes with pointed toes, high heels or flip flops, and even worse.

Finding the Right Shoes

If you have peripheral neuropathy in your feet, choosing the right shoes is vitally important.  Here are some tips to help you know what to look for and what to avoid when you’re buying shoes:

  • Never wear shoes with pointed toes.
  • Avoid shoes with a really flat sole or high heels.  Neither of these styles allow for even distribution of foot pressure.
  • Buy shoes with soft insoles.
  • Never buy plastic or synthetic materials that don’t allow your feet to breathe.
  • Only wear shoes made of leather, suede or canvas that allow air to circulate around your feet and help them stay dry.
  • Avoid slip ons – buy shoes with laces and buckles that allow you to adjust how tight your shoes are.
  • Ask for professional assistance in getting the proper fit in every pair of shoes you buy.
  • Proper shoes don’t have to look like something your grandmother would wear.  You can buy stylish shoes that won’t land you in the hospital.

Remember that neuropathy is nerve damage.  That means that the nerves in your feet are not functioning properly and you may not feel a problem until it’s too late and you have sores, blisters or ulcers.  Those can be deadly.

See Your Doctor Regularly

Ultimately, you need to see your doctor regularly[2].  Find a doctor who specializes in treating patients with neuropathy, like your local NeuropathyDR® clinician.  They can help you choose proper footwear and take care of your feet on a routine basis and stop any problems before they’re severe.  By seeing your doctor regularly and staying on top of any issues you may have, you can reduce your risk of amputation by between 20% and 70%.

For more information on coping with neuropathy, get your Free E-Book and subscription to the Weekly Ezine “Beating Neuropathy” at http://neuropathydr.co

[1] http://diabetes.webmd.com/guide/caring-feet?

Entrapment Neuropathy: More Than Just Carpal Tunnel!

Entrapment Neuropathy: More Than Just Carpal Tunnel!

Last week we talked about Carpal tunnel syndrome (CTS), one of the most common forms of neuropathy affecting a single nerve (mononeuropathy).  What you might not know is that carpal tunnel syndrome is only one of a family of ailments in the upper limbs known as entrapment neuropathies.  The other entrapment neuropathies are not as well-known in the mainstream as CTS, so people who suffer from nerve symptoms in their forearms and hands frequently jump to conclusions.  NeuropathyDR® is here to help set the record straight!

An entrapment neuropathy, also called nerve compression syndrome, occurs when a nerve is wedged or “pinched” against a bone, inflamed muscle, or other internal mechanism in your arm.  Aside from the median nerve (the one associated with CTS) there are two main nerves that help to control your arm and hand: the radial nerve and the ulnar nerve.  Both are susceptible to compression, and the results can be painful!

Entrapment occurs under a number of conditions, most commonly:

• When there is an injury originating at your neck or a disease of the cervical spine
• When your elbow has been injured due to fractures or improper use
• When your wrist has been injured due to fractures or Guyon canal alignment problems
• When there is aneurysm or thrombosis in your arteries
• As a result of factors commonly associated with peripheral neuropathy, such as diabetes, rheumatism, alcoholism, or infection

Your radial nerve runs the length of your arm, and is responsible for both movement and sensation.  Radial neuropathy usually occurs at the back of the elbow, and can present itself with many of the common symptoms of neuropathy such as tingling, loss of sensation, weakness and reduced muscle control (in this case, often difficulty in turning your palm upwards with your elbow extended).

A number of palsies affect the radial nerve, such as:

• Saturday night palsy (also called Honeymooner’s palsy), where your radial nerve is compressed in your upper arm by falling asleep in a position where pressure is exerted on it by either furniture or a bed partner
• Crutch palsy, where your nerve is pinched by poorly-fitted axillary crutches
• Handcuff neuropathy, wherein tight handcuffs compress your radial nerve at your wrists

Two main conditions affect the ulnar nerve: Guyon’s canal syndrome and cubital tunnel syndrome.  Guyon’s canal syndrome is almost exactly the same in symptoms as carpal tunnel syndrome (pain and tingling in the palm and first three fingers), but involves a completely different nerve.  Guyon’s canal syndrome is caused by pressure on your wrists, often by resting them at a desk or workstation, and is frequently experienced by cyclists due to pressure from the handlebars.

