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Pursuit Physiotherapy- Managing and Preventing Carpal Tunnel Syndrome

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Carpal tunnel syndrome is one of the most commonly diagnosed repetitive strain injuries. It occurs when the median nerve, which is the main nerve that travels down the inside of your forearm to your hand, becomes compressed or irritated as it passes through the carpal tunnel at the wrist. The carpal tunnel is an opening formed by ligaments and bones on the inside of the wrist which allow tendons and nerves to pass through it.

The problem is that this passageway is narrow and can be easily obstructed by local swelling and inflammation, usually from overuse or direct trauma. For example, repetitive work or leisure activities that involve a lot of gripping or use of the flexors (inner forearm muscles) can cause inflammation of the tendons. Similarly, long hours of computer work with improper ergonomics can cause excessive pressure on the inside of the wrist.

The common symptoms of carpal tunnel syndrome are numbness, tingling, or burning sensations in the palm of the hand and fingers, often accompanied by skin sensitivity and grip weakness. As the symptoms worsen people often experience sharp, shooting pain from the inner wrist up the forearm and decreased ability to use the affected hand.

Our treatment strategy is geared towards reducing the pressure on the carpal tunnel area and allowing the median nerve to function properly again. We are able to use a number of different treatment strategies such as:

  • Joint mobilization – stiff joints around the carpal tunnel can cause narrowing of the passageway and compression of the median nerve and flexor tendons. Using manual techniques we will loosen stiff joints and work to restore normal mobility and range of motion in the wrist and hand bones, taking pressure off the nervous tissue.

  • Soft tissue release – it is important to release tight muscles in the forearm and hand that may be compressing the median nerve and contributing to nerve pain and tightness. We can use a number of techniques to achieve this such as massage, cupping, acupuncture, and IMS.

  • Ergonomic correction – we will work with you to determine how to optimize your ergonomic set-up for work or home to minimize strain on your body. A brace may also be recommended to manage symptoms at work or at night. A brace will keep your wrist in a neutral position and prevent the wrist from flexing and compressing the carpal tunnel.

There are also a number of prevention strategies that you can use to reduce your risk of developing carpal tunnel syndrome:

  • Optimize your ergonomic set-up – position your keyboard and mouse so that your wrists are neutral and not hyperextended or flexed. Also be aware of your posture and try to keep your neck, shoulders, and back in a straight and relaxed position. Ergonomic equipment may also be useful especially for people who spend long hours at the computer. For more detail see the full blog on correct ergonomics.

  • Take regular breaks from repetitive activities – prevent tension and strain from building up in your tissues by planning regular breaks for stretching and changing position.

    Seek help from a physiotherapist at the first signs of pain; don’t wait for it to get worse.

Carpal tunnel release surgery is also an option for chronic cases that do not completely resolve with physiotherapy; however it should be seen as a last resort. A course of physiotherapy treatment is always recommended before having an invasive procedure.

**It should be noted that NOT ALL WRIST AND HAND TINGLING IS DIAGNOSED AS CARPAL TUNNEL SYNDROME. Your nervous system is a continuous network of tissue, therefore nerve compression or irritation in other areas of the body such as the neck, back, shoulder, or elbow can contribute to or cause your hand symptoms. Especially if your condition is bilateral (symptoms on both sides), it is likely that body parts other than your wrist and hand require treatment.

As physiotherapists we are trained to comprehensively assess and diagnose your body as a whole and treat all the factors contributing to your pain. We can help ensure you get thorough treatment to eliminate your symptoms as quickly as possible and prevent it from becoming a chronic condition. Don’t try to treat it yourself off the internet! Leave it in the hands of the trained experts.

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Yet another struggling soldier says Veteran Affairs Canada offered him euthanasia

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From LifeSiteNews

By Jonathon Van Maren

‘It made me wonder, were they really there to help us, or slowly groom us to say ‘here’s a solution, just kill yourself.’

Yet another Canadian combat veteran has come forward to reveal that when he sought help, he was instead offered euthanasia. 

David Baltzer, who served two tours in Afghanistan with the Princess Patricia’s Canadian Light Infantry, revealed to the Toronto Sun that he was offered euthanasia on December 23, 2019—making him, as the Sun noted, “among the first Canadian soldiers offered therapeutic suicide by the federal government.”

Baltzer had been having a disagreement with his existing caseworker, when assisted suicide was brought up in in call with a different agent from Veteran Affairs Canada.  

