Carpal tunnel Syndrome (CTS) is a very common problem affecting normal arm, hand and finger function. CTS occurs when the median nerve in the wrist in compressed, injured, inflamed, irritated, or compromised in some way.
Almost anyone can be afflicted with carpal tunnel syndrome and it’s not always related to overuse syndromes or wrist injuries surprisingly! For instance, did you know that CTS is common with pregnancy or in many instances it can actually originate from the neck (cervical spine)!
Let’s first lay out some common signs and symptoms associated with carpal tunnel syndrome:
- Pain in the wrist, hand, fingers.
- Numbness in the wrist, hand, fingers.
- Tingling in the wrist, hand, fingers.
- Loss of strength with hand gripping or lifting.
- Task difficulty like buttoning a shirt, writing, or turning door knobs.
- Difficulty with pinching or grasping objects.
- Swollen fingers feeling, even without visible outward signs.
Now that you know some of the more common signs and symptoms related to carpal tunnel syndrome, let us lay out what could be the cause. Most doctors assume that CTS is of local origin initially when a patient presents with some of the more common symptoms. True carpal tunnel syndrome occurs when the median nerve is compressed, irritated or compromised within the wrist. The median nerve travels through a narrow tunnel in the wrist that is formed from eight rounded little wrist bones, the distal ulna and radius arm bones, and held together by the transverse carpal ligament. Should the carpal tunnel become inflamed, compressed or injured, the median nerve can get pinched and produce symptoms. However, there can be many other causes of carpal tunnel syndrome that are frequently overlooked, undiagnosed, or frankly not thought of by doctors alike because it may not be their area of specialty. As a practicing chiropractor with over 23 yrs of clinically treating patients with CTS-like symptoms, I have found on many occasions that problems within the neck (cervical spine) are actually the culprit. You might be surprised to hear and learn of such a statement, but my experience and proven results in the treatment of CTS has motivated me write this article, help as many people as possible, and prevent some unnecessary painful surgeries. So, how can pain, numbness, tingling, weakness, or lack of dexterity in the hand or fingers be related to or caused by a problematic condition in the neck? Easy, the median nerve originates from common spinal nerves that exit out the lower cervical spine. Upon leaving the neck, they come together forming the brachial plexus in the upper trapezius area and continue down the entire arm through the wrist and into the hand and fingers. Only the median nerve travels through the carpal tunnel in the wrist. Many times CTS symptoms can be produced if a bulging or herniated disc is present in the lower cervical (neck) spine, putting pressure on the nerve root. Bulging and herniated discs not only cause direct mechanical pressure on the nerve, but produce local inflammation at and around the foramen where the nerve exits the spine. A degenerative disc can cause similar problems as well due to the decreased intervertebral joint space encroaching upon the nerve. Chiropractors not only treat these conditions, but have a high percentage success rate in the resolution of the associated radicular symptoms. There are many advanced, pain free treatment options that a doctor of chiropractic offers for CTS related symptoms associated with spinal disc disorders.
Some other common related conditions associated with CTS include:
- Osteoarthritis
- Postural imbalances
- Cervical myelopathy
- Golfers elbow (medial epicondylitis)
- Tennis elbow (lateral epicondylitis)
- Myofascial pain syndrome
- Peripheral neuropathy
- Tendonitis of the wrist
- Pronator teres syndrome
- Shoulder impingement conditions
- Pregnancy
- Diabetes
- Aging
- Injuries
- Overuse syndromes
- Daily work activities or hobbies
- Diet and medications
Early diagnosis and treatment are very important to avoid long term damage to the median nerve or prevent surgery. As with any medical condition, a proper and comprehensive history and physical examination should occur to the area and any related region that can be contributory. X-rays, CT scan or MRI may or may not be warranted and your doctor may suggest obtaining a nerve conduction velocity (NCV) study or an electromyogram (EMG) test to map the nerve function and determine severity, especially if your symptoms are not resolving or improving.
There’s good news though, as a chiropractor, we not only successfully treat CTS but, many of the associated conditions that could be the underlying cause as well. If your carpal tunnel syndrome symptoms are being produced locally by an entrapment within the wrist, chiropractors offer treatments such as cold laser therapy, myofascial release techniques, ultrasound, electrostimulation, specific joint adjustment releases, kinesio taping therapy, bracing or splinting, and physical therapy procedures. Essentially, everything short of surgery which should always be a last resort option! If the origin of the condition is from a peripheral joint like the elbow or shoulder, than chiropractors can apply similar techniques that are used just like that on the wrist effectively. As is the case many of times, the origin of CTS can be produced by a problem in the neck or a specific cervical spinal condition. Chiropractors are leading experts in musculoskeletal conditions related to cervical problems that could be producing the carpal tunnel syndrome symptoms. If the CTS is the result of a disc disorder (bulging, herniated, degenerative disc), than chiropractors offer treatments to decompress the disc, relieve nerve pressure, and release muscle tension.
Experienced chiropractors versed in treating carpal tunnel syndrome patients should suggest specific home supportive stretches, night bracing if applicable, avoidance of certain motions or activities that can aggravate the symptoms, proper workplace ergonomics, and lifestyle modifications to support any successful treatment protocols.
