Carpal tunnel syndrome symptoms arise from compression of the median nerve within the carpal tunnel, a passage created by the wrist bones and the transverse carpal ligament near the base of the thumb. Within the carpal tunnel, the median nerve shares space with nine flexor tendons that bend the fingers and thumb. Inflammation of the synovial tissues that surround the flexor tendons reduces the tunnel space, placing pressure on the medial nerve and producing pain and numbness.
However, the median nerve has its nerve roots at the neck, and travels down the upper arm and forearm, and through the carpal tunnel to innervate the hand and fingers. Carpal tunnel symptoms can arise from median nerve compression anywhere along its path, rendering conventional treatment approaches ineffective. They may also arise from hypersensitization of the median nerve related to trauma or overuse, requiring specialized alternative carpal tunnel treatment.
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Clinical director & DC RMSK
Dr. Lev Kalika, NYDNRehab’s clinical director, has over 15 years of clinical experience, working with pain syndromes, neuropathies and movement disorders. His dedication to finding drug-free solutions that treat the patient and not just the symptoms has made Dr. Kalika a premier healthcare provider in NYC.
Dr. Kalika is an expert in diagnostic ultrasonography, with multiple scientific articles to his credit. The NYDNRehab clinic features the highest resolution expert-grade ultrasound equipment available. Dr. Kalika’s unique and proprietary approach to carpal tunnel treatment includes ultrasound-guided dry needling, electromagnetic transduction therapy, percutaneous neuromodulation therapy, and radial and focused shockwave therapy. Non-invasive extracorporeal shockwave therapy (ESWT) is one of the most effective treatments for carpal tunnel syndrome.
Dr. Kalika specializes in the treatment of peripheral neuropathies of the hand and arm. His research and expertise in dry needling and regenerative therapies, and his mastery of diagnostic ultrasonography, set him apart as a leader in alternative solutions for carpal tunnel rehab in NYC.
Run-of-the-mill physical therapy clinics often take a one-size-fits-all approach to diagnosing and treating carpal tunnel symptoms, prescribing cookie-cutter exercises and generic devices that often fall short of resolving symptoms. When all else fails, surgery is often recommended, with several inherent risks and no guarantee of successful results.
At NYDNRehab, our commitment to personalized patient care ensures that your treatment is customized to your unique needs. Our diagnosis is not based on symptoms alone, but on the knowledge and expertise of our team, coupled with high resolution diagnostic ultrasound imaging.
Dr. Kalika is a seasoned specialist in diagnostic ultrasonography for nerve entrapment. Ultrasound allows us to travel the length of the median nerve, from shoulder to hand, to identify the exact site of compression. Accurate diagnosis takes the guesswork out of carpal tunnel therapy, and ensures that your personalized treatment plan will yield quick and lasting results.
Our clinic features some of the most advanced technologies for carpal tunnel therapy, giving our patients access to superior cutting-edge treatment options that really work!
Symptoms
Pain, numbness or burning sensation around your wrist and thumb
Tingling sensation that radiates to your forearm or shoulder
Muscle weakness when gripping or performing fine motor tasks with your hands and fingers
Loss of grip strength when holding objects
Loss of kinesthetic awareness of your hand position in space
Shooting pains in your wrist and forearm
Achy stiffness around the base of your thumb and wrist
Causes and Risk Factors
Genetically small carpal tunnel space
Being female, with increased symptoms during pregnancy
Older age
Wrist trauma
Metabolic disease and chronic inflammation
Neurological disorders
Repetitive overuse from keyboarding, using tools, or sports and exercise
Carpal tunnel symptoms are brought on by compression of the median nerve — a long nerve that travels from your neck, all the way down your arm. Many doctors are quick to diagnose carpal tunnel syndrome based on symptoms alone, without considering other potential causes. This can lead to ineffective treatment that prolongs your pain and costs you time and money.
In some cases, despite symptoms in the wrist and hand, median nerve compression is not within the tunnel itself, but further up the arm in the upper pronator teres of the forearm, under the lacertus fibrosus near the elbow, or in the brachial plexus of the shoulder. In such cases, carpal tunnel release surgery is completely ineffective.
At NYDNRehab, we use high resolution diagnostic ultrasound for carpal tunnel to view the median nerve from end to end, in real time, and with the patient in motion. Ultrasound imaging lets us identify the exact location of nerve entrapment, ensuring that our treatment protocol hits its target in the most effective way.
Conventional medical treatment for carpal tunnel syndrome involves night-time splinting, steroid injections, reduced activity and nerve gliding exercises. When those approaches fail to resolve the condition, surgery — called carpal tunnel release — is often recommended.
