Carpal Tunnel Syndrome (CTS) is a very common condition affecting many types of workers in different settings. It involves the median nerve and is often a chronic, overuse condition of pain, tingling and numbness in the wrist, palm or fingers of one hand. It is usually the result of repetitive movement, pressure on the nerve or direct damage to the median nerve.

 

The carpal tunnel is a small passageway between the wrist bones and a ligament from the wrist to the hand. This narrow tunnel must accommodate the median nerve, 9 other ligaments, tendons and blood vessels, thus there is little room for swelling if injury occurs. Through repetitive motion, bending the wrist or keeping the wrist flexed without resting the carpal tunnel is exposed to stress and inflammation. When the tissues within this tunnel become inflamed and swollen or when one of the tendons is injured direct compression is put on the median nerve. This compression can result in pain, weakness and numbness in the hand and wrist as well as pain up to the forearm.

 

The main area of the hand that the median nerve supplies is the thumb, index, middle, ring fingers and part of the palm. Often in mild cases the symptoms are intermittent and worse at night; with prolonged irritation symptoms can become more severe so that there is marked numbness, clumsiness (dropping things is common) and even wasting of the small muscles of the thumb.


Carpal Tunnel Syndrome occurs three times more commonly in women than men. In 2004, the Bureau of Labour Statistics reported that CTS caused the greatest number of missed workdays; 43 days for those who have the problem. More workdays were missed due to CTS than broken bones or back injury. Often it is said that our computer based society has caused this repetitive strain injury.

Predisposing factors

Any activity that puts pressure or involves repetitive wrist movement can affect the median nerve:

1. Working at a computer: improper mouse use is more often a problem than typing.

2. Use of vibrating machinery, such as power tools.

3. Working at a cash register.

4. Activities that involve repetitive bending of the wrist such as gardening/knitting.

5. Trauma: wrist fractures

It is not always associated with overuse and people with the following conditions are more at risk of developing CTS

1. Pregnancy

2. Arthritis

3. Diabetes

4. Hypothyroidism

It is important to determine if it is pressure on the median nerve in the wrist that is causing your symptoms or if there is another underlying cause. Since other conditions can cause the same symptoms in the forearm and hand, such as neck problems, disc herniations in the neck, whiplash and other joint problems it can be confusing for you to known what is causing your symptoms.

"The carpal tunnel is a small passageway between the wrist bones and a ligament from the wrist to the hand"

A chiropractor can determine through a history and thorough physical examination whether your symptoms are caused by a true carpal tunnel syndrome or another spinal condition. If it is found that you have carpal tunnel syndrome your chiropractor can adjust and improve the joint function and ‘open’ areas of compression in your hand, as well as use other treatment modalities and ergonomic advice to help improve your symptoms. Whether your symptoms are caused by CTS or another cause your chiropractor can most likely help alleviate your symptoms and keep you pain free while advising you on what you can do to prevent it recurring.

karpaltunnelsyndrom

Is it ok to wear a wrist brace?

A brace is often used to help protect the wrist and to reduce mobility. While it may alleviate some symptoms it does not address the malfunctioning joints that are causing the problem. The chiropractic approach is to restore normal motion and function of the affected joints as well as strengthen the supporting muscles, ligaments and soft tissues. Most patients with the correct care are able to return to their normal activities without the use of bracing.

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