Frequently Asked Questions
Rendez-vous
- How do I get an appointment at the TAGMED clinic?
To obtain an appointment at the TAGMED clinic, you can call the center directly, either in Montreal at +1 (877) 672-9060 or in Terrebonne at (450) 704-4447.
You can also visit our website for more information and book your appointment online here .
- How long does it take to get an appointment?
Most appointments at the TAGMED clinic, for a person who is already a patient of our clinic, can be made on the same day or the next day. Patients requesting an emergency appointment can be seen the same day, if they are willing to travel to the Montreal or Terrebonne clinic, depending on where the clinic is open that day. We are in Terrebonne on Monday, Wednesday and Friday and in Montreal on Tuesday and Thursday. Appointments for new patients are usually made within 3 days.
- What happens during your first visit?
The first visit to the TAGMED clinic will be as follows:
- A staff member will greet you and ask you to fill out a health history form, which includes information such as your medical history, allergies or current health problems. You will be asked to sign an informed consent form. The purpose of informed consent is to ensure that the patient fully understands the implications and risks associated with a treatment, so that they can make informed and educated decisions about how they wish to proceed.
- Waiting time in the waiting room is minimal and you will be seen by our health care professional at the time of your appointment, if you are not late, of course.
- In this regard, complete the Health History Form (download here ) before you arrive for your appointment. If you are unable to do so, please arrive 15 minutes prior to your appointment time to allow time to complete it before meeting with our therapist.
- Afterwards, you will meet with one of the qualified practitioners to discuss your condition and answer any questions or concerns you may have.
- Your practitioner may also perform a physical examination and/or suggest a variety of other tests (e.g., x-ray), if deemed necessary.
- If your treatment requires a physician's referral for medical imaging, it will be discussed with the practitioner and the appropriate information will be provided to obtain this request.
- Finally, your practitioner will discuss with you the steps to take regarding your treatment or care plan and can answer any other questions you may have about it so that you can make an informed decision.
- In most cases, we will be able to start the first treatment unless your condition requires further investigation to exclude underlying pathology.
- Calculate that you will be at our clinic for about 1 hour in total.
- At the end of the treatment, you should pay the fee, as you do at each visit.
- We accept cash, debit, Visa or Mastercard.
- We will print or email you a claim form for your insurance.
- You will need to schedule your next appointment with the receptionist, if suggested by your therapist.
- If your condition requires more than one treatment, we will explain how many treatments you will need and how often. Since every patient is different, and we do not know the severity or nature of your condition at the time of reading this, we are not able to provide you with more information in this regard. All of this will be discussed at your first visit. However, you will be able to get a general idea of the course of treatment for your particular condition by consulting our section on conditions and their treatment here
- How long will my first visit take?
The length of your first visit to the TAGMED clinic will depend on your reason for coming. However, in general, it will be between 30 minutes and 60 minutes.
You can help us reduce the time you spend in our clinic by completing the health history form which you can download here
Finally, if you have not been able to fill out our form, as mentioned above, please arrive 15 minutes prior to your appointment time to ensure that you have enough time to complete your form, properly discuss your condition, do the evaluation and your treatment.
- What forms do I need to fill out?
If you are a new patient, you can download the necessary forms before your first visit here .
If you are an existing patient, your therapist may ask you to fill out a re-evaluation form: if you have a new condition or if you are coming for a re-evaluation of your condition after several visits.
- Will I be able to start my treatment at the first visit?
In general, you may be able to start your treatment during your first visit to the TAGMED clinic.
However, this will depend on the reasons you made the appointment and the type and level of care you need. The staff will review each case individually and make a decision on the spot at the end of the initial examination.
If you have already had X-rays, MRI (magnetic resonance imaging), SCAN (computed tomography or CT scan) or ultrasound examinations and have the written reports, please make sure you have them with you on your first visit to our clinic: this will allow us to begin your treatment without delay.
Therefore, you may be able to begin treatment on your first visit to the TAGMED clinic, but this will depend on the nature of your visit and the severity of your condition: a simple back pain with no worrisome neurological symptoms can usually be treated on the first visit, whereas a herniated disc with severe numbness in the legs or arms requires medical imaging studies before starting any treatment, to ensure that there are no contraindications to treatment and that we can safely begin treatment.
. Medical management and examinations will be performed at your appointment and a personalized treatment plan will be developed to meet your specific needs.
Prix
- What are the fees for your treatments?
Fees for treatment at TAGMED vary depending on the type of treatment and services provided. We will provide you with an insurance receipt if needed and our rates are competitive. The best way to know the exact price is to consult our "prices" section. here
In general, the first visit will cost you between $100 and $130Depending on the treatment that will be required for your condition.
- Is there a consultation or examination fee?
Yes and no: TAGMED only charges a consultation fee if the patient does not wish to start treatment on the same day as the first visit and if the consultation took more than 15 minutes. However, if you have a treatment on the day of your first visit, we will not charge you a consultation fee: you will only pay the fee for the treatment you received. See the price list of treatments here. Otherwise, the fee for an initial consultation will be $85.
Similarly, there will be no charge for your initial exam if you have your treatment that same day.
For those of you who are unsure of the difference between a treatment, a consultation and a review, here is a short summary:
A consultation is a discussion between a therapist and a patient during which the therapist asks questions about your health and the condition for which you are seeing him or her, gives advice, and suggests different tests to evaluate you.
On the other hand, a review is a procedure that allows the practitioner to gather more information about the patient's health and may include physical tests (range of motion, orthopedic or neurological tests) or an evaluation based on your x-ray, MRI, SCAN or ultrasound test report.
Finally, a treatment is an intervention plan designed by a therapist to treat or alleviate the symptoms of a health condition (e.g. herniated disc) or injury (e.g. lumbar sprain). Treatment may include manual therapy, traction and/or therapies such as laser or shockwave, as appropriate. See the list of treatments offered at the TAGMED clinic here .
- How much will the first visit cost me?
The first consultation at TAGMED can cost between $75 and $185, depending on the type of treatment provided. Additional fees may apply for complementary therapies. For example, if you are seeing us for treatment of one or more herniated discs in your lower back, you will pay $130 for neuro spinal decompression treatment for one area of your spine. On the other hand, if you would rather have one neurovertebral decompression treatment for a herniated disc (or discs) in your lower back and a second treatment for a herniated disc (or discs) in your neck, it will cost $185, as these are two treatments for two different areas (the neurovertebral decompression table cannot do traction of your back and neck at the same time: it can only do one area (lower back or neck) at a time. See the complete price list by clicking here
Traitements
- What kind of patients come to us?
