Do you have pain in the hand or medial (closer to the body) forearm? You may also have paresthesia (pins and needles) into the ring and little finger of the same arm/hand.   It could be due to ulnar nerve syndrome. This post is about Chiropractor West Palm Beach: Acupuncture Treatment for Ulnar Nerve Syndrome.

Anatomy of the Ulnar Nerve

The ulnar nerve is one of the 5 terminal (end) branches arising from the medial (closer to mid line) cord of the brachial plexus (network of nerves in the shoulder).  It supplies motor and sensory innervation to the upper extremity. The ulnar nerve originates from contributions of the C8 and T1 nerve roots of the spinal cord. The nerve courses along the medial arm and forearm, and then it passes into the wrist, hand, and fingers.

The ulnar nerve provides motor (voluntary movement) innervation to part of the forearm and a majority of the hand. It supplies sensory cutaneous (skin) innervation to the medial forearm, medial wrist, and medial fifth digit, medial half of the fourth digit, and the corresponding part of the palm.

In the hand, the ulnar nerve branches to give rise to a palmar cutaneous (relating to the skin) and dorsal cutaneous branch.

 Chiropractic Care in West Palm Beach: Causes of Ulnar Nerve Entrapment at the Wrist and Elbow

Wrist Entrapment Site: Tunnel of Guyon

The ulnar nerve enters the hand through the Tunnel of Guyon’s canal.  The tunnel of Guyon relays the ulnar neurovascular bundle (ulnar nerve, ulnar artery/vein, lymphatic vessels) into the hand.  This is a fibro-osseous tunnel formed by the pisiform and hook of the hamate (2 of 8 carpal/wrist bones). And the ulnar nerve may be compressed in the tunnel of Guyon at the wrist.

Of course, the cause could be due to a traumatic sporting activity. For example, you may have slammed the ball while playing basketball against the rim of the hoop.  Also, prolonged pressure over the hypothenar eminence (base of fifth digit/little finger) can be a culprit. For instance, constant compression on handlebars, as with cyclists, may cause this problem (i.e. handlebar or cyclist’s palsy). In addition, other causes include vascular abnormalities and/or a ganglion cyst.

Elbow Entrapment Site: Cubital Tunnel

Firstly, the humerus, radius and ulna bones articulate to form the elbow synovial joint. The cubital tunnel is just distal to the medial epicondyle of the humerus (upper arm).  And the cubital tunnel floor is made up of the ulnar collateral ligament and the capsule of the elbow joint.  The cubital tunnel’s ceiling is formed by Osborne’s ligament (triangular arcuate ligament) and the cubital retinaculum (fascia).  This is a ligament spanning from the medial epicondyle to the olecranon process of the elbow. And the medial epicondyle and olecranon act as the walls on either side. Lastly, the ligament is continuous with the fascia connecting the humeral and ulnar heads of the flexor carpi ulnaris muscle.

Secondly, irritation of the ulnar nerve at the elbow can be due to compression, stretch or direct trauma. Typically, a stretch injury is due to a valgus (turned outward) force to the elbow. Moreover, compression may be at the two heads of the flexor carpi ulnaris muscle where the nerve can get entrapped.  Also, you may have arthritis and osteophytes (bony spur) at the cubital tunnel causing nerve irritation. 

Thirdly, research indicates the cubital tunnel syndrome is the second most common compressive neuropathy in the upper extremity (limb). Often, you may have had throwing activities (e.g. Baseball).  Subsequently, this is where the ulnar nerve was medially stretched.  Therefore, the pressure in the tunnel is increased with elbow flexed and wrist extended as in throwing. Additionally, you may have slept wrong with your elbow flexed causing compression and “sleep paralysis”. Also, less common causes include lipomas, ganglions, and abnormal soft tissue structures (e.g. scar tissue).

Chiropractor West Palm Beach: Acupuncture Treatment for Ulnar Nerve Syndrome: Research

First, Ulnar Nerve syndrome is a peripheral neuropathy. And a peripheral neuropathy is a result of damage to the nerves located outside of the brain and spinal cord. It is a disease characterized by pain or loss of function in the nerves that carry signals to and from the brain and spinal cord (the central nervous system) to other parts of the body.  

Second, Researchers looked at fifteen studies which included neuropathy patients. Furthermore, they studied acupuncture for neuropathy caused by diabetes, Bell’s palsy, carpal tunnel syndrome, and idiopathic (unknown cause) conditions.

