Carpal Tunnel

Carpal tunnel syndrome is a condition that causes numbness, tingling and other symptoms in the hand and arm. CTS is caused by a compressed nerve in the carpal tunnel, a narrow passageway on the palm side of your wrist. This nerve controls sensation and muscle movements in the hand if the carpal tunnel becomes narrowed from swelling or injury the nerve becomes compressed or impinged, leading to the diagnosis of CTS.

Cause of Carpal Tunnel Syndrome is usually unknown. Pressure on the nerve is the main reason for developing this condition. The pressure can be caused for several reasons including; swelling of the flexor tendons, joint dislocations, arthritis and fractures.                                                            Keeping the wrist bent for extended periods of time has led to diagnosis, thyroid conditions, diabetes and rheumatoid arthritis can also be related in developing carpal tunnel.

Western Medicine and Carpal Tunnel                                                                                                                                             Carpal Tunnel Syndrome sends over a million patients into a physicians office each year. In which approx 400,000 cases result in surgery. Treatments also recommended in Western medicine may include, splits, steroid and non-steroidal medications, and anti-inflammatory drugs. Some recommended homecare ideas include icepack, rest, stretching and there are a few specialty therapies including occupational therapy, physical therapy, neurologist, and physical rehab that can also be of help for a patient suffering from CTS.

Surgery for Carpal Tunnel is the most frequent surgery done in the wrist/hand to date. Surgery can cost anywhere from $1500 to $3000.                                                                                                                                A surgery overview would look something like this, the surgeon would go in through the palmar side of the hand, cut the transverse carpal ligaments releasing pressure on the medial nerve, they’d then close the incision up with stitches.                                                                                                                         Recovery can be anywhere from 4-6 weeks with strength and movement improving over the next year, most cases needing some type of physical therapy. Some cases are never

Alternative or Traditional Chinese Medicine offer other healing methods with clients who have CTS.  A fundamental in Chinese medicine is to not just treat the symptoms of the disorder, but to discover the cause and work on a treatment that targets the root of the problem.

These are some options TCM recommends if you are trying to prevent Carpal Tunnel;     Good health, If you work at a desk, move as much as possible, don’t sit in the same position for 45minutes, keep warm, often people who have cold hands are more prone to CTS, keeping circulation strong is important, and use both hands evenly.

A few things to do if you are noticing signs or have been diagnosed; try wearing a splint, get a massage helping release tension throughout the body can help loosen everything, including hands, rest, try yoga, and acupuncture is a highly recommended treatment in TCM for this condition.                                                                                                        

Acupuncture is a holistic health technique that stems from Traditional Chinese Medicine practices in which trained practitioners stimulate specific points on the body by inserting thin needles into the skin.  Although, needles are used in acupuncture, treatments are relatively pain-free. The energy then circulates throughout the body along well-defined pathways. If the energy circulation is disrupted, the result can be pain or illness. (Such as CTS) Acupuncture points are stimulated to balance the circulation of energy, which influences the health of the entire being and promotes the body's natural healing ability.                                                                                                                      

A very successful treatment in TCM for carpal tunnel that has been used it Acupuncture combined with moxa along the specific points of the body. A client may have to return into acupuncture clinic for several weeks for a full recovery and may also be referred for massage along with acupuncture. The cost per session of acupuncture can vary greatly depending on your area of living.

I found the information I’ve researched on this topic very interesting. Happy Healing! 

Edema

Edema is the medical term for swelling. Body parts swell from injury or inflammation. It can affect a small area or the entire body. Medications, infections, pregnancy, and many other medical problems can cause edema.

Edema happens when your small blood vessels become "leaky" and release fluid into nearby tissues. That extra fluid builds up, which makes the tissue swell.

Western Medicine vs. Chinese Medicine View of Edema

Western medicine looks at edema differently than Chinese medicine as simply an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body. Generally, the amount of interstitial fluid is determined by homeostasis, and increased secretion of fluid in to the interstitial spaces, or impaired removal of this fluid may cause edema. Six factors can contribute to the formation of edema:

1. Increased hydrostatic pressure.
2. Reduced oncotic pressure within blood vessels.
3. Increased tissue oncotic pressure.
4. Increased blood vessel wall permeability e.g. inflammation.
5. Obstruction of fluid clearance via the lymphatic system.
6. Changes in the water retaining properties of the tissues themselves. Raised hydrostatic pressure often reflects retention of water and sodium by the kidneys.