The TAGMED clinic is a fascinating place. It serves a wide range of patients from around the world, from athletes to people with chronic pain. Its services attract people of all ages, genders and lifestyles who are looking for state-of-the-art health care from experts in the field. Patients come to the clinic for treatments that may not be available in their area, as well as for access to specialists who can provide complex therapies. Everyone is always treated with respect and kindness, while benefiting from the latest technological and medical advances. So, if you need specialized care or want to be seen more by top professionals, TAGMED is the place to go!
- What is specific osteopathy?
Osteopathy is a manual therapy technique that consists of manipulating the body to reduce pain, discover dysfunctions and restore joint mechanics. Two very distinct osteopathic approaches are specific osteopathy and classical osteopathy. Specific osteopathy is a more modern approach that uses evidence-based findings and current technologies, while classical osteopathy returns to the original form and uses deeper manipulation of the body while relying on the osteopath's intuition and experience.
Specific osteopathy is different from classical osteopathy: it is a unique form of manual medicine focused on the precise treatment of musculoskeletal dysfunctions through evidence-based scientific treatments. This technique aims to reduce aches and pains, while providing many patients with increased mobility. Osteopaths also place importance on overall health, taking into account lifestyle and emotional states before choosing an appropriate treatment plan. It is particularly suitable for those who prefer natural alternatives to medical treatment, as osteopathy not only provides relief, but also promotes long-term well-being.
Specific osteopaths are highly skilled practitioners who not only use their hands to evaluate and treat various physical dysfunctions of the body, but also use medical imaging (X-rays, MRI, SCAN or ultrasound) and complementary high-tech therapy. These treatments are very specific to the patient's condition and therefore much more effective and safe.
For example, a herniated disc will not be treated with classical structural osteopathy mobilizations. Although this technique may provide some short-term relief, it will have no medium or long-term benefit. On the other hand, numerous clinical studies have demonstrated the effectiveness of neurovertebral decompression treatment for herniated discs. See some published scientific articles on neurovertebral decompression here
- Should I use ice or heat to relieve my pain?
One of the most persistent difficulties many people face is finding pain relief. Unfortunately, there is no single answer to the question of whether ice or heat is the best solution to relieve your pain. It all depends on the nature and location of the pain. If you have a muscle strain or sprain, applying ice will help reduce inflammation in the area and generally make you more comfortable. For joint problems such as arthritis that cause stiffness, heat will generally be more beneficial in soothing the area and increasing flexibility. If you are not sure which method to use, consult us for more information. See our simplified guide in French here or in English here .
- Do I need to have x-rays to receive care at TAGMED?
At TAGMED, we strive to provide the best care for all of our patients. The safety and health of our patients is our top priority, so in some cases, x-rays may be necessary in order to receive the best care possible. Our team of professionals will determine whether or not x-rays are necessary and will explain the reasons for any x-ray request. Understanding why a particular test or procedure is needed can help ease discomfort and help you make informed decisions about your care.
We all need to be careful about the frequency of our x-rays, as excessive exposure to ionizing radiation can pose a significant health risk. Physicians should only order x-rays for truly necessary examinations, ensuring that these examinations are performed in the safest possible manner, using specialized shielding and techniques. Patients also play an important role in limiting their own exposure by asking tough questions about every x-ray they may need and understanding why it is medically necessary in order to assess their own risks. By taking these steps, we can ensure that exposure to ionizing radiation is kept to an absolute minimum while providing health care professionals with the diagnostic images needed to make informed decisions.
Rest assured that if X-rays are recommended, it is because they are necessary to provide you with the most appropriate care for your health condition!
- How do I prepare for the first visit to the TAGMED clinic?
To be prepared for your first visit to the TAGMED clinic, we recommend that you:
- Prepare a list of questions and find out your current medical history (including medications you are taking).
- Take any relevant information such as the results of examinations or laboratory tests performed by a previous health care professional.
- If you have a ticket to another specialist's referral, please bring it with you.
- If you have developed any new or unusual symptoms between the time your appointment was scheduled and the time you arrive at the clinic, please report them to the health care professional who will evaluate you.
- Download, print and complete our health history form here
- Familiarize yourself with the different treatments offered by our clinic and know what you can expect.
- Also, make sure you are aware of the different risks and possible side effects associated with the treatment offered by the Tagmed clinic.
- You should also take any necessary steps (e.g., apply ice to the inflamed area) to ensure that your body is ready for further treatment.
- Finally, if you were unable to complete our form, as mentioned above, arrive 15 minutes before your appointment time to ensure you have enough time to discuss your condition, make the assessment and your treatment.
- Do your treatments at TAGMED require a doctor's referral?
Most of the treatments offered at the TAGMED clinic can be taken without a medical recommendation or prescriptionfor an initial consultation.
That being said, if your condition requires treatment for a specific condition such as a herniated disc, your general practitioner may recommend an appropriate medical imaging test (X-ray, MRI, SCAN) tailored to your needs.
If you have already had these tests done, please obtain the results and have them available at your first visit to our clinic.
- What health conditions do you treat at the TAGMED clinic?
Our experienced therapists have the expertise to assess and treat a wide range of musculoskeletal conditions, including chronic back pain, neck pain and headaches. Using highly specialized treatments, they can help relieve referred pain away from the areas that were originally injured - improving their patients' overall quality of life.
More specifically, the TAGMED clinic treats a variety of health conditions including:
- Musculoskeletal disorders (joint and muscle pain)
- Sports and/or professional injuries
- Chronic and/or acute pain
- Carpal tunnel syndrome
- Herniated disc
- Heel Spur
And many other conditions. To see the complete list and more details about each condition click here
- Are your treatments covered by my group insurance?
Treatments offered at the TAGMED clinic may be covered by your group insurance. The amount of reimbursement will depend on the terms of your insurance policy and the services that are provided. We recommend that you contact your insurance company for more information and to clarify the amount you will receive in reimbursement.