Third, in conclusion, most benefited with acupuncture.  Specifically, this was true for diabetic neuropathy, Bell’s palsy, and carpal tunnel syndrome. Indeed, Acupuncture appeared to improve nerve conduction (evaluates peripheral nerve strength) study parameters (strength and speed etc).  And this was true in both sensory and motor nerves.

Chiropractor West Palm Beach: Acupuncture Treatment for Ulnar Nerve Syndrome: More Research

First, in one study researchers presented a standardized acupuncture protocol for the treatment of peripheral neuropathy.

Second, the standardization included point selection, number of needles used, needle-retention time, needling depth, amount of needle manipulation, and use of moxibustion and electroacupuncture (EA) .  

Third, the outcome for patients was that the standardized protocol was effective. And it was effective for the treatment of neuropathy of various causes.    

Chiropractor West Palm Beach: Acupuncture Treatment for Ulnar Nerve Syndrome 

Acupuncture has been used for over 4000 years to treat pain and other health problem. Acupuncture effects what the ancient chinese practitioners called Meridians (energy channels) in your body under the skin. Additionally, traditional acupuncture is based on the belief that an energy, or “life force”, flows through the body in these meridians.

Today, Researchers believe when an acupuncture needle is inserted, nerves are stimulated. Next, this sends a message to your brain and nervous system. Ultimately, Acupuncture improves blood flow and calms the nervous system.  Similarly, this triggers nerve signaling that affects bodily functions. And this includes other parts of the body such as organs.

Dr. Natalie Meiri is a chiropractic physician, board certified in acupuncture with over 20 years of experience.  Call 561-253-8984 today!  Ask to make an appointment or find out more about: Chiropractor West Palm Beach: Acupuncture Treatment for Ulnar Nerve Syndrome.

References:

1. Acupuncture for the Treatment of Peripheral Neuropathy: A Systematic Review and Meta-Analysis

https://pmc.ncbi.nlm.nih.gov/articles/PMC5359694/

2.     Introducing a Standardized Acupuncture Protocol for Peripheral Neuropathy: A Case Series

 https://pmc.ncbi.nlm.nih.gov/articles/PMC5733739/

Do you have Paresthesia (tingling, numbness or “pins and needles”) in your shoulder or arm (above the elbow)?  Also, do you have weakness in your arm?  You may have limitation of motion of your triceps muscle? These are all symptoms of Radial Nerve Syndrome above the elbow. It could be due to Radial Nerve Syndrome. This post is about Chiropractor West Palm Beach: Acupuncture Treatment for Radial Nerve Syndrome.

 Symptoms/ Signs of Radial Neuropathy

As mentioned previously, there is usually weakness of the triceps if the compression is in the axillary area.  This differentiates higher from lower levels of compression.  Moreover, entrapment from the level of the spiral groove of the humerus down usually does not affect the triceps. 

However, if severe enough, compression in the axilla can be very extensive.  It can lead to loss of elbow, wrist (wrist drop) and finger extension. This is because entrapment at the axilla affects all of the motor and sensory (possible numbness) radial distributions. 

Radial Neuropathy/Nerve Entrapment Causes

Firstly, your pain and paresthesias (numbness and tingling) could have come on insidiously (gradually).  However, radial neuropathy/nerve entrapment can be due to various causes such as trauma, tumor, scaring/fascial restrictions, fracture, and tourniquet or crutch use causing pressure at the axilla.

Secondly, Saturday night palsy; where you are sleeping with the head on an outstretched hyperabducted (stretched above head) arm may lead to it as well.

Thirdly, sports such as gymnastics and wrestling may be a cause due to some of the maneuvers.

Fourthly, other sports such as baseball and weight lifting where your elbow is forcefully extended may be a cause.

Fifthly, even runners are at risk for radial neuropathy.  Runner’s Radial nerve palsy occurs due to keeping the elbow tightly flexed while running.  This causes numbness in the forearm and dorsal (upper) hand.

Sixthly, repetitive or prolonged muscle contracture in laborers and throwers may be a cause.

Anatomy of the Radial Nerve

The radial nerve is the terminal (end) continuation of the posterior (back) part of the brachial plexus. And the brachial plexus is a bundle of nerves that originate from nerve roots in the cervical (neck) and upper thoracic (torso) sections of the spinal cord (C5-T1). Ultimately, the brachial plexus creates a network that connects to the nerves in the arm. Therefore, the radial nerve contains fibres from nerve roots C5 – T1.