Hydrostatic pressure within blood vessels tends to cause water to filter out into the tissue. This leads to a difference in protein concentration between blood plasma and tissue. As a result the oncotic pressure of the higher level of protein in the plasma tends to suck water back into the blood vessels from the tissue. Most water leakage occurs in capillaries or post capillary venules, which have a semi-permeable membrane wall that allows water to pass more freely than protein. If the gaps between the cells of the vessel wall open up then permeability to water is increased first, but as the gaps increase in size permeability to protein also increases with a fall in reflection coefficient.

Changes in the variables can contribute to the formation of edema either by an increase in hydrostatic pressure within the blood vessel, a decrease in the oncotic pressure within the blood vessel or an increase in vessel wall permeability. The latter has two effects. It allows water to flow more freely and it reduces the oncotic pressure difference by allowing protein to leave the vessel more easily. A rise in hydrostatic pressure occurs in cureardiac fail. A fall in osmotic pressure occurs in nephritic syndrome and liver failure. It is commonly thought that these facts explain the occurrence of edema in these conditions.

Causes of edema which are generalized to the whole body can cause edema in multiple organs and peripherally. For example, severe heart failure can cause pulmonary edema, pleural effusions, ascites and peripheral edema. Although a low plasma oncotic pressure is widely cited for the edema of nephritic syndrome, most physicians note that the edema may occur before there is any significant protein in the urine (proteinuria) or fall in plasma protein level.

Fortunately there is another explanation available. Most forms of nephritic syndrome are due to biochemical and structural changes in the basement membrane of capillaries in the kidney glomerulae, and these changes occur, if to a lesser degree, in the vessels of most other tissues of the body. Thus the resulting increase in permeability that leads to protein in the urine can explain the edema if all other vessels are more permeable as well. Edema will occur in specific organs as part of inflammations, tendonitis or pancreatitis, for instance. Certain organs develop edema through tissue specific mechanisms.

The movement of water in the body involves all of the organs; starting in the Stomach and ending in the Urinary Bladder. Water is moved and controlled by an invisible organ in Chinese Medicine called the San Jiao or Triple Heater or Burner. It is the San Jiao's responsibility to move water throughout the body and any disruption of this can lead to edema. When the San Jiao is working properly water moves freely between organs and freely in and out of the cells. Also, edema in Chinese Medicine comes in two varieties; Qi Edema and Water Edema.

Types of edema well treated with Chinese herbs:

• Lymph edema
• Ankle edema
• Leg edema
• Arm edema
• Facial edema

The Chinese Medicine treatment of edema generally involves arriving at the appropriate TCM diagnosis or pattern. This pattern within the individual is what treatment is based on not the general condition (see treating the cause and not the symptoms).
The following patterns may represent the underlying contributing factors for the development of edema:

• Heart Yang Deficiency
• Lung Wind Invasion - Wind Cold
• Spleen Yang Deficiency
• Spleen Invasion - Cold Damp
• Kidney Yang Deficiency

Edema - Acupuncture Protocols

The treatment of conditions with acupuncture can be a complicated endeavor that should only be undertaken by individuals with a deep understanding of the underlying Chinese Medicine theory (and/or whatever system being used for treatment). There are many approaches, but generally speaking few viable approaches are involved on a point to condition basis. Rather using proper diagnostic procedures the patients diagnostic pattern is ascertained and that is what is treated. The protocols listed here exemplify some of these clinical approaches.

The following Acupuncture Treatment Protocols May Be Used With Edema

• Acupuncture for Pregnancy, Childbirth and Postpartum Issues (3rd Trimester)

How Does Massage Therapy Work? 

Massage therapy works by directing pressure at the skin and muscle areas affected by edema. The lymphatic system is activated during the process and the fluid drains away naturally. 

The activation of the lymph nodes is the key to getting the body to naturally drain away the excessive fluid accumulation that causes edema.

Lymphatic Massage Therapy for Edema

Lymphatic Massage involves a light touch massage therapy which helps in enhancing the functioning of the lymphatic system. It is also known as Lymphatic Drainage Massage or Manual Lymphatic Massage. If there is a problem in the functioning of the lymphatic system, then it leads to swelling, headaches, cramps, fluid retention, fatigue, lethargy, joint pain, and repeated cold and flu infections.

The lymphatic massage technique involves stimulating the lymphatic drainage system. This helps in encouraging the drainage of accumulated fluids and helps in restoring the normal function of the lymphatic drainage system. Lymphatic massage technique involves gentle touch with the massage strokes directed towards the heart (direction of the lymphatic flow). Preferably one finger should be used to perform these massage strokes. The massage strokes should be short and in one direction beginning with the affected limb lying closest to the trunk.