During this procedure, median nerve pressure is relieved by cutting the transverse carpal ligament, to create more room for the median nerve and tendons. However, carpal release surgery only addresses the symptoms, without resolving the underlying causes of carpal tunnel syndrome. If nerve compression occurs higher up the arm, tunnel release surgery may be a complete failure.
At NYDNRehab, we use the latest technologies and innovative therapies to provide fast and effective relief for carpal tunnel syndrome. Your treatment protocol may include physical therapy for carpal tunnel, along with one or more of the following carpal tunnel rehab options:
Focused ESWT is a regenerative technology that uses high frequency sound waves to stimulate the body’s own reparative mechanisms. It is especially effective for reducing inflammation associated with median nerve compression, allowing the nerve to glide freely.
EMTT is a fairly new technology that transmits high energy magnetic pulses to targeted tissues. The magnetic waves synchronize with the body’s own magnetic fields, causing a disturbance that triggers a regenerative response at the cellular level to promote healing.
Extracorporeal Pulse Activation Technology (EPAT)
EPAT, also known as defocused shock wave therapy, uses acoustic pressure waves to enhance blood circulation to targeted tissues. This speeds up the delivery of oxygen and nutrients to damaged tissues and stimulates cellular metabolism, to accelerate the healing process.
HEIT uses electromagnetic fields to penetrate cells, tissues, organs and bones, to reactivate the electrochemical function of cells and cell membranes. HEIT generates a magnetic field 600 times stronger than the field of a normal magnet, to stimulate healing of nerves, muscles and blood vessels.
Our INDIBA machine converts electrical current into a stable frequency of 448 kHz, designed to increase and stabilize the exchange of ions in damaged cells, evoking a regenerative response that accelerates healing.
Carpal tunnel symptoms are sometimes due to hypersensitivity of the median nerve, brought on by sensory and motor impairments. Percutaneous electrical nerve stimulation uses thin needle electrodes, closely placed along the median nerve, to apply an electrical current. The electrical stimulation helps to calm the hypersensitized median nerve, thereby reducing pain and improving function.
Carpal tunnel syndrome is mainly caused by inflammation. Chronic inflammation can become a dangerous condition that ultimately affects your cardiovascular system and undermines your metabolic health. There are several actions you can take right away to prevent inflammation and reduce your risk of carpal tunnel syndrome and metabolic disease.
Get regular exercise
Avoid processed and sugary foods
Stop smoking
Stay hydrated
Lose weight
Don’t over-grip
Take regular work breaks
Stretch and strengthen your hands and fingers
Seek early treatment
Median nerve compression can seriously interfere with your productivity, especially if your daily work relies on the use of your hands and fingers. Conventional treatment approaches can take weeks or even months, with only modest relief, and surgery does not guarantee success.
The nerve pain specialists at NYDNRehab take a holistic approach to carpal tunnel treatment. We understand that pain in the wrist and hand can have its origins farther along the median nerve. Our personalized one-on-one treatment plans ensure that you will get the very best care, based on your personal profile. Our advanced technologies speed up the healing process while minimizing pain and discomfort for the patient.
If you think you may have carpal tunnel syndrome, contact NYDNRehab today. Our quick and accurate diagnosis and cutting-edge treatment options ensure that your carpal tunnel syndrome will be resolved in the fastest time possible, without drugs or surgery.
Dr.Kalika revolutionized foot and ankle care by using high resolution diagnostic ultrasonography for structural diagnosis, combined with with gait and motion analysis technology. Dr.Kalika’s motion and gait analysis lab is the only private lab in the US that features research-grade technology found only at top research universities, made available to patients in his private clinic.
The initial symptoms of weakness and paralysis of the fingers and the hands.
Tingling is usually a sign of nerve injury. Nerves generally have two major functions. There are sensory nerves which sense information in the skin, and there are moto occur in people that use the computer frequently, use the cash register, or are involved in activities that involve repetitive motion at the wrist. There is greater frequency of carpal tunnel syndrome among post-menopausal women.
The diagnosis of carpal tunnel syndrome is made using a nerve test called EMG/Nerve conduction study. Since there are multiple other causes of hand tingling, nerve testing is crucial toms could progress and become permanent.
Once the diagnosis of carpal tunnel syndrome is made we will determine the best possible treatment for the patient trying to our attention the chances of recovery are less, the patient could develop permanent paralysis, and surgical procedures might be required even though they could have been avoided early in the disease course. Patients with carpal tunnel syndrome could have full recovery with minimal intervention if they seek medical attention and treatment early.