Hilma Volk: One of my passions, in recent years, is helping people to help themselves to treat their own carpal tunnel, or things that resemble carpal tunnel, or things that aren’t carpal tunnel at all but give problems to the hands if it’s due to their occupation or hobbies. And there are various degrees of these problems; maybe you have tingling in your hands once in a while; maybe you have numbness in your fingers comes and goes, you think “Oh, it’s just one of those things”. Or maybe it’s gotten more severe, where you’re fumbling with buttons, you’ve modified your lifestyle so you’re not using your dominant hand as much, or your injured hand as much, you’re doing everything with your other hand, or you’re using your shoulder or elbow to open doors when you otherwise would have used your hands; maybe you’ve given up playing guitar, or reduced the amount of time you spend playing your musical instrument, like piano. Or maybe you’ve given up knitting, or gardening or playing sports because it’s just too painful, or you have numbness that wakes you up at night. Maybe it comes and goes, maybe it’s only certain activities, like riding a bicycle, or when you’re driving a car, and other times it goes away. If you don’t do something about your problem, it’s just going to get worse.
But before we get into that, let me tell you a little something about myself. I started massage school in Eugene, Oregon back in 1990, and the first day of massage school I learned that carpal tunnel syndrome was a hazard to massage therapists. I didn’t even know what carpal tunnel syndrome was, and obviously it’s a hazard to a lot of occupations. Whether you’re a hair dresser, carpenter, you use a computer, you’re a court reporter, you’re a meat packer, many occupations have that problem. I became a student of carpal tunnel after I became a massage therapist because I wanted to prevent it for myself; I read lots of books, lots of articles, been all over the Internet, and a lot of books and stuff were not that helpful, really. They gave a lot of statistics, and they gave a lot of things on how to use a computer properly so that you’re not hurting yourself, which is very good; ergonomics, which is how to use equipment so it’s not hurting yourself, is a very good thing to learn, but it really didn’t give me a lot of help in knowing what to do about carpal tunnel if you get it.
Later on, I was working at a spa at a resort, and I was working rather long hours, and my fingers were getting numb. The stretches that I learned in massage school not only weren’t helping me (or maybe I just wasn’t persistent with them), but they actually seemed to make things worse; so, I was using ice on my forearms, because I knew that the forearm muscles moved the fingers. I’ll tell you a little bit more about that, but I’d come home and I’d stick my arms in a bucket of ice water and move from there to a bucket of warm water and transfer back. I was doing that every night, and I thought, there’s got to be a better way.
I stumbled onto this one article on the Internet; it was not written by a health professional, it was written by an athlete of a particular sport, and he told about a method that their team was using to get rid of the numbness in their hands. That article became the basis of me finding self-help tricks to use on myself, and they got rid of the numbness in my hands right away. That’s another video, and I’ll show you where to get that video at the end, but that was the basis of me starting my techniques for self, for carpal tunnel.
But then I started having another problem: see, in massage therapy, I’m working with my arms down all the time, but occasionally I would have to do reflexology, and that’s sitting in a chair working on people’s feet with your arms up, and immediately almost, I would get numbness in my fingers. Usually it would start with these two fingers and it would spread itself to the whole hand, and I’d be working on people’s feet. I still had function in my fingers, but I had numbness, and they just started to feel dead after a while. As soon as I stopped, the numbness would go away. And so, I’d do my technique more and more and more in my hands, and it didn’t make any difference, until an instructor I took in another course was showing people how to work on a muscle called the pectoralis minor. And this instructor in passing just mentioned that you can get a false carpal tunnel from tight pectoralis minor muscles. Really? So I developed my own technique to work on myself, and voila, almost instantly, I got rid of that problem. So I could work with my hands up, and not have numbness anymore. It was totally amazing.
Well let me explain briefly what carpal tunnel syndrome is, because it’s often misunderstood. The carpal tunnel is a ditch made up of wristbones, which are called carpal bones, and there’s a strap across here, which is a hard strap called the carpal tunnel ligament. Through there goes nine tendons; they’re flexor tendons (flex means do this), and the median nerve, and the median nerve supplies the nerves to the thumb, this finger, this finger, and half of the ring finger.