It arises from the axilla and exits the axilla inferiorly (below).  Next, it supplies branches to the long and lateral heads of the triceps brachii muscle.

The radial nerve then descends down the arm.  It travels in a shallow depression within the surface of the humerus (long upper arm bone), known as the radial groove.

To enter the forearm, the radial nerve travels anterior (front of) to the epicondyle of the humerus, through the cubital fossa of the elbow. The nerve then ends by dividing into two branches:

-Deep branch (motor) – innervates (supplies) the muscles in the posterior (back) compartment of the forearm.

-Superficial branch (sensory) – contributes to the cutaneous (skin) innervation of the dorsal (back) hand and finger

Acupuncture Care in West Palm Beach: Causes of Radial Nerve Entrapment/ Neuropathy 

Radial Nerve Syndrome is a peripheral neuropathy. And a peripheral neuropathy is a result of damage to the nerves located outside of the brain and spinal cord. It is a disease characterized by pain or loss of function in the nerves that carry signals to and from the brain and spinal cord (the central nervous system) to other parts of the body.  

Entrapment Sites of the Radial Nerve:

High Radial Nerve compression

High radial nerve compression involves compression from the axilla to the proximal (beginning) elbow. Entrapment can first occur as the radial nerve passes in front of the subscapularis (one of 4 rotator cuff muscles), tendons of the latissimus dorsi and teres major muscles. 

Furthermore, entrapment can include axillary compression and compression at the spiral groove of the humerus, fibrous arcade (band) at the origin of the lateral head of triceps muscle and within the triceps muscle.

Compression proximal (near) to the elbow

Entrapment occurs proximal (nearer) to the elbow on the lateral (side) position between the brachialis (muscle goes from humerus and inserts to ulna bone of elbow) and brachioradialis (muscle goes from humerus to radius bone at wrist). 

Also, with Cheiraigia Paresthetica (Wartenberg’s Syndrome) there is numbness or tingling over the dorsolateral (back and the sides) aspect of the wrist and hand. The superficial branch of the radial nerve is susceptible to trauma between the tendons of the extensor carpi radialis longus (ECRL is a forearm extensor muscle) and the brachioradialis (muscle of the forearm that flexes the forearm at the elbow).

Do you have pain, numbness, and tingling in the palmar (palm side or grasping side) surface of the thumb and radial (toward the thumb side) two and one half fingers? It could be due to Carpal tunnel syndrome. This post is about Chiropractor West Palm Beach: Acupuncture Treatment for Carpal Tunnel Syndrome.

Chiropractic Care in West Palm Beach: Causes of Median Nerve Entrapment at the Carpal Tunnel of the Wrist

Carpal Tunnel Syndrome is a peripheral neuropathy. And a peripheral neuropathy is a result of damage to the nerves located outside of the brain and spinal cord. It is a disease characterized by pain or loss of function in the nerves that carry signals to and from the brain and spinal cord (the central nervous system) to other parts of the body.  

With carpal tunnel syndrome (neuropathy at the wrist), the median nerve runs through an osteofibrous tunnel created by the transverse carpal ligament and carpal (wrist) bones. Direct compression from ganglions (sac-like swelling or cyst), fractures, and dislocations is possible.  However, it is more common to have a history of direct external pressure on the tunnel.  Also, a history of prolonged wrist use in full flexion or extension (down or up) can be the culprit. Lastly, pressure inside the tunnel increases in these extreme repetitive positions. Additionally, other factors may contribute such as rheumatoid arthritis, diabetes, connective tissue disorders and fluid retention as in pregnancy. Deficiency in B vitamins may predispose you to carpal tunnel syndrome as well.

Anatomy of the Median Nerve

First, the median nerve is a major peripheral nerve of the upper limb and are formed from the nerve roots of C6 – T1. Also, contains fibres from C5 in some individuals.  The median nerve comes from the medial (inner) and lateral (outer) cords of the brachial plexus. And the brachial plexus is a bundle of nerves that originate from nerve roots in the cervical (neck) and upper thoracic (torso) sections of the spinal cord (C5-T1). Ultimately, the brachial plexus creates a network that connects to the nerves in the arm. Therefore, the median nerve contains fibres from nerve roots C6 – T1.

Second, it arises from the brachial plexus in the axilla and descends down the arm. At first, it is lateral to the brachial artery. Halfway down the arm, the median nerve crosses over the brachial artery.  It is then in the medial (inner) arm. Next, the median nerve enters the anterior (front) compartment of the forearm via the cubital fossa at the elbow.