“It made me wonder, were they really there to help us, or slowly groom us to say ‘here’s a solution, just kill yourself,” Baltzer told the Sun.“I was in my lowest down point, it was just before Christmas. He says to me, ‘I would like to make a suggestion for you. Keep an open mind, think about it, you’ve tried all this and nothing seems to be working, but have you thought about medical-assisted suicide?’” 

Baltzer was stunned. “It just seems to me that they just want us to be like ‘f–k this, I give up, this sucks, I’d rather just take my own life,’” he said. “That’s how I honestly felt.” 

Baltzer, who is from St. Catharines, Ontario, joined up at age 17, and moved to Manitoba to join the Princess Patricia’s Canadian Light Infantry, one of Canada’s elite units. He headed to Afghanistan in 2006. The Sun noted that he “was among Canada’s first troops deployed to Afghanistan as part Operation Athena, where he served two tours and saw plenty of combat.” 

“We went out on long-range patrols trying to find the Taliban, and that’s exactly what we did,” Baltzer said. “The best way I can describe it, it was like Black Hawk Down — all of the sudden the s–t hit the fan and I was like ‘wow, we’re fighting, who would have thought? Canada hasn’t fought like this since the Korean War.” 

After returning from Afghanistan, Baltzer says he was offered counselling by Veteran Affairs Canada, but it “was of little help,” and he began to self-medicate for his trauma through substance abuse (he noted that he is, thankfully, doing well today). Baltzer’s story is part of a growing scandal. As the Sun reported:  

A key figure shedding light on the VAC MAID scandal was CAF veteran Mark Meincke, whose trauma-recovery podcast Operation Tango Romeo broke the story. ‘Veterans, especially combat veterans, usually don’t reach out for help until like a year longer than they should’ve,’ Meincke said, telling the Sun he waited over two decades before seeking help. 

‘We’re desperate by the time we put our hands up for help. Offering MAID is like throwing a cinderblock instead of a life preserver.’ Meincke said Baltzer’s story shoots down VAC’s assertions blaming one caseworker for offering MAID to veterans, and suggests the problem is far more serious than some rogue public servant. 

‘It had to have been policy. because it’s just too many people in too many provinces,” Meincke told the Sun. “Every province has service agents from that province.’

Veterans Affairs Canada claimed in 2022 that between four and 20 veterans had been offered assisted suicide; Meincke “personally knows of five, and said the actual number’s likely close to 20.” In a previous investigation, VAC claimed that only one caseworker was responsible—at least for the four confirmed cases—and that the person “was lo longer employed with VAC.” Baltzer says VAC should have military vets as caseworkers, rather than civilians who can’t understand what vets have been through. 

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Jonathon’s writings have been translated into more than six languages and in addition to LifeSiteNews, has been published in the National PostNational ReviewFirst Things, The Federalist, The American Conservative, The Stream, the Jewish Independent, the Hamilton SpectatorReformed Perspective Magazine, and LifeNews, among others. He is a contributing editor to The European Conservative.

His insights have been featured on CTV, Global News, and the CBC, as well as over twenty radio stations. He regularly speaks on a variety of social issues at universities, high schools, churches, and other functions in Canada, the United States, and Europe.

He is the author of The Culture WarSeeing is Believing: Why Our Culture Must Face the Victims of AbortionPatriots: The Untold Story of Ireland’s Pro-Life MovementPrairie Lion: The Life and Times of Ted Byfield, and co-author of A Guide to Discussing Assisted Suicide with Blaise Alleyne.

Jonathon serves as the communications director for the Canadian Centre for Bio-Ethical Reform.

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2025 Federal Election

Study links B.C.’s drug policies to more overdoses, but researchers urge caution

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By Alexandra Keeler

A study links B.C.’s safer supply and decriminalization to more opioid hospitalizations, but experts note its limitations

A new study says B.C.’s safer supply and decriminalization policies may have failed to reduce overdoses. Furthermore, the very policies designed to help drug users may have actually increased hospitalizations.

“Neither the safer opioid supply policy nor the decriminalization of drug possession appeared to mitigate the opioid crisis, and both were associated with an increase in opioid overdose hospitalizations,” the study says.

The study has sparked debate, with some pointing to it as proof that B.C.’s drug policies failed. Others have questioned the study’s methodology and conclusions.

“The question we want to know the answer to [but cannot] is how many opioid hospitalizations would have occurred had the policy not have been implemented,” said Michael Wallace, a biostatistician and associate professor at the University of Waterloo.