Be aware that insurance covers for care provided by professionals (e.g. osteopath or naturopath) rather than for a specific treatment, such as robotic traction (neurovertebral decompression).
Furthermore, even though we are a member of several associations, insurers can at any time include or exclude an association in a very random way, without us being informed.
- What treatments are offered at the TAGMED clinic?
TAGMED Clinic offers a variety of treatments, including osteopathy, neurovertebral decompression, laser therapy and shockwave therapy. Each of these treatments is designed to help relieve pain and improve body function. Treatments may include specific manual movements, specialized stretches or pulls, mobilizations and complementary therapies that are designed to address your condition in a very specific way with the goal of achieving quick and lasting relief.
Our forward-thinking approach to health care means we use the most reliable and well-documented technologies, backed by substantial scientific research. Get ready for an unparalleled level of care!
You can get more details about our treatments here
- Do your osteopathic treatments at TAGMED include massage?
No, the osteopathic treatments offered at TAGMED are evidence-based structural osteopathic treatments and do NOT include massage. The osteopathic techniques used may vary depending on your condition and the treatment recommended by the treating staff.
The main difference between massage therapy and osteopathy is that massage therapy is only focused on relaxation and the treatment of muscular tension, while osteopathy offers a more holistic approach to correcting structural dysfunctions and restoring normal body movement. Massage therapy will not be able to directly correct these structural dysfunctions, whereas osteopathy focuses on understanding the underlying cause of the problem and resolving it through various manual techniques.
- How long will my treatment last?
The length of each visit to the TAGMED clinic will depend on your initial treatment plan and the type of treatment used in your case. Care may vary depending on your diagnosis and may take time for more complex procedures. Nevertheless, most appointments are intended to be short and to the point, to ensure that you get the best treatment possible.
In this regard, a shockwave treatment may take 5 minutes for certain conditions while a neuro spinal decompression treatment for a herniated disc requires a combined treatment of 30 minutes in total. As for osteopathic treatments, here is our WARNING Contrary to most osteopathic clinics, we do not believe that a general treatment of a fixed duration (e.g. 60 minutes) is the most efficient way to solve the health problems for which you consult us: specific osteopathy is more precise and efficient than traditional osteopathy because the treatment is more specific and personalized to the exact condition of the patient. Therefore, the treatment in specific osteopathy generally takes from 10 to 30 minutes depending on the condition to be treated and the level of pain and/or inflammation. Generally speaking, the more pain the person is in, the less time the procedure will take since we need to relieve the pain quickly without further irritating the structure where the inflammation is occurring. Obviously, if you are looking for a long term relaxation treatment, you are not in the right place. However, if you are looking for a specific treatment, personalized to your condition, and effective, you have found the clinic that can help you.
- How much treatment will I need?
It is difficult to predict how many treatments will be required at the TAGMED clinic as this will depend on the specific needs of the patient and the treatment plan developed by the treating staff.
In addition, the amount of treatment you need at TAGMED will depend on your condition, its chronicity, severity and the therapist's recommendations. Treatments can range from a simple examination to a series of visits to monitor your progress and adjust the treatment plan accordingly.
For example, a simple recent backache may require only one treatment, while a herniated disc may need several weeks of care.
With over 30 years of experience in this field and our evidence-based clinical judgment and your imaging exams, we will be able to answer this question accurately after meeting with you.
We cannot answer such a question over the phone: this would be a demonstration of a blatant lack of competence and judgment...
"Good osteopaths do everything in their power to help their patients feel better as quickly as possible with as little treatment as necessary, ultimately reducing care to a follow-up plan as needed. They also give advice on how to avoid future problems by evaluating lifestyle activities, ergonomics, posture and orthotics."
- Are all patients treated the same way?
No, not all patients are treated the same at TAGMED. Therapists and staff take into account each patient and their unique condition to develop a personalized treatment plan that works best for each individual patient.
In short, no two treatments are the same because you are unique!
References
The best non-surgical treatment for carpal tunnel syndrome: laser therapy!
Introduction to carpal tunnel syndrome
Introduction Carpal tunnel syndrome (CTS) is a common condition that affects the hand and wrist. It occurs when the median nerve, which runs from the forearm to the hand, is compressed as it passes through the narrow carpal tunnel in the wrist. This compression can cause a range of symptoms, including pain, numbness and tingling sensations in the hand and wrist.
STC is more common in women than in men, with a higher prevalence in women between the ages of 45 and 60. It can be caused by a variety of factors, including repetitive motions, anatomical factors, medical conditions, and hormonal changes.
Treatment for CTS depends on the severity of a person's symptoms and the underlying cause of the condition. In mild cases, conservative treatments may be effective, while more severe cases may require surgery. Laser treatment is a relatively new option that may offer an effective alternative to traditional surgery.
In this text, we will explore the symptoms, causes, diagnosis, and treatment options for carpal tunnel syndrome, with an emphasis on laser treatment.
Carpal tunnel syndrome is a common condition that affects the hand and wrist. It is caused by compression of the median nerve as it passes through the narrow carpal tunnel in the wrist. Laser treatment can be an effective option for relieving the symptoms of carpal tunnel syndrome. In more severe cases, surgery may be required.
Symptoms of Carpal Tunnel Syndrome
Symptoms Symptoms of carpal tunnel syndrome can vary in severity and may include:
- Pain or discomfort in the wrist or hand
- Numbness or tingling sensations in the hand or fingers, especially the thumb, index and middle fingers
- Weakness in the hand or difficulty grasping objects
- Burning sensations or pain in the wrist or hand
Symptoms of carpal tunnel syndrome usually develop gradually and may be more pronounced at night or during activities involving repetitive wrist movements.
Symptoms can also affect other parts of the arm, including the forearm, elbow, and shoulder, and can be confused with other conditions, such as peripheral neuropathy or arthritis.
Causes of carpal tunnel
Causes The exact cause of carpal tunnel syndrome is not fully understood, but there are several factors that can increase the risk of developing this condition. These factors include:
- Repetitive movements: Repetitive movements: Activities involving repetitive movements of the wrist, such as typing on a keyboard or playing a musical instrument, can put stress on the median nerve and contribute to the development of carpal tunnel syndrome.
- Anatomical factors: Some people may be born with a narrower carpal tunnel, which may increase their risk of developing carpal tunnel syndrome.
