Larry, a 52 year old male patient presented to our office with continued CTS after failed CTS surgery. The gentleman stated that he had been suffering from right hand pain and numbness for several years and finally elected to have the surgical procedure to release the nerve.
This procedure was performed approximately 1 year prior to him coming to our office. He stated that his symptoms resolved after recovering from the surgery, but gradually began to return about 6 months later. He stated that he is concerned that the symptoms would again get as bad as they were before the surgery.
Upon observation, poor posture with a forward head position and protracted shoulders was noted. Examination revealed moderately restricted over all neck range of motion. Significant muscle tightness and shortening was noted in the upper trapezius, scalene, and pectoral muscles bilaterally. Tightness and trigger points were noted in the forearm flexor muscles of the right arm. Nerve tension tests and specific wrist tests were able to mildly reproduce the patient’s hand symptoms. X-rays revealed a loss of the normal curve along with moderate degenerative changes throughout the lower neck.
Based on the findings, multiple sites of nerve irritation/impingement were implicated. Treatment focused on muscle and nerve release techniques, improved posture and spinal curves, improved spinal biomechanics, and strengthening and stabilization exercises. By addressing all of the components of the issue, the patient was able to experience symptom improvement quickly, correct the cause of the problem, and prevent future occurrences.
Health problems like this tend to be multifaceted. If the focus of the clinician is too narrow, many related components can be overlooked. Be sure to choose a health care provider who understands how to look at the whole person and not just the part that hurts.