Leg and Foot Massage for Edema

• Using a single finger, start the massage using gentle and light strokes on the affected leg nearest to the trunk of the body.
• Make sure the massage strokes are in upward direction.
• Slowly move downwards along the limb using similar strokes. These massage strokes help in encouraging the fluid drainage through the pathway. The reason for beginning from the trunk is to remove any obstructions that could be blocking the normal flow of lymphatic fluid towards the heart and preventing lymphatic tissue damage.
• This massage should be done in the proper manner by a qualified massage therapist. Each massage session could last for over 30 minutes.

https://www.webmd.com/allergies/relief-advisor

https://agelessherbs.com/edema/natural-alternative-herbs/

https://theory.yinyanghouse.com/conditions-treated/alternative-natural-options-for-edema
https://www.epainassist.com/manual-therapy/massage-therapy/massage-therapy-for-edema-lymphatic-massage-or-lymphatic-drainage-massage
http://www.progressivehealth.com/massage-for-edema.htm

Traditional Chinese Medicine, Western Medicine, and Massage Therapy

Clinical Depression: How We View It and How We Heal It

Isabelle LoPresti

“DSM-IV Criteria for Major Depressive Disorder (MDD)

·             Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.

·             Mood represents a change from the person’s baseline.

·             Impaired function: social, occupational, educational.

·             Specific symptoms, at least 5 of these 9, present nearly every day:

1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g. appears tearful).
2. Decreased interest or pleasure in most activities, most of each day
3. Significant weight change (5%) or change in appetite
4. Change in sleep: insomnia or hypersomnia
5. Change in activity: psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Guilt/ worthlessness: feelings of worthlessness or excessive or inappropriate guilt
8. Concentration: diminished ability to think or concentrate, or more indecisiveness
9. Suicidality: thoughts of death or suicide, or has suicide plan”

-Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes, Diagnostic and Statistical Manual of Mental Disorders (DSM) IV

 

A woman speaks –

“Depression is messy. It feels like sadness or guilt or anger. It feels illogical and irrational. It doesn’t make sense. It hurts. Depression makes you want to give in, give over, give up. It splits you from yourself and turns on you with anger. Depression makes you angry with your body, your self, your life but it never allows the anger to be released. Depression despairs of hope and cannot see a light at the end of the tunnel. Nothing can make you feel better when you are depressed.

Except maybe...

A soft and gentle hand on your back that asks for nothing and gives only soothing. A quiet voice that gives you direction and helps you to move. A deep release from the tension behind your eyes and the headache and soul ache that wakes you every morning. The salve of kindness that eases low back pain or massages the feet with warm lotion or oil. A respite. A break from the isolation and pain. And after a while, if the dark clouds part and it’s possible to see into the day again, the depression may lift, if only momentarily. In that moment, the isolation fades and it may be possible to connect with another human being – the person behind the hand on the back and the fingers on the brow.”

- Lois

 

Pamela Fitch, RMT, “Depression: How Can Massage Therapy Help”

Depression from a Western Medicine Point of View

Depression can affect someone in many different ways and does not have one specific cause. The range of causes include:

·        Chemical imbalance- Serotonin receptors do not pick up correctly causing a lack of reuptake.

·        Environmental cause- hours of daylight per day and seasons can have an affect on Seasonal Affective Disorder and the presence of depression bouts.

·        Trauma- recovery from trauma can often induce an inability to cope and overwhelming feelings of sadness and hopelessness.

·        Hereditary- the chemical balance of parents can have an effect on the child’s ability to create and maintain proper serotonin levels in the body. Parents also have a large influence on the way that a child views life and the coping mechanisms the child develops in the face of hardship.

·        Nutritional- a lack of proper nutrition can result in worsened mood and an inability to maintain homeostasis in many ways, including serotonin levels and mental state.

·        Social- problems maintaining a healthy mental state can occur when the human need for a proper support group and a feeling of being loved goes unmet.

·        Financial- in a world where money is a large part of every day life, the inability to pay for basic human needs largely factors into one’s mental state.