- Medical conditions: Certain medical conditions, such as diabetes, rheumatoid arthritis, and thyroid disorders, can increase the risk of developing carpal tunnel syndrome.
- Hormonal changes: Changes in hormonal levels, such as those that occur during pregnancy or menopause, can contribute to the development of carpal tunnel syndrome.
Diagnosis of carpal tunnel
Diagnosis To diagnose carpal tunnel syndrome, a doctor will first perform a physical exam and ask for information about a person's symptoms and medical history. He may also order imaging tests, such as an X-ray or MRI, to rule out other conditions that may be causing similar symptoms.
A nerve conduction study may also be done to measure the speed of electrical impulses as they pass through the median nerve. This test can help determine the severity of nerve compression and guide treatment decisions.
Carpal tunnel treatment
Treatment Treatment for carpal tunnel syndrome depends on the severity of a person's symptoms and the underlying cause of the condition. Treatment options include:
- Hand rest: If symptoms are mild, resting the hand and reducing repetitive motions may be enough to relieve symptoms.
- Wrist brace: A wrist splint can help keep the wrist in a neutral position, reducing pressure on the median nerve.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs can help reduce the inflammation and pain associated with STC.
- Injection of corticosteroids: Injections of corticosteroids into the carpal tunnel can help reduce inflammation and relieve symptoms.
- Surgery : Surgery: In more severe cases, surgery may be needed to relieve pressure on the median nerve. This may involve cutting the ligament that forms the roof of the carpal tunnel to increase the space available for the median nerve. The surgery is usually performed on an outpatient basis, and most people can return to their normal activities within a few weeks.
- Laser treatment: Laser Treatment: Laser treatment is a relatively new option that may offer an effective alternative to traditional surgery. Laser treatment uses concentrated light energy to stimulate healing of damaged tissue, reduce inflammation and relieve pain. During the treatment, a small laser probe is placed on the wrist and emits pulses of light that penetrate the tissues to stimulate healing. Laser treatment for CTS may be a particularly attractive option for people who wish to avoid surgery or who are not ideal candidates for surgery due to their medical condition.
Laser treatment for STC has shown promising results in several studies. A 2016 study compared the effectiveness of laser treatment to that of surgery and corticosteroid injections in patients with CTS. The results showed that the laser treatment was as effective as surgery and corticosteroid injections in relieving the symptoms of CTS.
Another 2018 study compared the effectiveness of laser treatment versus wrist splints in patients with TCS. The results showed that the laser treatment was more effective than the wrist splint in reducing pain and improving hand function.
Comparative table of the different treatments and their effectiveness:
laser treatment | High |
---|---|
Hand rest | Weak |
Wrist splint | Moderate |
NSAIDs | Weak |
Surgery | High |
IF YOU VISIT OUR WEBSITE...
It's because you have carpal tunnel syndrome!
1. WHAT ARE YOUR CARPAL TUNNEL TREATMENT OPTIONS?
* In order to avoid ineffective treatment, it is important to ensure that the diagnosis of signs and symptoms of median nerve damage is accurate and that the site and mechanism of median nerve compression have been identified. The chiropractor has all the knowledge necessary to make a proper diagnosis and to direct the patient to the most appropriate interventions.
1.1 Possible risks associated with surgery
Anesthesia: In Canada, the chance of a healthy person dying from a complication of anesthesia is 1:100,000. Reference 1
Nosocomial infections (e.g. C. difficile): In Quebec, they cause about 90,000 victims and 4,000 deaths each year. Reference 2
Medical errors: On average, 112 Quebec patients die each month as a result of medical errors. Reference 3
Waiting list: It can take a year and a half to two years from the time you first see a doctor to get a prescription to see an orthopedic surgeon and the date of your surgery. Your condition has time to deteriorate significantly and your suffering to be prolonged unnecessarily. Reference 4
1.2 Risks of soft laser treatment
Non-invasive treatment: very safe and risk-free.
This site was designed for anyone who suffers from hand pain, numbness, finger pain, burning sensation in the hands, wrist pain, tingling, arm pain, neck pain, as well as for some patients with carpal tunnel stenosis and finally for those who have undergone wrist surgery but still suffer from pain.
The purpose of this site is to fully inform the thousands of Quebecers who suffer from debilitating pain on a daily basis. Patients, like you, can now be informed about these conditions and the technological breakthroughs of the soft laser.
If you or a family member is struggling with one of these debilitating conditions and have had little or no success with your treatments to date, ask yourself the following questions:
- Are you currently dependent on medications that you must take on a daily basis?
- Are you limited in your daily activities?
- Have you had repeated injections with little or no relief?
- Are you considering surgery and are you uncomfortable with the choice?
- Have all the options been explained to you?
- Have you ever tried chiropractic or physiotherapy?
- Have you been forced to miss work because of pain?
If you answered yes to any of these questions, have tried every treatment option available and are still suffering...Laser is a viable treatment option and may very well be what you have been looking for. You may have found the treatment that will solve your problem.
The soft laser was designed by a dedicated team of engineers to meet the needs of today's patients, providing doctors with the clinical results they desire and patients with the quality of life they deserve.
Are you ready to get started and get rid of that pain, for good? Becoming a new patient at our clinic is simple.
2. DEFINITION OF CARPAL TUNNEL SYNDROME OR CARPAL TUNNEL
Carpal tunnel syndrome is caused by compression of the median nerve at the wrist as it passes through the carpal tunnel.
Carpal tunnel syndrome is a very common condition. Its incidence is about three times higher in women than in men. In about 70% of cases, it is bilateral with a prevalence in the dominant hand.
3. SIGNS AND SYMPTOMS OF CARPAL TUNNEL
Definition: Carpal tunnel syndrome is related to the compression of the median nerve of the wrist. This nerve is responsible for the sensitivity of the thumb and the 2 or 3 neighboring fingers. It is also the motor nerve that controls the muscles at the base of the thumb.
The carpal tunnel, formed by the transverse carpal ligament and the carpal bones. The "carpal tunnel" is in fact a tunnel formed behind by the 8 small bones of the wrist, which have the shape of a gutter; this gutter is closed in front by a very thick ligament, the "anterior annular carpal ligament".
