Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) belongs to a group of disorders referred to as cumulative trauma disorders (CTDs). With CTS, the cumulative wear and tear of a repetitive motion can cause injury to the upper extremity. This can result in changes in movement intended to avoid further injury that then overstress another part of the arm, leading to a second injury. It can become like a chain reaction of injury after injury eventually resulting in multiple conditions between the neck and hand.

Carpal tunnel syndrome is so debilitating because it affects the thumb, index, third, and fourth ring finger that comprise 90 percent of the hand's function. This part of the hand is innervated by the median nerve that travels through the carpal tunnel at the wrist. When injured, it can make fine motor movements very difficult and/or painful. Grip strength is also greatly affected by pressure on the median nerve, so the ability to lift and carry is compromised.

Some risk factors for CTS include being over age 50, female, obese, having a repetitive motion type of job, and presence of another CTDs such as forearm or hand tendonitis. You are also at higher risk if you have certain metabolic conditions such as thyroid disease, diabetes, and rheumatoid arthritis.

There are several things you can do to manage CTS. Symptoms of CTS are generally worse at night because the hand naturally flexes as you sleep, putting more pressure on the wrist. Using a wrist splint at night can prevent that flexed position. Chiropractic adjustments of the small joints of the wrist and hand, and often the elbow and neck, help to reduce joint dysfunction and nerve pressure. Muscle and tendon myofascial release and other mobilization techniques can also be beneficial.

Recent studies have reported the use of non-steroidal anti-inflammatory drugs (NSAIDS) like Advil, Aleve, and aspirin can interfere with and delay the healing process. Better options to reduce inflammation include low-level laser therapy, ultrasound, supplements (boswellia, turmeric, ginger, etc.), ice and massage.

Your doctor may order an EMG/NCV (electromyogram/nerve conduction velocity) if your case is not responding appropriately. Surgical intervention should be the last resort because frequently CTS is easily managed with non-surgical chiropractic care.

For more information, contact Dr. Wendy at [email protected].