Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) can be a very painful condition that affects the wrist and hand. It can make it difficult to sleep, sometimes even impossible to work, cook and enjoy your life. Gripping objects and computer work are some of the most painful tasks.
One patient put it this way….
“I dread going to bed, I dread cleaning, doing dishes…any type of housework, because of the pain.”
What is CTS?
The Mayo Clinic’s definition of Carpal Tunnel Syndrome:
“Carpal Tunnel Syndrome is a hand and arm condition that causes numbness, tingling and other symptoms. Carpal Tunnel Syndrome is caused by a pinched nerve in your wrist.”
Simply put, this means that the opening through which the nerves, tendons and blood vessels to the hand has decreased in size. This can be caused by swelling, obesity and/or partial (or full) collapse of the Carpal Tunnel. Sometimes Carpal Tunnel Syndrome is the result of an injury but most of the time it is the result of commonly repeated motions such as swinging a hammer, craft work, or typing on a computer.
Another common cause of Carpal Tunnel Syndrome is a misalignment of the carpal bones themselves. The carpals consist of two rows of four bones in the wrist that that are prone to mechanical problems from repetitive stress such as using a keyboard, hand tools, or machinery. When the carpals push too far forward, they narrow the size of the carpal tunnel. This results in irritation to the Median nerve.
The Median nerve controls both sensation and muscle strength to the palm and first three digits (but typically not the little finger). If you have any of the following symptoms you should be evaluated for potential Carpal Tunnel Syndrome:
- Pain in the Wrist
- Pins & Needles in Hands
- Numbness or Pain in Arms
- Difficulty Grabbing Objects
- Elbow Pain
- Difficulty Writing
The following conditions must also be ruled out:
- Cervical Neuropathies (compromise of the nerves in the neck)
- Pronator Teres Syndrome (nerve entrapment in a muscle of the forearm)
- Arthritic Conditions
- Thoracic Outlet Syndrome
- Diabetic Neuropathies
Carpal Tunnel Treatment
Before we begin treatment for Carpal Tunnel Syndrome, we must first make an accurate diagnosis. Any interference along the Median nerve path can mimic Carpal Tunnel symptoms. Thus, it is important to examine the neck, shoulder, elbow and wrist.
Once we determine that the problem is actually in the wrist, we must evaluate how well the carpal bones are working mechanically. When they are aligned and moving like they should, they create an arch on one side of the tunnel with the transverse ligament attaching to create the other half of the tunnel. Think of it like an archery bow. The bow itself would be the carpal bones and the string would represent the transverse ligament. We use a variety of chiropractic techniques to reset the bones in the wrist to reinforce the correct shape of the carpal tunnel and remove the pressure on the nerve.
We also want to make sure the tendons and Median nerve are free to move, without irritation, as they pass through the carpal tunnel. Adhesions and scar tissue can form in this area which causes these structures to catch or bind and become irritated. We use soft tissue protocols such as Graston Myofascial Therapy and Neurodynamics to break up and remove these adhesions.
There is also an inflammatory component to Carpal Tunnel Syndrome which must be addressed. Spinal & Sports Care Clinic utilizes state-of-the art Low Level (Cold) Laser Therapy directly over the wrist to help reduce inflammation and promotes healing of the injured nerve. Along with these therapies there are a couple of other research-based, conservative measures that have been shown to be effective in treating Carpal Tunnel Syndrome:
