Mark: Hi it’s Mark Bossert, producer of the Evolution Wellness laser series and we’re here with Dr. Harold Meinzer of Evolution Wellness in Vancouver and Langley. Today we’re going to talk about a very common thing, one I’ve suffered from myself actually, carpal tunnel syndrome. How you doing today, Dr. Harold?
Dr. Harold: I’m doing fantastic, Mark. Thanks for asking. How are you?
Mark: I’m really good. So, carpal tunnel. It hurts like a bugger. How can you help it with lasers?
Dr. Harold: Yeah, carpal tunnel. It’s very interesting but plagues a lot of people and we see it in the office all the time. It’s that wrist complaint, the median nerve going through that carpal tunnel. Pressure on it causes tingling, numbness, all sorts of peripheral symptoms into the wrist and hand, really kind of loves these fingers and can be caused from a variety of things. Lots of people get it from repetitive overuse or typing or ergonomic things as well, as it could be from overuse with … like your case, I guess, you can let us know, repetitive overuse with tree planting.
Mark: Of course, the little tweaks with mousing, you know, if you aren’t switching to different mice and track pads, et cetera. I’ve noticed in the past too.
Dr. Harold: Well, the biomechanics of the wrist and how your ergonomic setup is at your desk and your work station makes a huge contributing or play into this. You really don’t want to be up and about like this, which a lot of people are, on top of the desk top. Really want to be at sort of 90 degrees with the elbow and then the wrist will stay flat. You can’t see it on the screen, but so that wrist is sort of flat in that position instead of like this or on the desk top, which looks funny on camera and it even looks funny on the desk too.
Mark: Well, I notice a lot of times when I really found it at my … I was laying, resting my wrist on the desk top and typing or trying to move the mouse. That’s when I really felt it. I got ergonomically smart, no more issues. However, when the pain’s happening, how do you treat it with lasers?
Dr. Harold: Well, it’s sort of an inflammatory, right? So it’s compression on that nerve as it goes through that tunnel. So obviously, we want to correct whatever biomechanical fault. If you’re on the desk top and you’re doing weird things that … Obviously, we got to stop doing that. We’re going to smack you on the wrist. We’re going to crack those things. Then, we’re going to use a couple different techniques, again, and always, I guess, with … In my clinic, I like to assess the soft tissue and then making sure that there’s no adhesions within the flexor extensor group of the wrists and arm. That would be just some myofascial release. But then using the laser.
Lasers are great as that natural anti-inflammatory. This is irritation compression and it’s angry at you, so we want to reduce the inflammation in this area and in and around the wrist. By doing that with the laser, then we’re going to reduce the symptoms and symptomatology. So it’s correcting biomechanics, laser, a little soft tissue work, and then, obviously, some cold at home. That could be a really great little trifecta to get that system back into working condition.
Mark: Do you ever recommend using aspirin or any kind of anti-inflammatory like that?
Dr. Harold: Yeah. Patients can use that at home at their discretion, or if they want to talk about that with their physicians. For me, we stay out of … With my license, we stay out of sort of that type of arena. I’m just really going to focus in on using that laser to reduce the inflammation. Typically, with these types of injuries, it’s superficial, so there’s not a lot of tissue to penetrate. That’s different than, say, if you’re going to into a glute or a hamstring, which is a very dense and thick tissue. This is superficial, so we get, I think, even better results within the wrist and hand by reducing that inflammation.
Mark: What’s your typical sort of treatment course?
Dr. Harold: The protocol for that would be … I probably would see somebody over two weeks. We’d see them every other day for a treatment. The treatments are pretty quick because there’s not a lot of tissue to go through. So it would probably be a 10-minute sort of follow-up to 20-minute follow-up, depending if it’s one issue or two issues. And then I would also make sure that in my exam we’ll look at the wrist also, if there’s any dysfunction at the elbow as well, because that can be interconnected into it. And if you want to trace the nerve root back to what’s happening in the cervical spine, sometimes I’ll even do some laser work in the cervical spine where the nerve root comes out that’s innervating that entire arm. That would be more of an extreme case.
Mark: Right. Basically, if you’ve got a gravelly feeling and a lot of pain in your wrist, lasers could be a really noninvasive, quick, quicker way of, a non-painful way of creating some healing.
Dr. Harold: Yeah, that’s absolutely correct. That’s well put, something that’s with no side effects. There’s no detriment to it. There’s no breaking of bonds. It’s just stimulation into our body’s natural healing and increasing blood flow to that area for that anti-inflammatory effect. You also get a little pain killing, endorphin and keplin release into that area. But really, just speeding up our body’s natural healing. A lot of times these inflammatory conditions just need that bump up to get ahead so that that system starts working, and then pain levels will drop off.
Mark: I think it’s important in this case, especially, that because this can be a repetitive use thing, that it is an ergonomic … There has to be a change in how you’re doing things in order for there to be a change in the long-term prognosis of how … Are you going to get sore again? Is that right?
Dr. Harold: Yeah, absolutely. If you don’t change the underlying mechanism of injury, then you’ll be back to see me. I mean, I love my patients but I’d like to see them less, if that being said. So if we can solve that problem but then have it reoccur over and over again and then we’re sort of chasing our tail. So we’d want to kind of look at the underlying what your sort of … probably your work station looks like, correct that. Then, with that, that will also help in reducing the amount of irritation that’s happening on a daily basis along with the laser and soft tissue work and ice and cold. All those things will play a part in it, for sure.
Mark: So carpal tunnel, is this kind of related to some of the other tendonitis type of things that people might come to see you about?
Dr. Harold: It’s a little bit different because the carpal tunnel would be more like a nerve irritation that happens through the tunnel. It’s like a neuropathy or a nerve irritation, where like we talked about before where we have tennis elbow or golfer’s elbow, that would be more of a tendinopathy within that muscular system. So similar, both are irritated, but different structures.
Mark: . Have you got sore wrists, the guy to see is Dr. Harold Meinzer at Evolution Wellness. They’re located in Vancouver and North Langley. You can reach to book at 604-881-2404. You have to call and book ahead. He is always busy. Thank you so much, Dr. Harold.
Dr. Harold: Yeah, thanks for having me again, Mark. It was great to talk with you.