Symptoms: Initially, it is characterized by tingling in the fingers, followed by night-time pain in the hands. Later on, a burning pain and paresthesias on the ventral surface of the hand and fingers with pain radiating to the forearm, appear gradually. In addition, a decrease in the sensation of distribution of the median nerve and atrophy of the muscles at the base of the thumb may occur.
Symptoms may range from minor to severe dysfunction. Moderate cases resolve with avoidance of factors. Once a pregnant woman gives birth, for example, the wrist swelling disappears and the symptoms of carpal tunnel syndrome diminish.
Often, the main complaint centers around episodes of paresthesias and numbness of the hand in the evening. Symptoms may appear during activities: driving or typing on a keyboard. The onset is insidious: patients describe tingling at the fingertips. Symptoms are often relieved by shaking or raising your hand. In 70% of cases we find nocturnal numbness of the hand; and in 40% cases, pain with paresthesias.
To the pain and paresthesia is added a sensation subjective disability of the fingers, clumsiness during activities requiring precision such as buttoning a blouse, writing, sewing, unscrewing a cork, turning the keys or picking up small objects. Even light objects such as a coffee cup or clothing can be difficult to handle. Some patients may feel as if their hands are "swollen".
In severe cases, hand and wrist pain is described as burning, stabbing pains that may spread to the shoulder, neck, chest. Sensory loss radiates along the median nerve distribution accompanied by muscle weakness, slow nerve conduction through the carpal tunnel is characteristic.
Symptoms gradually intensify and severe cases may progress to muscle atrophy with sensory loss. The symptoms can make the patient disabled and prohibit certain simple tasks making daily life difficult. A disease long ignored can cause irrevocable damage.
It is a condition that predominates in women over fifty. The pain is typically located on the volar side of the first three fingers of the hand, but can affect the whole hand and even radiate to the front side of the forearm.
More than real pain, it is more often a question of tingling, of extremely annoying tingling. The nocturnal recrudescence of these pains is usual, waking up the patient at night, often at the same time. Certain gestures calm the pain, by shaking the hand or by letting it hang outside the bed.
Vasomotor disorders are frequent, with hypersudation or edema of the hand. Initially nocturnal, these painful phenomena persist during the day, thus handicapping the patient in everyday household activities. Bilateral forms are frequent, with a clear predominance of one side.
The examination may be normal, thus limiting the symptomatology to subjective phenomena; this is stage I. It can show the existence of sensory disorders objectives in the territory of the median, and particularly at the level of the pulp of the first three fingers; this is stage II. It can reveal the presence of motor disorders at the level of the opponent of the thumb, with readily amyotrophy of the thenar eminence; this is stage III.
4. CARPAL TUNNEL DIAGNOSIS
4.1 How is it diagnosed?
Often, people who suffer from carpal tunnel syndrome seek medical attention. Part of the assessment for carpal tunnel syndrome includes a search for occupational risk factors. The assessment begins with a job analysis and requires a detailed description of all activities in a typical work day. The frequency, intensity, duration and regularity of each operation performed during the work are also taken into account. The diagnosis of carpal tunnel syndrome is confirmed by tests designed to identify damage to the median nerve. median nerve.
4.2 Questionnaires
Which hand is most involved in work activities?
Is an accidental event the cause of the pain?
Questions about previous work activities: Work performed, duration in months, and factors involving the hand or upper limb?
Questions about hand/wrist activities: Frequency of movement and force required to flex, extend, or rotate wrists, apply pressure with fingers or palm, handle small objects, handle, pull, or push heavy objects, use vibrating or impact tools, other activities to be specified?
Questions about co-factors that increase musculoskeletal loading: Wearing work gloves, exposure to cold, and upper extremity abducted or flexed more than 60 degrees?
Questions about the organizational factors of the job: In the course of their work, does the person have to feed a machine tool at a regular rate; does the person work under time or production constraints; does the person have to pay a lot of attention; does the person perceive their work as monotonous; can they change their work pace; do they rotate to other jobs; are there other organizational factors that may have contributed to the problem? If so, what are they?
Questions about sports or domestic activities involving the hand or the wrist: Type of activities, number of hours per week and others?
4.3 Physical examination
Carpal tunnel syndrome should be diagnosed and treated promptly as it can be potentially irreversible if the median nerve is compressed too long. A physical examination of the hands, arms, shoulders and neck can help determine if your symptoms are related to your daily activities or an underlying disorder.
It is important before proceeding with the physical examination to take a good medical history and to document the various professional, sports, recreational or domestic activities that could have contributed to the appearance of this syndrome.
The symptoms are mainly sensory (paresthesias) affecting the first three fingers of the hand, but can also have a motor component. They are due to the compression of the median nerve at the level of the carpal tunnel. Painful radiation affecting the other fingers of the hand or the forearm can also accompany these symptoms. The patient may express the following symptoms:
- Paresthesias nocturnal in the hand (numbness and tingling that usually disappears when the hand is shaken - Flick sign)
- Paresthesias occurring during activities involving the wrist and hand
- Discomfort in the hand, wrist and forearm
- Muscle weakness and clumsiness of the hand
The physical examination must include in addition to the wrist and the hand, the entire upper limb and the cervical region. The examination must include: observation and palpation, provocation tests, evaluation of tenderness and muscle strength. It may be supplemented by electrodiagnostic studies.
4.4 Observation and palpation
Upper extremity: observe if there are deformities, signs of old fractures, tumors, osteoarthritis; examine the antalgic regions; compare the two members
4.5 Orthopedic and neurological tests
Your osteopath may also do other specific orthopedic tests to try to replicate the symptoms of carpal tunnel syndrome. One of these tests is called the sign of Tinel and involves tapping your finger lightly on the back of your wrist to see if there is tingling or pain in your hand. The test of Phalen is also useful. It involves bringing your wrist into maximum flexion and holding it there for some time. This maneuver can produce tingling or numbness in the fingers.
4.5.1 Challenge tests
There are two carpal tunnel provocation tests:
- The intracarpal pressure increase test (the Phalen. Sign of Phalen - The patient places his hands back to back and bends his wrists for one minute. A tingling sensation in the fingers suggests an injury to the median nerve.
- The percussion test of the median nerve (test of Tinel). Sign of Tinel - The doctor lightly hits the median nerve in the wrist. A tingling sensation in one or more fingers suggests an injury to the median nerve.