How Massage Therapy Treats Depression

Well-intended human touch has a variety of positive benefits that treat symptoms of depression. Decreased cortisol (also known as the stress hormone) levels allow for lower presence of stress, whole body and mind relaxation, and better quality and quantity of sleep. A person suffering from depression can benefit greatly from knowing that there is someone there with them, decreasing feelings of loneliness and helplessness. Human connection through touch can help a person experiencing overwhelming negative emotions allow those feelings to release, knowing they are safe. Focusing on the present moment, taking care of the body, and mindfulness are all parts of massage therapy that are greatly beneficial in decreasing symptoms of depression. Swedish massage therapy techniques such as effleurage, petrissage, and compression focus on soothing and relaxing tense muscles and relieving muscle knots. Temporomandibular joint (TMJ) work helps with headaches that are caused by clenching the jaw and teeth, a common side effect of increased stress that comes with depression. Cranio-Sacral Massage techniques are also very helpful to release occipital-axial compression that may cause dizziness, pain, brain fog, and headache. Proprioceptive Neuromuscular Facilitation (PNF) and Passive Range of Motion (PROM) exercises performed by the Massage Therapist help to ease muscle tension as well as provide a simple self-care practice that the client can take home and work on alone. Having a goal and set of exercises can be very beneficial to provide the right amount of responsibility for one’s self that will boost the person’s confidence in their ability to care and love themselves without being too overwhelming. Exercises and stretches done at home, a regular schedule of massage, human connection, and decreased mental and physical stress all provide a perfect atmosphere to ease the symptoms of someone suffering with depression.

Tips for the Massage Therapist

Working on a person affected by depression can be emotionally draining if the Massage Therapist does not take proper measures to secure their own emotional well-being. It is important to remember that counseling and psychiatric help are to be performed by a professional in that field. Massage therapy work for depression can be similar to working on someone with chronic pain- it is key to keep in mind that the focus is to alleviate symptoms and provide a safe atmosphere for healing rather than attempting to cure the condition.

         Easing hypersensitivity through the use of dim lights, weighted blankets (to promote the parasympathetic nervous system’s “rest and relaxation” response), ear plugs or soft music, and relaxing smells such as lavender and peppermint are great tools to utilize during the massage.

         Communication is key! Checking in with the client and being open-minded about treatment options is a highly effective way to ensure maximum comfort, relaxation, and healing.

        

Depression from a Traditional Chinese Medicine Point of View

Depression is described as “Yu Zheng” in Traditional Chinese Medicine (TCM). Causes include:

·     Lung Qi Deficiency- deficiency of lung qi is characterized with grief, inability to let go, shortness of breath, and difficulty speaking what needs to be said.

·     Liver Qi Stagnation- liver qi that cannot move can cause irritability and frustration, anger, and tension in the muscles.

·     Kidney Yang Deficiency- irrational fear and anxiety can be the result of an insufficient amount of yang energy in the kidneys.

·     Presence of Phlegm- phlegm creates a fog in the brain that makes it hard to think clearly and make decisions. It makes the body feel heavy, fatigued, and sluggish.

·     Excess Yin- too much calm and grounded energy can leave a person in a depressed state, unable to get the energy that they need to function correctly and feeling lackluster toward life. Yin is characterized as a feminine energy, explaining why depression affects more women than men.

Yin Organs and Their Related Energies That Manifest in Depression:

Spleen-worry

Liver-anger

Kidneys-fear

Lungs -grief and anxiety

How Traditional Chinese Medicine Treats Depression

Through a variety of treatment options including Qi Gong, herbs, moxa, acupressure and acupuncture as well as energy work, the symptoms of depression can be addressed and treated through TCM. Special attention to the water element, which is considered the life source, aids in the building of zest for life and ability to function and feel happiness toward one’s state of being. Water building exercises in Qi Gong are a great tool for clients to perform with their Massage Therapist and at home.

         Tonifying the Qi in Yin organs mentioned above can ease the negative symptoms that come from stagnation and deficiency. This can be done through acupuncture and acupressure along the specific meridians and points as well as herbal concoctions or burning moxa.

         The 9 Points to Revive Yang treatment taught by Cynthia McMullen is an excellent way to tonify yang and bring energy back to the person experiencing symptoms of depression. Some herbs recommended for Yu Zheng treatment in TCM include:

·     Suan Zao Ren and He Huan Pi for balancing Shen

·     Bai Zhu, Huang Qi, and Wu Wei Zi for tonifying Lung Qi

·     Chai Hu, Bai Shao, Bai Zhu, and Dang Shen for moving Liver Qi stagnation

·     Ban Xia, Fu Ling, and Hou Po for treating Phlegm and Phlem/ Qi clashing.

·     Gan Cao, Fu Xiao Mai, and Da Zao for Yin and Blood Deficiency

The most important thing in treating depression through TCM is to regain balance in whatever form is best for the client. Many treatments can be used simultaneously and allow for a multi-faceted approach to healing the body and mind.

Sources:

“Depression & Traditional Chinese Medicine”, Stanley J. Swierzewski, III, M.D.

“Depression: How Can Massage Therapy Help”, Pamela Fitch, RMT

“Depression: Causes and Treatment by Traditional Chinese Medicine” by FEMTC of biomanantial.com

Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes, Diagnostic and Statistical Manual of Mental Disorders (DSM) IV