Third, in the forearm, the nerve travels between the two heads of pronator teres muscle, and then descends in a plane between the flexor digitorum profundus and flexor digitorum superficialis muscles. Here, the median nerve gives rise to two branches in the forearm:

• Anterior interosseous nerve – supplies the deep muscles in the anterior forearm.
• Palmar cutaneous nerve – innervates the skin of the lateral (outer) palm.

Fourth, after giving off the anterior interosseous and palmar cutaneous branches, the median nerve enters the hand via the carpal tunnel.  Finally, the median nerve terminates by dividing into two branches:

• Recurrent branch – innervates the thenar muscles.
• Palmar digital nerves – innervates the palmar surface and fingertips of the lateral three and half digits. Additionally, provides branches to the lateral two lumbrical muscles.

Chiropractor West Palm Beach: Acupuncture Treatment for Carpal Tunnel Syndrome (CTS): Research

In one study, participants were randomly assigned to either a control group (without acupuncture) or an intervention group (with acupuncture). One group had night splinting, vitamin B1, B6 and sham acupuncture for four weeks.  And another group got acupuncture in 8 sessions over 4 weeks and night splinting. So the short term effects of acupuncture for mild to moderate carpal tunnel syndrome was assessed. The results showed acupuncture significantly improved clinical symptoms of CTS. Therefore, acupuncture can improve the overall subjective symptoms (e.g. pain) of carpal tunnel syndrome.  

Chiropractor West Palm Beach: Acupuncture Treatment for Carpal Tunnel Syndrome  (CTS): More Research

Firstly, in another study, funded in part by the National Center for Complementary and Integrative Health and conducted by a multicenter team of scientists at Massachusetts General Hospital, Logan University, the Korean Institute of Oriental Medicine, Spaulding Rehabilitation Hospital, Harvard Vanguard Medical Associates/Atrium Health, and Beth Israel Deaconess Medical Center, is the first sham-controlled neuroimaging acupuncture study for CTS. It was published in the journal Brain.

Secondly, the scientists looked at local pain-relieving effects in people with carpal tunnel syndrome (CTS) with acupuncture.  Similarly, they looked at how acupuncture was effecting the brain’s pain centers. The conclusion was, acupuncture may improve CTS pathophysiology (body’s changes due to disease) by both local and brain-based mechanisms. The scientists looked at the neuroplasticity of the primary somatosensory cortex. So they were looking at the brain’s ability to reorganize.  Specifically, its touch, pain, and “body-position maps” following injury, learning, or changes in sensory input. This dynamic rewiring allows healthy neurons (nerve cells) to take over areas that lose input.  It also allows the brain to adapt through repetitive practice.

Thirdly, the aim was to study the short term effects of acupuncture treatment of mild to moderate carpal tunnel syndrome. The results showed that patients receiving acupuncture had significantly better outcomes in clinical symptoms of CTS.

Chiropractor West Palm Beach: Acupuncture Treatment for Carpal Tunnel Syndrome

Acupuncture has been used for over 4000 years to treat pain and other health problem.  Acupuncture effects what the ancient chinese practitioners called Meridians (energy channels) in your body under the skin. Traditional acupuncture is based on the belief that an energy, or “life force”, flows through the body in these channels called meridians.

Today, Researchers believe when an acupuncture needle is inserted, nerves are stimulated. This sends a message to your brain and nervous system. Ultimately, Acupuncture improves blood flow and calms the nervous system.  This triggers nerve signaling that affects the function of other parts of the body, including organs.

Dr. Natalie Meiri is a chiropractic physician, board certified in acupuncture with over 20 years of experience.  Call 561-253-8984 today!  Ask to make an appointment or find out more about: Chiropractor West Palm Beach: Acupuncture Treatment for Carpal Tunnel Syndrome.

References:

1. https://pmc.ncbi.nlm.nih.gov/articles/PMC3523426/

Acupuncture in treatment of carpal tunnel syndrome: A randomized controlled trial study,  J Res Med Sci. 2012 Jan;17(1):1–7.