“We can never come up with truly definitive conclusions in cases such as this, no matter what data we have, short of being able to magically duplicate B.C.”

Jumping to conclusions

B.C.’s controversial safer supply policies provide drug users with prescription opioids as an alternative to toxic street drugs. Its decriminalization policy permitted drug users to possess otherwise illegal substances for personal use.

The peer-reviewed study was led by health economist Hai Nguyen and conducted by researchers from Memorial University in Newfoundland, the University of Manitoba and Weill Cornell Medicine, a medical school in New York City. It was published in the medical journal JAMA Health Forum on March 21.

The researchers used a statistical method to create a “synthetic” comparison group, since there is no ideal control group. The researchers then compared B.C. to other provinces to assess the impact of certain drug policies.

Examining data from 2016 to 2023, the study links B.C.’s safer supply policies to a 33 per cent rise in opioid hospitalizations.

The study says the province’s decriminalization policies further drove up hospitalizations by 58 per cent.

“Neither the safer supply policy nor the subsequent decriminalization of drug possession appeared to alleviate the opioid crisis,” the study concludes. “Instead, both were associated with an increase in opioid overdose hospitalizations.”

The B.C. government rolled back decriminalization in April 2024 in response to widespread concerns over public drug use. This February, the province also officially acknowledged that diversion of safer supply drugs does occur.

The study did not conclusively determine whether the increase in hospital visits was due to diverted safer supply opioids, the toxic illicit supply, or other factors.

“There was insufficient evidence to conclusively attribute an increase in opioid overdose deaths to these policy changes,” the study says.

Nguyen’s team had published an earlier, 2024 study in JAMA Internal Medicine that also linked safer supply to increased hospitalizations. However, it failed to control for key confounders such as employment rates and naloxone access. Their 2025 study better accounts for these variables using the synthetic comparison group method.

The study’s authors did not respond to Canadian Affairs’ requests for comment.

 

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Correlation vs. causation

Chris Perlman, a health data and addiction expert at the University of Waterloo, says more studies are needed.

He believes the findings are weak, as they show correlation but not causation.

“The study provides a small signal that the rates of hospitalization have changed, but I wouldn’t conclude that it can be solely attributed to the safer supply and decrim[inalization] policy decisions,” said Perlman.

He also noted the rise in hospitalizations doesn’t necessarily mean more overdoses. Rather, more people may be reaching hospitals in time for treatment.

“Given that the [overdose] rate may have gone down, I wonder if we’re simply seeing an effect where more persons survive an overdose and actually receive treatment in hospital where they would have died in the pre-policy time period,” he said.

The Nguyen study acknowledges this possibility.

“The observed increase in opioid hospitalizations, without a corresponding increase in opioid deaths, may reflect greater willingness to seek medical assistance because decriminalization could reduce the stigma associated with drug use,” it says.

“However, it is also possible that reduced stigma and removal of criminal penalties facilitated the diversion of safer opioids, contributing to increased hospitalizations.”

Karen Urbanoski, an associate professor in the Public Health and Social Policy department at the University of Victoria, is more critical.

“The [study’s] findings do not warrant the conclusion that these policies are causally associated with increased hospitalization or overdose,” said Urbanoski, who also holds the Canada Research Chair in Substance Use, Addictions and Health Services.

Her team published a study in November 2023 that measured safer supply’s impact on mortality and acute care visits. It found safer supply opioids did reduce overdose deaths.

Critics, however, raised concerns that her study misrepresented its underlying data and showed no statistically significant reduction in deaths after accounting for confounding factors.

The Nguyen study differs from Urbanoski’s. While Urbanoski’s team focused on individual-level outcomes, the Nguyen study analyzed broader, population-level effects, including diversion.

Wallace, the biostatistician, agrees more individual-level data could strengthen analysis, but does not believe it undermines the study’s conclusions. Wallace thinks the researchers did their best with the available data they had.

“We do not have a ‘copy’ of B.C. where the policies weren’t implemented to compare with,” said Wallace.

B.C.’s overdose rate of 775 per 100,000 is well above the national average of 533.

Elenore Sturko, a Conservative MLA for Surrey-Cloverdale, has been a vocal critic of B.C.’s decriminalization and safer supply policies.

“If the government doesn’t want to believe this study, well then I invite them to do a similar study,” she told reporters on March 27.

“Show us the evidence that they have failed to show us since 2020,” she added, referring to the year B.C. implemented safer supply.


This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.

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