Nearly everyone has experienced cubital tunnel syndrome: it’s the “dead arm” sensation we’ve all felt when we wake up after sleeping on top of our arm!  Sleeping with your arm folded up compresses the ulnar nerve at your shoulder, causing it to effectively “cut off” feeling to your arm.  As you probably know from experience, this sensation is unsettling but temporary.

Diagnosis for all compression neuropathies is fairly consistent: your NeuropathyDR® clinician will examine your arms for signs of neuropathy, and will likely ask you to perform several demonstrations of dexterity.  If your clinician suspects you may have an underlying condition, nerve or blood tests may be recommended.  To pinpoint the specific location of a compression, your clinician may also suggest MRI or x-ray scans.

Similar to carpal tunnel syndrome, most cases of compression neuropathy are mild. Treatment for these mild cases involves ice, rest, and a change in habits of motion or stress that are causing the symptoms.  For more severe cases, your clinician may prescribe painkillers or anti-inflammatories, and in extreme cases, a surgical solution is sometimes justified.

If you suffer from a compression neuropathy or have questions about this or any other kind of neuropathy, NeuropathyDR® can help!  Contact us, and we can answer your questions and put you in touch with a NeuropathyDR® clinician in your area who has been specially trained to treat any symptoms you might have.  As with any neuropathy, don’t wait!  The sooner a condition is diagnosed, the more options for treatment your clinician will have.

For more information on coping with entrapment neuropathy, get your Free E-Book and subscription to the Weekly Ezine “Beating Neuropathy” at http://neuropathydr.com.

 

http://www.mdguidelines.com/neuropathy-of-radial-nerve-entrapment

http://emedicine.medscape.com/article/1285531-overview

http://emedicine.medscape.com/article/1244885-overview

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2599973/?tool=pmcentrez

 

Carpal Tunnel Syndrome: A Common Household Neuropathy

Carpal Tunnel Syndrome: A Common Household Neuropathy

If you experience sharp, shooting pains in your arms and wrists when sitting at your desk, driving, or doing other stationary activities, you probably don’t think of neuropathy.  You probably associate neuropathy with extensive nerve damage, like the kind that has to do with diabetes, severe injury, or cancer.  One of the most common forms, though, is a relatively minor condition that affects millions of healthy people: carpal tunnel syndrome.

The carpal tunnel is the small space between bones in your wrist that small tendons and the median nerve run through.  The median nerve runs from your forearm into your palm and controls movement and feeling in most of your hand, except for your little finger.  Carpal tunnel syndrome (CTS) occurs when there is pressure on the median nerve in your wrist from swelling or tension.  This is known as mononeuropathy, or neuropathy that affects only a single nerve.

People who suffer from carpal tunnel syndrome usually experience symptoms in their arms and hands that are similar to other kinds of neuropathy.  Soreness, numbness and tingling, loss of temperature sensation and problems with fine motor control are common.  Because the little finger is not controlled with the median nerve, symptoms that affect the other fingers but not the little finger could represent carpal tunnel syndrome.  At first, symptoms usually show up at night (people often sleep with flexed wrists) and go away by shaking the affected hand.  As time passes, though, symptoms can really stick around throughout the day.

So who is the most susceptible to getting carpal tunnel syndrome?  Many sufferers are simply genetically predisposed, usually because they have thinner wrists that constrict the carpal tunnel and the median nerve.  Women are three times more likely than men to develop the condition, again, because of thinner wrists. 

Many people associate carpal tunnel syndrome with heavy computer use.  This is probably unfounded; a 2001 study at the Mayo Clinic found that using a computer for up to 7 hours a day did not increase the likelihood of CTS developing.  Carpal Tunnel syndrome is not particularly confined to any specific industry or job over any other, but studies establish that it is more common in workers doing assembly, due to the repetitive nature of the task.  Because of the incorrect “conventional wisdom,” conditions such as tendonitis and writer’s cramp are often mistaken for carpal tunnel syndrome.

As with any neuropathy, it is important to identify carpal tunnel syndrome early to avoid permanent damage to the median nerve.  A NeuropathyDR® clinician will be able to examine your neck, back, arms, and hands to establish the nature of any symptoms you might be having.  The clinician may also recommend blood tests to check for related health conditions and nerve tests to determine any damage.