5.5.2 Sensitivity tests
There are two categories of tests to assess sensitivity:
Innervation density tests like;
- The discrimination test between two static points
- The needle prick test
And sensory threshold perception tests such as;
- The Semmes-Weinstein monofilament test
- Tests that evaluate the vibratory threshold.
4.5.3 Assessment of muscle strength
The following structures should be tested for strength:
- The hand as a whole
- The bidigitale (thumb-index) clamp
- The abductor brevis of the thumb
- The opponent of the thumb.
4.6 Radiology
Laboratory tests and X-rays may reveal the presence of diabetes, arthritis, fractures, and other causes that could cause pain in the wrists and hands.
X-rays usually show nothing abnormal unless there is an obvious change in bone structure due to old fractures or arthritic lesions. Blood tests are also normal, except in the presence of conditions that may be contributing to the problem, such as rheumatoid arthritis.
X-rays of the wrists and hands are not always necessary. It allows to detect a narrowing of the canal of post-traumatic osseous origin. However, X-rays of the cervical spine are sometimes requested to rule out a compression upstream or associated with the wrist compression.
4.7 Electrodiagnosis
This test is usually carried out in a specialized department. Sometimes electrodiagnostic tests, such as nerve conduction velocity, are used to help confirm the diagnosis. We place electrodes on the forearm and pass an electric current: we can thus establish at what speed and to what extent the median nerve transmits nerve messages to the muscles, which can determine if the nerve has been damaged. Carpal tunnel syndrome will slow down the speed of these nerve impulses and point your doctor or chiropractor to this diagnosis. Therefore, nerve conduction tests or an electromyography (EMG) will help determine if the nerves and muscles in your arm and hand show the typical signs of carpal tunnel syndrome.
Electrodiagnostic studies are an essential adjunct to the examination. It confirms the presence of the syndrome and estimates the severity of sensory and motor damage.
4.8 Magnetic resonance imaging (MRI)
In the more complex forms, magnetic resonance imaging can be used in the event, in particular, of failure of a surgical intervention or atypical forms (forms on exertion or extrinsic compression). Magnetic resonance imaging (MRI) of the wrist finds indications in recurrences: It allows to appreciate the aspect of the anterior annular ligament and the content of the carpal tunnel.
4.9 Ultrasonography/ultrasound
Ultrasound can confirm tendon inflammation with a thickened tendon and a fluid layer encompassing the tendons.
4.10 Conclusion
The biological workup shows nothing special. A systematic search for diabetes, a frequent favouring factor, is necessary.
5. DIFFERENTIAL DIAGNOSIS OF CARPAL TUNNEL
When faced with sensory disorders of the hand that may resemble carpal tunnel syndrome, it is important to make a differential diagnosis.
5.1 Central nervous system disorders
- Transient cerebral ischemia
- Sclerosis in plate
5.2 Peripheral nervous system disorders
- Cervical radiculopathy (C6, C7)
- Syndrome of the thoracic outlet
- Syndrome of Raynaud
- Compression of the median nerve for example by the muscle pronator round in the forearm
- Systemic diseases such as diabetes and alcoholism
- Taking medication
- Exposure to toxic substances such as lead, solvents, pesticides and plastics
Carpal tunnel syndrome is often difficult to diagnose. 25% patients with nerve disorders pose a problem of differential diagnosis (false positives) with other diseases such as Raynaud's phenomenon as well. Raynaud also.
It is difficult to determine whether the primary cause is due to an occupational or medical problem, as many conditions, including obesity and other diseases, can contribute.
A positive diagnosis is suggested by occupational history, confirmed by presentation of appropriate symptoms, physical examinations (the Phalensign of Tinel) and confirmed by electromyogram or by the defects of the conduction of the median nerveThe X-ray of the cervical spine should also be taken.
The most common ones are C6-C7 nerve root damage, the thoracobrachial crossing and the peripheral neuropathies; syndrome pronator round (The compression of the median nerve elbow) or interosseous nerve previous.
6. CAUSES OF CARPAL TUNNEL
Carpal tunnel syndrome is related either to a retraction of the anterior ligament (container), or more often to an increase in volume of the flexor tendons (synovitis or inflammation of the content).
This results in a compression and a progressive loss of the conduction of the median nerve. In the final stage, the chronic compression of the nerve can eventually laminate it and destroy it completely, irreversibly.
There are multiple factors that favor the appearance of carpal tunnel syndrome: repeated trauma to the palmar surface of the wrist, bone anomalies protruding into the canal, hormonal changes in women, kidney dialysis, obesity (especially in young patients), etc. There also seems to be a genetic predisposition.
This syndrome is most often found in women.
In women, the cause is usually hormonal, which is why this syndrome is more common in pregnant women and women nearing menopause.
In humans, the cause is almost exclusively mechanical, typically, the worker frequently using a jackhammer or other vibrating tools.
The forms of carpal tunnel syndrome of occupational origin are numerous in Quebec. Injuries attributable to repetitive work or poor workstation design, such as carpal tunnel syndrome, have been recognized by the CSST, the courts and the Canadian Centre for Occupational Health and Safety.
It is more and more frequently observed in people working on a non-ergonomic computer workstation (keyboard, mouse, poorly adapted seat position...). In this case, it is sufficient to review the configuration of the workstation to remedy it.
Other causes are more rare: tenosynovitiscompression by the flexor muscles during rheumatoid arthritis, infectious causes, algodystrophies, amyloid deposits (during hemodialysis).
The syndrome is more common in diabetes, hypothyroidism, myelomaof sarcoidosis...
A significant number of carpal tunnel syndromes have no identified cause (idiopathic).
Some people have a narrower carpal tunnel than others, which makes compression of the median nerve more likely. In other cases, carpal tunnel syndrome can develop due to an injury to the wrist which causes inflammation of the tunnel and compression of the blood vessels that supply the wrist. median nerve, overactivity of the pituitary gland, hypothyroidism, diabetes, inflammatory arthritis, mechanical problems in the wrist, poor work ergonomics, repeated use of vibrating hand tools, and fluid retention during pregnancy or menopause.
In addition, this syndrome may be associated with repetitive occupational trauma (CUMULATIVE TRAUMATIC DISORDERS); wrist trauma; AMYLOID NEUROPATHY; RHUMATOID ARTHRITIS; ACCROMEGALIA; other diseases.
