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Carpal Tunnel Syndrome (CTS) – “Fact Sheet”

What is it? Carpal Tunnel Syndrome (CTS) occurs when the median nerve is “pinched” as it passes through the carpal tunnel.

What are the symptoms? CTS symptoms include numbness, tingling, or a half asleep sensation into the 2nd, 3rd, and 4th fingers. This is often worse at night due to the wrist being bent during sleep and can disturb sleep. Grip weakness is also associated with CTS, such as difficulty opening jars.

What are the causes? Usually, CTS results from activities including repetitive line work (meat/fish/poultry packing, cookie/food packing), typing, sewing, carpentry, or waiting tables that can cause the tendons to swell inside the carpal tunnel, placing pressure on the median nerve. Other “contributors” include hormone-related conditions such as hypothyroid, dysmenorrhea, diabetes, and obesity.

Who is at risk? Gender is a significant factor as women are 3x more likely to develop CTS than men (the carpal tunnel may be smaller in woman). The dominant hand is often first affected and more severe. Hormone imbalances as described above also increase risk.

How is it diagnosed? To diagnose CTS, a doctor will review a patient’s history as well as conduct a physical examination of the hands, arms, shoulders, and neck. The exam consists of trying to reproduce the numbness into the fingers by pressing/holding over the carpal tunnel and other areas where the median nerve runs down the arm (including the neck where the nerve originates), tapping over the CT with a reflex hammer, and bending and holding the wrists at the extreme endpoints of motion. Questionnaires and hand diagrams completed by the patient are helpful and quantify the degree of severity.

How is it treated? Chiropractic approaches include manipulation of the wrist, hand, forearm, shoulder, and neck, specifically addressing the areas of greatest restricted motion. Soft tissue therapy includes massage, active release, trigger point, and a host of physical therapy modalities such as light/low level laser, IFC, ultrasound, and microcurrent. A patient may also be instructed to perform exercises throughout the day to help the healing process. Wrist bracing — especially at night — is also a common treatment approach used by all healthcare providers. In some cases, patients may receive nutritional counseling and supplementation recommendations.

How can it be prevented? Workstation assessments, staying in shape (avoid obesity), taking “minibreaks” when doing repetitive work, and proper treatment for conditions like hypothyroid, diabetes, and other disorders associated with CTS can reduce an individual’s risk for the disorder.

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