If you have been diagnosed with carpal tunnel syndrome, there are several routes for treatment.  Mild conditions can be treated at home with ice and rest to reduce swelling.   Avoid activities that cause repetitive wrist motions for extensive periods without resting.  Practice keeping your wrist in a neutral position, such as the way it rests when holding a glass of water.  Additionally, practice using your whole hand, not just your fingers, when you hold objects.

For more serious cases, or when damage to the nerve has already taken place, your NeuropathyDR® clinician may recommend more extensive measures.  If your symptoms have continued for more than a few weeks with home treatments, see your ND clinician as soon as possible!  Your ND clinician will be able to prescribe our specially designed CTS Protocol which is proving successful in centers around the country!

For the most serious cases of carpal tunnel syndrome, where mobility or nerve function is seriously impaired, surgery can be a solution. But almost never should you do this without trying the non-invasive ND/CTS Protocol First! [In these rare cases, a surgeon can reduce tension on the median nerve by cutting the ligament that constricts the carpal tunnel.]

If you have any questions about carpal tunnel syndrome or other neuropathic conditions, NeuropathyDR® is here to help!  Don’t hesitate to contact us—we can give you more information about your symptoms and help you find a NeuropathyDR® clinician in your area.

For more information on coping with carpal tunnel syndrome, get your Free E-Book and subscription to the Weekly Ezine “Beating Neuropathy” at http://neuropathydr.com.

 

http://www.mayoclinic.com/health/carpal-tunnel-syndrome/DS00326

http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm

http://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome-topic-overview

Physical Therapists, Neuropathy and Chronic Pain Patients

Physical Therapists, Neuropathy and Chronic Pain Patients

Neuropathy Treament ChallegePeripheral neuropathy affects virtually every patient differently.

Some neuropathy patients suffer strictly from nerve pain, some have issues with numbness and still others have issues with mobility or some combination of symptoms.

Any neuropathy symptom can make functioning and carrying on a normal life virtually impossible.

While your pain may make any kind of physical activity the furthest thing from your mind, a good clinician can greatly increase your potential for rehabilitation.  Your neuropathy does not have to be a life sentence.

Who Should See A NeuropathyDR  Specialty Clinician

If you suffer from any of these issues:

·            Pain

·            Weakness or numbness

·            Increased nerve sensitivity

·            Abnormal gait when you walk

·            Decreased endurance

·            Limited range of motion

·            Difficulty keeping your balance

·            Problems with bracing yourself

·            Joints that are stiff or contracted

A good therapist, chiropractor or osteopathic physician may be able to help you.  Clinicians who specialize in treating neuropathy patients, like our NeuropathyDR® therapists and chiropractors will have a strong knowledge base when it comes to addressing whatever your particular neuropathy symptoms happen to be.

What To Expect

We will do a complete history and physical and find out where you need the most assistance and what course of treatment will work best for you.  Therapy can be a crucial step to increase the likelihood of rehabilitation from your peripheral neuropathy.

Be sure to find a physical therapist with expertise in treating neuropathy patients.  A good physical therapy specialist will be able to develop a treatment regimen that won’t make your neuropathy symptoms worse.

One thing to remember – in order for your insurance to pay for therapy treatment, you will more than likely need a prescription from your treating physician.  Ask if there are any NeuropathyDR® therapists in your area or go online and find one yourself.

Therapy Treatment Options

Some Clinicians will attack your particular issues directly or they may opt to work indirectly and work around the underlying problem to first address whatever your particular deficits may be.  If you have balance issues, they may work to build your muscle strength and allow you to be more grounded.

Every patient is different.  What worked for one may not work for the next.  A good Clinician will take the time to fully understand your particular issues and prescribe a treatment regimen that addresses the areas where you need the most assistance and that will show the best opportunity for improvement.

If you’ve never been to a therapist, you may not really understand what they do.  Here are some basic treatment techniques used in a therapy regimen that might help you:

·            Soft tissue manipulation techniques

·            Peripheral and/or spinal mobilization

·            Thermal treatments

·            Electrical stimulation

·            Ultrasound

·            Near infrared phototherapy

·            Balance systems

·            Individualized therapeutic exercise

·            Functional activities

Seeing an expert NeuropathyDR Clinician can give you a chance at a positive outcome and improve your ability to function normally.  Give yourself every opportunity to get your life back and live beyond your peripheral neuropathy and chronic pain issues.

We hope you found this information helpful and you take steps today to find a NeuropathyDR® practitioner in your area. Be an informed patient.

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