A doctor will tell you that carpal tunnel syndrome is a nerve entrapment problem, which it is, but they don’t tell you why it is, or they often don’t think about why it is, they just go treat the symptoms. When you use your hands, most people are using their hands, closing them. That uses the flexor muscles. Now, most people don’t know that most of the movement of the fingers, particularly this type of motion, is coming from your forearm. You can tell that by squeezing your forearm muscles, and just opening and closing your fingers and whatnot, when you squeeze you’ll feel it there, and you’ll see these long, pencil-like things on the front of your forearm right there; those are tendon sheaths. The muscles in the forearm have to attach to the fingers somehow, and tendons connect muscles to bone, so in the case of these particular tendons, they’re really long and skinny, where many other places they’re very short.
These pencil-like things are actually hollow tubes – think of it as a bicycle cable, where it’s a hollow tube, and in the middle is your tendon, and there’s liquid in there that helps lubricate it. Now, if you overuse it that liquid is going to dry out, causing irritation, and the irritation can make those tendons swell up, causing less room in there. Also, because you’re using these muscles that close the hand more than the ones that open them, these muscles get relatively tighter than the muscles in the back, that shortens the muscles, that shortens the tendons. Just in a nutshell here, that causes the carpal tunnel to be closed instead of open, and it causes a irritation on the tendons; if you’re working with your hands in a non-neutral position (this is neutral), if you’re working with your hands in different ways that makes the tendons go around corners, and it irritates them. They swell up; they swell because they’re shortened, and for various reasons.
Now, old-school doctors will prescribe anti-inflammatory drugs, or you may be taking them yourself, whether it’s ibuprofen or Tylenol or whatever. I’m not talking about the side effects, I’m just talking about the fact that these drugs, first of all, don’t cure carpal tunnel – they never have, they never will. They mask the symptoms. But the most important thing is they will make your problem worse in the long run. In the short run, the inflammation goes down and you feel better, but what is happening is the tendons inside the sheaths, they get irritated; pieces of cell are sloughing off, cells die in there naturally.
Well, what happens is naturally, you have systems in your body to clean those out. If you’re taking drugs, it’s like turning off the engine warning light. Your system doesn’t know that there’s a problem there, and so these things can accumulate inside those little narrow tendons and cause you major problems in the long run. Don’t do it! There’s a much safer way.
As I told you, when I was having problems, I was icing my hands. Ice is a natural anti-inflammatory. Other things that doctors will do is prescribe night splints, which can be helpful. What they do is, they keep the carpal tunnel open at night, so that your hands are not flopping around, because any time your arms or hands are not in a neutral position, that makes the carpal tunnel have less room in it, and then you wake up with numb hands and what not; so, having those splints on at night can make you sleep better, but it’s not improving your condition. You’ve still got the problem. There are some doctors – fortunately, very few – that actually put casts on people, which is a big mistake, because casts are for broken bones. They’re not for soft tissue. You need circulation for healing, you need that blood supply in there, and it’s not just the heart that moves the blood; movement of muscles will move the blood through the muscles as well.
The next thing that surgeons do is, they’re following the symptoms, they’ll put cortizone in there, and cortizone is a very powerful anti-inflammatory, but it’s also quite dangerous. One shot is a quick fix, but it doesn’t last. It may go away after two months, maybe after two years, but the solution goes away. Most doctors won’t prescribe cortizone in the same area more than once or twice, because it can deteriorate the tissue, it can deteriorate the tendon, it can deteriorate bone even; it’s very powerful and very dangerous, and it’s a quick fix. You’re following the symptoms, not the cause. You have to get at the cause to have a permanent solution; otherwise you’re just doing quick fixes.
The other thing they’ll do is carpal tunnel surgery, which is the most unnecessary procedure unless you’ve let it go so bad that your hands are mostly dead all the time. What they do is, they slice the carpal tunnel ligament to provide more room in there. That usually gives relief of the symptoms, but the problem is, there’s a high failure rate with carpal tunnel syndrome surgery. In about a third of the cases, everything is beautiful, everything works out fine and everyone is happy. In about a third of the cases though, because you have this ligament there to provide leverage for your fingers, your hands become weaker, or don’t have the same function as they did before. In a third of the cases it’s a total failure. It can be a failure for several reasons. There can be a mistake in the surgery – you know, there’s always a risk – they’ll cut something they’re not supposed to cut, or there’s an infection, or the more common one is it was never carpal tunnel to begin with. It could be a false carpal tunnel, and nerve conductivity tests are not entirely accurate.