Carpal Tunnel Case Study - Remedial Therapy Fusing East and West

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I rarely sight Carpal Tunnel cases in clinic that have not already undergone surgical intervention to snip the Carpal Ligament releasing pressure impinging the nerves of the hand. Short of this, conventional medical practitioners and therapists do not have an effective treatment for the condition. Unfortunately, this procedure permanently impairs grip strength. My earliest teacher, Prof Lun Wong AO, 9th dan Tang So Do, advised surgery should only be considered where it is a matter of life and death. In this instance, there is an effective alternative option once gaining a fuller understanding of the condition and its causes.

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This case is a 50 year old female who was previously a self-employed cleaner and now unable to work due to her condition. She had been afflicted by 24/7 numbness in both hands for a period of two years accompanied by shoulder pains shooting down the arms. This was medically diagnosed as Carpal Tunnel. Nerve conduction testing supported the diagnosis and she was now on the Disability Pension. She came to me for treatment of the shoulder/back pain which forced her to use strong pain killers so that she could sleep at night. She had no expectation the Carpal Tunnel symptoms might benefit from treatment.

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Resistance testing of shoulder function proved negative. This is good and largely rules out injury. Palpation revealed high degrees of tightness and pain through Middle Traps, Rhomboids, Infraspinatus and Teres musculature of the right shoulder. Muscle tone of back and Costals laterally and through to the front was in a high state of tightness with a gristle like quality down on the bone. Range of motion at the shoulder restricted by tightness through the chest and under the arm.

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I advised her the Remedial Therapy I practice with a fusion of Eastern and Western concepts was likely to relieve her of much of the pain and discomfort she was experiencing and to not be surprised if the Carpal Tunnel symptoms abated. Proceeding with treatment to open the chest, warm up the shoulders and loosen the back generally I then carried out the Shoulder Treatment Protocol as described elsewhere on this site. Apart from obvious Sports and Swedish Massage technique that might normally come to mind, my work incorporates Indirect Fascial Release technique from Osteopathy and TCM Cupping and Gua Sha. It is very physical and achieves deep release through shoulder, rib cage and torso. At moments with client in sidelying, I will be using near on my full body weight to compress and mobilise upperbody, chest, ribcage and shoulder. Applied with directed breath work, it is a Muscular Energetic Technique (MET) of the most overt nature. By the end of this first treatment session, shooting pain and numbness on the left side was resolved. The right side was unchanged.

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She returned for further treatment one week later and advised that while she felt fantastic on the day of treatment, for three days after she experienced high levels of pain through her upper back and chest generally…almost too much to bear. Once it passed, she noticed improvement and decided to continue treatment. I expect clients to feel some degree of pain following Remedial treatment where deep work has been carried out to release chronic soft tissue tightness but I was surprised by this report…I thought I had been moderate and adverse reaction might be limited. I was wrong. Her case was more acute than expected.

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A total of four treatment sessions were carried out before pain was entirely cleared from the shoulders and arms. Eventually, three days after the final treatment, sensation returned to the right hand. Nerve function can be slow to return after prolonged impingement. She has required no further treatment and I have been advised her condition remains good.

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Interestingly, although reporting at the end of the first treatment that she could once again feel with her left hand...the numbness was gone...it did not seem to have pierced her consciousness the Carpal Tunnel symptoms were being resolved. She had consulted Medical Doctors and Specialists who offered no treatment except surgery. While averse to surgery, she had no expectation of an alternative effective treatment. It was not until the condition was cleared in both hands did she fully realise what had happened.

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The principal energetic Qi flow effect behind this case is a proximal energetic block at hip or shoulder has an impact distally on the limb. Blocking energetic flow for any reason be it due to overwork, injury, internal health conditions, weather or emotional impact causes a thickening and tightening through the connective tissue. It may be subtle and barely perceived by the subject or under loading and the influence of other factors escalate to acute pain, dysfunction and injury. This thickening and tightening can be mistaken for inflammation but unlike inflammation, on clearing the blockage, the tissues rapidly warm and soften as energetic flow resumes, pain dissipates and function returns to normal. This can occur in a matter of minutes.

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Direct treatment at forearm, wrist and hand for Carpal Tunnel or Repetitive Strain Injury rarely provides effective or enduring benefit. The cause of the problem in the arm is coming from energetic blockage at shoulder and torso thickening the forearm flexors creating pressure under the Carpal Ligament and impinge nerves to the hand.

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It is unfortunate conventional medico’s and therapists are not trained to sense, cultivate and control energy/Qi. In the absence of rupture and injury, they consider biomechanical and neurological effects. This is not the full story. As a result, their treatment outcomes can be poor and resort to unnecessary surgical procedures.