7. CARPAL TUNNEL REGRESSION
When the carpal tunnel syndrome is related to a general pathology (e.g. diabetes), the treatment of this pathology is imperative in first intention and the regression of the symptoms will be of medium to long term.
Similarly, the syndrome occurring during pregnancy usually regresses after delivery without any intervention.
In other cases :
In stage I, where the symptoms are purely sensitive and subjective, it is possible to simply immobilize the hand and wrist with an orthosis, at least at night, with a prescription for painkillers and/or anti-inflammatories, but their action is most often very transient and in many cases, will require more permanent means of treatment, such as soft laser therapy or surgery in some cases.
If, however, you have recourse to local infiltrations of corticosteroids (cortisone, prednisone), be aware that in many cases, the symptom relief effect will only be temporary, temporarily reducing the inflammation of the nerve which is tight in the canal, that injections more than three times a year are not recommended (Reference 4) and that there are inherent risks with these injections, including the possibility of developing type II diabetes, even after single injection (Reference 123).
In stages II and III, with sensory and motor disorders objectivesthe indication of a soft laser therapy is strongly recommended and the indication for surgery may be mandatory if no other treatment has succeeded in resolving the problem.
The results of surgery are generally excellent, provided that the nerve has not been damaged by prolonged compression and that the differential diagnosis has been done rigorously; eliminating other probable causes, notably cervical radiculopathy (C6, C7) which can mimic the symptoms of carpal tunnel syndrome. However, surgery has many disadvantages including loss of work due to recovery, possible permanent scarring and the risks inherent in any surgery including infections (Reference 5) and side effects of anesthetics (Reference 6), to name a few.
Before considering surgery, it would be beneficial to attempt to resolve this debilitating condition with the help of soft laser therapy. It has no side effects and succeeds, in many cases (84% efficacy) (Reference 7), in completely relieving the symptoms of carpal tunnel within more or less six weeks, without having to be absent. work and suffer the loss of income that accompanies it.
8. THE SOLUTION TO CARPAL TUNNEL: LASER THERAPY
8.1 The definition
Synonyms of the soft laser: cold laser, low level laser, low level laser therapy, LLLT, photo bio-stimulation, light therapy, phototherapy, soft laser therapy.
The word "laser" is the abbreviation of "light amplification by stimulated emission of radiation".
The soft laser or soft laser is neither harmful nor dangerous and it can never be.
The light rays penetrate the tissues at a shallow depth (5 centimeters) without damaging them, nor cutting them, nor even heating them. They energize the tissues they pass through.
The soft laser therefore has an anti-pain, anti-inflammatory, antispasmodic, healing and anti-oedematous action.
8.2 Technology
This technology is called soft laser. Unlike lasers used in surgery or aesthetics, the soft laser emits no heat and is completely safe since it cannot damage the tissues of the treated area. On the contrary, the beams of concentrated light emitted by the device penetrate 5 centimeters under the skin and allow cell regeneration, a reduction in inflammation and pain relief.
In the late 1960s, researchers introduced the concept of low-intensity laser biostimulation (soft laser) to produce non-thermal effects in human tissue.
The first experimental application of low-intensity (soft) lasers was described in 1968, when researchers used a ruby-argon laser on ulcers that would not heal.
Later research demonstrated the effectiveness of the treatment in laser to accelerate wound healing, reduce pain, reduce tissue inflammation in both humans and animals.
To treat chronic pain with the biostimulation effect of soft laser, the laser beam must reach a certain depth in the tissues in order to irradiate the affected area.
Laser wavelengths that are between 820 nanometers to 840 nanometers have a very low absorption rate in human tissue, allowing deeper penetration of laser light.
The 830 nm laser beam is also well absorbed by the subcellular organelles, causing them to function normally.
The output power of the low-intensity laser also affects the depth of beam penetration, and has been shown to be effective in treating human tissue.
Clinical research has shown that soft laser with a wavelength of 830 nm and an output power between 60 milliwatts (mW) and 90 mW is optimal for the treatment of chronic pain.
After examining damaged cells in detail, researchers realized that dysfunction in the nervous system, lymphatic system, or circulatory system contributed to cell dysfunction. The soft laser is effective largely because it emphasizes the interdependence between the nervous, circulatory and lymphatic system.
Although it is possible for damaged cells to heal themselves without the aid of the soft laser, the use of the low intensity laser can accelerate the tissue healing process. A good example of how the soft laser accelerates the healing process can be demonstrated in cases of acute soft tissue trauma. Such an injury involves several elements of the tissue layers beneath the epidermis, including muscle, nerve, lymphatic and vascular tissues. The body's natural response to soft tissue trauma is to contain the injury with local inflammation: Inflammation is due to increased blood flow into the capillaries. Classically, inflammation is manifested by four main signs: redness, heat, swelling and pain. The inflammatory mechanism involves a large number of substances present in the blood, among others many hormones, such as prostaglandins, histamine, supplements, cytokines participate in the inflammation. This excessive swelling prevents proper circulation in the damaged tissues and results in two types of pain: The first type of pain is caused by the actual trauma of the injured tissues, while the secondary pain comes from the swelling itself.
The soft laser therapy targets the lymphatic system first, as it maintains fluid balance in the body and the infrared laser light also works to improve reabsorption of edema. Thanks to the soft laser, swelling is reduced and the mobility of the treated area is restored.
8.3 Special Report
- The soft laser beam does not overheat the tissue and therefore cannot damage it, making the treatment very safe.
- The soft laser is more effective than electrical stimulation (Stim) or ultrasound.
- It is easy to use.
- It has been used in Europe and Asia for over 35 years.
- It is approved the FDA in the United States for several applications including pain and inflammation relief as well as for its effectiveness in the treatment of carpal tunnel syndrome, and this for only 5 years.
- It is successful in relieving conditions that do not respond to other treatment modalities.
- It helps patients without the use of drugs or surgery, eliminating the risk of side effects.
- The soft laser treatment is imperceptible and therefore painless for the patient and takes only 5 to 15 minutes, depending on the case.
- It is effective for the treatment of muscle spasms or pain, arthritis or other joint pain.
- It also reduces muscle tension and improves blood and lymphatic circulation.