Saeid Khosrawi ¹, Alireza Moghtaderi ^2,✉, Shila Haghighat ³ PMCID: PMC3523426  PMID: 23248650

     2. https://www.nccih.nih.gov/research/research-results/how-the-body-and-brain-achieve-carpal-tunnel-pain-relief-via-acupuncture

         How the Body and Brain Achieve Carpal Tunnel Pain Relief via Acupuncture

Runners participating in sports have shown positive outcomes from acupuncture interventions. Acupuncture isn’t just for pain management.  Indeed, acupuncture helps you with injury repair and recover faster. Ultimately, acupuncture gives you the extra ability to achieve peak performance. West Palm Beach Chiropractor: Runner’s Lower Extremity Injuries Acupuncture Can Help is about just that.

Acupuncture has been used for over 4000 years to treat pain and other health problems. The acupuncture treatment stimulates the imbalanced pathways along the meridians to bring balance back.  Mainly, the goal is to activate the body’s natural healing abilities and bring balance back to your body. It’s often used as part of a broader approach to healthcare.

Every athlete is different and so treatments are different for everyone.   For example, an athlete with digestion issues will not get the same treatments as someone with hormonal issues or allergies. Indeed, Acupuncture enhances peak oxygen levels, maximum heart rate, delayed-onset muscle soreness, pain, swelling, explosive force production, and joint mobility. Furthermore, the efficacy of acupuncture appears to be similar regardless of age and sex.

Athletes may also use acupuncture immediately before or after a major event. And then as part of the recovery phase afterward. 

3 common runner’s lower extremity injuries acupuncture can help

1. Achilles Tendonitis

The achilles tendon is a very large tendon which connects the gastronemius and soleus (calf muscles) to your calcaneus (heel bone).

The Achilles tendon is covered by a peritenon (connective tissue sheath surrounding a tendon) composed of mainly areolar tissue (fatty tissue) which functions as a cushion.  The area most affected in tendinitis is approximately 2 cm proximal (close) to the calcaneal insertion (heel attachment). The demands on the tendon are high in running and jumping.

Next, at the heel insertion (attachment site) there can be a complicating problem. The retrocalcaneal bursa (small cushioning sac between the heel bone and the achilles tendon) can get irritated.  Eventually, this may lead to a Haglund’s deformity (bony enlargement found on the back of the heel).

Common symptoms of achilles tendonitis include a dull pain above your heel, swelling along the tendon, or a limited range of motion when you try to flex your foot toward your shin.

Acupuncture can be part of your treatment for an Achilles tendon injury right away when you begin to feel pain. Otherwise, the risk of rupturing it increases.  Then you will need surgery and months of recovery will delay your training and running.

2. “Runner’s Knee”

Runner’s Knee is also called patellofemoral syndrome or chondromalacia patella.  It is seen in various athletes, but most commonly seen among runners. You may have anterior (front) knee pain. However, your knee pain may be found behind, in and around your patella (knee cap) as well. It may be vague aching pain that is aggravated by going up and down stairs. Moreover, there may be associated crepitus (cracking or grating) and knee pain going through any squatting maneuver. 

Certainly, biomechanical (study of living body) abnormalities can lead to an erosion and fragmentation of the sub patellar (beneath kneecap) cartilage. This breaking up of the patella articular cartilage due to repetitious stress leads to chondromalacia.  So patella tracking problems can occur primarily from injuries to the knee and quadriceps (group of four muscles that cover the front and sides of your thighs) mechanism.  And it can secondarily be in response to problems affecting the ankle or hip. An acupuncture treatment can be rendered for healing.

3. Hamstring Strain or Adductor Strain/Sprain (Groin Pull)

Perhaps you were running, sprinting or jumping and you over contracted the hamstrings while in a position of stretch?  You may be a runner who feels a sudden pull or pop at the back of the thigh following a forceful knee extension maneuver?

The hamstrings are a group of three muscles that run along the back of your thigh. They allow you to bend your leg at the knee. Tendons and aponeurosis (a sheet of pearly white fibrous tissue) connect the muscles with the structures (i.e. bones ) to be moved. Strains (injury to muscle) of  hamstrings occurs most often at the junction of the muscle and aponeurosis.

Perhaps you were sprinting or jumping and felt a sudden pulling sensation in the groin that was incapacitating?  The adductors are a group of muscles on the inside of your thigh. So a sprain is an injury to the ligaments, a fibrous connective tissue that attaches bone to bone, and usually serves to hold structures together. And the cause of an adductor sprain (injury to ligaments) is often a sudden contraction from a stretched position.

While ice and rest from the inciting activity are a start.  And you may try a conventional drug for fast pain relief for the moment. However, drugs are not a long term solution. Get your acupuncture treatment if it’s not getting better. 

Acupuncture  Research