Numb Struck: Chiropractic, and Relief for that Wonky Hand

By Martha Michael

It’s another day at the office, staring down your screen and working that mouse like you were conducting a lab test. The keyboard has been your friend for years, but today, there’s something different. You’re just not feeling it. And that’s the problem. Your hand is numb. You may not know it yet, but you’ve got a problem.

Symptoms of hand numbness and tingling in the wrist sometimes appear slowly, beginning with a little discomfort and getting worse with age. In the case of carpal tunnel syndrome due to pregnancy, symptoms appear with the growth of the fetus. But there is another reason one’s hand begins to feel wonky: Neurological causes that may become symptomatic suddenly.

Such was the situation in a case report in the Journal of Chiropractic Medicine about a woman whose right hand had become numb and weak with little warning of onset.

Examination

A chiropractic assessment showed problems in her grip strength and most of her symptoms were along the medial part of her forearm and three fingers. Her numbness was severe enough that she couldn’t identify whether sensations to her hand were sharp or dull.

Diagnosed with ulnar nerve compression, her symptoms were detected in her arm and hand, but the actual root of this condition can be traced to various places along the nerve, which begins in the neck and extends down the arms to the hands. Chiropractors in this case determined there were two points along the nerve that were compressed, so the patient’s condition was described as double crush syndrome, or DCS.

Her job as an academic counselor didn’t involve extreme physicality or action specifically affecting the forearm or hand, and she didn’t report experiencing any trauma. But a significant detail about her work is something her chiropractors felt had significance. The patient worked at a desk, hunched over for most of the day with her head in a forward position, and this posture was compromising the health of her spine.

Chiropractic tests included:

• Observing her arms held at a 90-degree angle, fisted and released
• Palpation of the triceps on her right arm
• Checking the range of motion of her elbows and wrists
• Examining reflexes in her upper extremities

“The working diagnosis was subacute mild right ulnar nerve pathology with associated thoracic and cervical intersegmental dysfunction,” the case report says. “It was suspected that there was compression of the ulnar nerve at the thoracic outlet and cubital tunnel.”

Ulnar nerve entrapment occurs when one of your arm’s three main nerves is compressed or irritated, according to the American Academy of Orthopaedic Surgeons website. Because the ulnar nerve runs the distance from your neck to your extremities, the effects from a constriction may occur under your collarbone or at your wrist. It’s called cubital tunnel syndrome when the nerve compression is occurring at your elbow.

Patients may feel a range of sensations, including tingling, numbness or weakness in the fingers, wrist, elbow, or shoulders. If left untreated, it can lead to chronic symptoms, or even death. That’s quite an arm pain.

Treatment

Health professionals need to examine more than just the site of symptoms because ulnar nerve compression can occur at any number of locations along the neural pathway.

When patients present with these symptoms, it’s not uncommon to be diagnosed with carpal tunnel syndrome because they often have similar complaints. Carpal tunnel syndrome causes pain and numbness in the arm and hand due to a compression of the median nerve. Patients typically use a splint on their wrists to reduce the symptoms, but a visit to your chiropractor is advised because, if left untreated, it may result in nerve damage.

Some physicians go immediately to such treatment as oral medications or injections to reduce pain, which tend to mask the symptoms instead of addressing the root of the problem.

Chiropractic care, on the other hand, seeks less invasive measures of treatment, but only after a proper assessment identifying the cause of the condition. If nerve compression is detected, a chiropractor may respond by recommending that you use a brace, as well as help you design a treatment strategy that nips the problem in the bud. You may also receive recommendations for exercises to counteract the effects and strengthen the necessary muscles, ligaments and tendons in the region affected.

The immediate goal is to remove the pressure from the ulnar nerve and provide a more permanent solution, which is possible through visits to your chiropractor.

The patient in the Journal of Chiropractic Medicine’s study was treated by chiropractors with manual therapies, including soft tissue mobilizations and spinal manipulation. They also educated her about improved work conditions, including ergonomic office furniture options, in addition to a home exercise program to reduce the symptoms of her ulnar nerve compression.

The result from her first treatment was immediate relief from her symptoms; after 11 visits to her chiropractor, the numbness and weakness in her hand had completely rescinded.

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