- It is used for the treatment of many conditions including: neck pain, back pain, shoulder pain, elbow pain (tennis elbow or epicondylitis), wrist pain (carpal tunnel syndrome), hip pain, knee pain and foot pain.
8.4 Benefits of the soft laser therapy
- Relieves acute and chronic pain
- Increased speed, quality and tensile strength of tissue repair
- Increased blood supply
- Stimulates the immune system
- Stimulates nerve function
- Develops collagen and muscle tissue
- Allows the development of new healthy cells
- Promotes healing
- Reduces inflammation
8.5 Physiological effects of soft laser :
- Accelerated tissue and bone repair
- Increased collagen production
- Increased vasodilation
- Increases cell metabolism
- Increased microcirculation
- Increased pain threshold
- Reduction of inflammation
- Increased lymphatic response
- Increased enzymatic response
- Reduction of swelling
8.6 Our laser in brief :
- Approved by the FDA for the treatment of carpal tunnel syndrome
- Patented technology
- Reimbursed by group insurance
- Non-invasive
- Reduces inflammation
- Stimulates the functioning of the nervous system
- Backed by over 25 years of clinical research
8.7 Dedicated professionals
Our members are dedicated to helping patients who suffer from severe pain caused by carpal tunnel syndrome.
8.8 Now there is hope!
Professionals have come together to provide a medical breakthrough: non-surgical, drug-free soft laser care for patients suffering from severe pain caused by carpal tunnel syndrome.
The objective of our professionals also includes the improvement of physical capacity, functional performance and the return of their patients to their activities of daily living.
8.9 Treatment
8.9.1 What is the duration of the treatment?
The duration of the soft laser treatment depends on the severity and history of the injury or disease. The treatment is given in small amounts over time. Improvements are usually noted within a short period of time. In addition, the soft laser therapy does not require preventive or maintenance care once the problem is resolved, as is often the case with other types of care. The standard treatment protocol for carpal tunnel syndrome is two (2) visits per week for six (6) weeks.
8.9.2 How is the treatment performed?
After the initial consultation, the soft laser treatments are performed in the professional's office on the treatment table. The laser is applied to the target areas. The treatment requires light skin contact (in most cases). Although some patients often experience an almost imperceptible tingling sensation, no pain is involved. The treatment lasts from 5 to 15 minutes for each area.
8.10 Fees
The recommended treatment protocol is 12 treatments. However, many patients will achieve satisfactory results more quickly. Therefore, there is no no obligation to complete the full protocol.
8.10.1 Health Insurance
The Quebec Health Insurance plan does not pay for therapeutic laser care.
8.10.2 Group Insurance
Part of your fees are covered by your group insurance: each case is different.
8.11 Doctor's prescription
Laser treatment does not require a prescription from your doctor.
8.12 No two carpal tunnel syndromes are alike!
The treatment of carpal tunnel syndrome is very complex due to the individualized nature of each patient's pain and/or symptoms. A treatment option that relieves pain for one patient may not work for another. However, by working with one or more types of spine and musculoskeletal specialists, patients can find the best combination of treatment options that will relieve their pain. This way, they will avoid surgery.
8.13 Our carpal tunnel laser treatment is :
- Non-invasive
- Non-surgical
- Curator
- Sweet
- Safe
- Supervised by a health professional, holder of a doctorate
- Laser treatment approved by the FDA
- Effective for a variety of inflammatory conditions
9. How to become a patient?
9.1 Your exam results
First, you must make sure you have the results of your examinations and your diagnosis, if you have already consulted a doctor or another specialist for your condition.
9.2 Your first visit
During your first visit, we will first file the results of your examinations in your file and study them in more detail before beginning your treatment.
We will also assess your condition and possibly complete your examination by suggesting an X-ray of your cervical spine, to confirm the diagnosis in suspected cases and to exclude other pathologies such as neuropathies, radiculopathies and other deficiency syndromes.
Finally, we will explain in detail the treatment protocol for laser therapy.
9.3 Laser treatments
We will begin your treatment at the first visit. The recommended treatment protocol for carpal tunnel syndrome is an average of twelve (12) laser treatments, with two (2) visits per week, depending on the severity of the patient's condition.
In summary
Carpal tunnel syndrome is a common condition that affects the hand and wrist. It is caused by compression of the median nerve as it passes through the narrow carpal tunnel in the wrist, which can cause pain, numbness and tingling in the hand and wrist. Laser treatment can be an effective option for relieving the symptoms of carpal tunnel syndrome. In more severe cases, surgery may be required. It is important to see a healthcare professional if you have symptoms of carpal tunnel syndrome to receive an accurate diagnosis and appropriate treatment.
Carpal Tunnel Synonyms: CTS (Carpal tunnel syndrome), CTS (Carpal tunnel syndrome), carpal tunnel, CC syndrome, TC syndrome, carpal tunnel syndrome, median nerve compression neuropathy in carpal tunnel, carpal tunnel syndrome.
Synonyms of the soft laser: cold laser, low level laser, low level laser therapy, LLLT, photo bio-stimulation, light therapy, phototherapy, soft laser therapy.
Preparations for laser treatment
- Book your appointment online or contact our staff at the TAGMED clinic to book your appointment by phone.
- Before going to the TAGMED clinic in Montreal or Terrebonne for your first treatment, there are some things you should absolutely do. First, make sure you have your medical imaging reports (X-ray, MRI, or ultrasound) available.
- Also, make sure you are aware of the various possible risks and side effects associated with treatment at Tagmed Clinic. You should also take all necessary measures (ex. Apply ice to the inflamed area to ensure that your body is ready for further treatment.
- Also, make sure you are aware of the various possible risks and side effects associated with treatment at Tagmed Clinic. You should also take all necessary measures (ex. Apply ice to the inflamed area to ensure that your body is ready for further treatment.
- Finally, if you were unable to complete our form, as mentioned above, arrive 15 minutes before your appointment time to ensure you have enough time to discuss your condition, make the assessment and your treatment.
To be completed before your consultation at TAGMED clinic
TAGMED Clinic
Terrebonne:
1150 Lévis Street, suite 200, Terrebonne, QC, J6W 5S6
(450) 704-4447
TAGMED Clinic
Montreal
1140 Beaumont Avenue, Mount Royal, QC, H3P 3E5
1-877-672-9060