If you have ever awakened with your arm asleep, you know the weirdness of not feeling your hand and arm. You see your arm but you can’t feel it - it’s like it’s not even there.
Gradually, you feel the numbness fade as it is replaced by tingling. Within seconds to minutes, your full sensation returns and you can use your arm again.
Imagine if the numbness and tingling came and went, or worse - it never went away.
I had a patient (let’s call her Nancy) come into my office complaining about numbness and tingling in her forearm, wrist, and hand. It was so bad that “I can’t grip anything anymore and I keep dropping little things like paperclips at work. It’s so bad in the morning too because I wake up with my fists clenched - my hands are tingling so bad I could scream.”
Nancy was an office worker who spent 6 hours per day at her computer. She had been doing this type of work for over 20 years.
As I evaluated her, I discovered that she had several tight muscles throughout her forearm and hand. In addition, her posture was horrid. Her head jutted forward from all those years staring at the computer screen. Her shoulders were rounded forward too - no doubt decreasing blood flow to the rest of her arm and pinching the nerves above the collarbone that branch off into the arm.
I asked her to sit upright as if a string were pulling her head like a puppet. She could not.
Nancy was a hot mess!
Not only did she have carpal tunnel syndrome, but she also had shoulder tightness, shoulder weakness, and very bad posture from the cumulative affects of sitting at a computer and not moving.
Even though the root cause of her carpal tunnel syndrome was her posture and shoulder tightness, I provided treatment to the carpal tunnel area first to try to give her relief. I recommended a carpal tunnel wrist brace at night to prevent her from clenching her fists, flexing her wrists, and pinching the nerves to her hands. This would help provide temporary relief while I did hands-on therapy to loosen the tight muscles of her forearm, wrist, and hand. I also taught her a self-massage program she could do at home and at work.
I focused on restoring muscle balance throughout her postural muscles. She responded well to the prescribed stretching exercises for her tight muscles and the strengthening exercises for her weak muscles. Hands-on therapy to her shoulder and shoulder blade muscles helped melt away the tension restricting her motion. I also recommended a few workstation set-up options with her keyboard, mouse, and computer screen so that her computer station would be an environment of healing instead of a source of pain.
After 8 sessions of physical therapy and Nancy working diligently at home, her symptoms were finally subsiding. She just needed 4 more sessions to almost completely eliminate her symptoms. I say “almost” because she still had some residual tingling after being on the computer for more than 2 consecutive hours.
I recommended setting a little alarm on her watch or computer to alert her every hour so she could do 1-2 posture stretches and get out of her computer position. After she started adding in the hourly stretches, her symptoms “rarely occurred until after lunch.”
Nancy was quite relieved to avoid surgery and I’ll be honest, I wasn’t sure if physical therapy was going to be enough. She had let her symptoms go for so long that I was concerned her nerve might be too irritated to tolerate the therapy.
Because of Nancy and numerous others who have waited and waited and waited some more to seek help, I have a little rule that I share with my family, friends, and patients. If you have pain that doesn’t get better or go away on it’s own within 7-10 days, it’s probably not going to get better on it’s own. Seek help. Stop suffering. You will most likely do more damage with the “wait-and-see” approach than if you just asked for help or a consultation. Plus, you will get peace of mind knowing what the next step is to feeling better faster.
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