Carpal Tunnel Syndrome (CTS) is one of the most common causes of wrist pain. CTS is a condition affecting hand(s) and/or wrist(s) in which the median nerve that runs through the “carpal tunnel” in the wrist becomes compressed/entrapped. The carpal tunnel is made of fibrous tissues, bones, and ligaments in the wrist. The contents of the carpal tunnel are the median nerve and tendons. Symptoms of CTS can start with burning, itching or tingling sensations in the palm and specifically the thumb, index, middle, and part of the ring finger. These symptoms can progress to pain, numbness, and tingling in the hand and sometimes forearm. In severe cases, weakness and muscle wasting may be evident in the hand. This can lead to difficulty grasping objects or performing manual tasks. In particular, night pain can be a significant characteristic of CTS since most people sleep with a flexed wrist. People with CTS will often have an urge to shake their affected hand(s) and flex their fingers vigorously to relieve the pain and discomfort.
Carpal Tunnel Syndrome currently affects approximately 3-6% of the general population and the prevalence of CTS is higher in women than in men. CTS is also more common in work-related activities that involve excessively flexed or extended wrists (like using a keyboard!), repetitive hand motions, and use vibratory tools.
Carpal Tunnel Syndrome is caused by a compression of the median nerve in the wrist and is often a result of a combination of factors. Some causes include: a congenitally narrow carpal tunnel, trauma to the wrist that cause swelling, systemic endocrine or inflammatory conditions, repeated use of vibratory tools, a cyst or tumor in the carpal tunnel, or fluid retention during pregnancy or menopause. In fact, pregnant women have a 17% likelihood of developing CTS. Research tells us that CTS is more common in women and people with specific risk factors, including: diabetes, obesity, arthritis, old age, previous wrist fracture, and working in certain occupations. Approximately half of all CTS cases are related to occupation.
Most patients with carpal tunnel syndrome are treated non-surgically. However, it is important to be assessed, for example by a chiropractor, so that they can make a correct diagnosis and determine if you are a candidate for non-surgical, conservative management of CTS. Almost a third of patients who undergo CTS surgery experience persistent or recurrent symptoms and the initial improvement with surgery in those patients is lost within less than two years. In the event that surgery is necessary, chiropractors can help too! Post-surgical carpal tunnel surgery rehabilitation is aimed to speed up recovery and manage pain or discomfort.
Chiropractic Treatment of Carpal Tunnel Syndrome
It is important to undergo a proper assessment of your condition to ensure a proper diagnosis is made. There are several conditions that may mimic CTS, which is why it is important to be assessed by a chiropractor. A specific diagnosis will lead to appropriate treatment and eventual reduction of symptoms. Typical conservative management strategies for CTS include: ultrasound, low level laser therapy, splinting/hand braces, mobilizations/adjustments, soft-tissue therapy, stretches, exercises, and acupuncture. Treatments are aimed at improving circulation to the wrist, decreasing the pressure on the median nerve therefore decreasing pain and improving overall wrist flexibility. Chiropractors also emphasize the importance of preventing the recurrence of CTS. In doing so, chiropractors may evaluate your workplace or home ergonomics and prescribe individualized modifications.
Thanks for reading.
Yours in health,
Dr. Gaelan Connell, BHK, DC