Carpal Tunnel Syndrome (CTS) develops from a nerve problem in the wrist (the median nerve) and is NOT a “muscle problem” like some people believe. That is not to say the median nerve cannot be trapped and pinched by muscles. When this occurs, the condition is labeled with a different name, depending on which muscle(s) are pinching the nerve or where the entrapment is located. Here are some more FACTS about CTS that you need to know:
SYMPTOMS: CTS complaints include numbness, pain, tingling, and/or weakness of the hand (especially fingers two, three, and four), and while this can be constant, it usually comes and goes.
ONSET: CTS usually comes on gradually. However, the length of time over which it progresses can be HIGHLY VARIABLE. It can take weeks, months, or even years before the patient consults with their chiropractor or family doctor.
CAUSE: There are MANY reported causes of CTS, but it is not completely known how the process starts out or how it evolves for different people. Risk factors include age greater than 50, obesity, genetics (family history of CTS), gender (as it favors females over males), work type (highly-repetitive, hand-intensive work), pregnancy, birth control pill usage, thyroid disease, diabetes, rheumatoid arthritis, and more. In general, swelling is the culprit that results in pressure on the median nerve. This most commonly occurs from overuse of the hands and fingers. Playing musical instruments, sewing, crocheting, basket weaving, assembly/line work, meat processing work, typing/computer work, and waitressing are common over-use activities.
CLINICAL COURSE: Early into the disorder, CTS is usually easily managed and reversible. However, if the amount of pressure on the nerve is too much, the symptoms can become permanent. Think of a wire and how wearing away the plastic coating will “short” the wire. There are multiple layers to our nerves and the wearing away of the outer layers over time can become a problem resulting in permanent numbness and/or weakness.
BIGGEST MISTAKE: Don’t wait until your symptoms are terrible! If you feel periodic numbness and tingling and you find yourself shaking your hand and “flicking” your fingers in attempt to “wake them up,” NOW IS THE TIME TO COME VISIT YOUR CHIROPRACTOR before nerve damage occurs and the risk of permanency increases.
HOW CHIROPRACTIC HELPS: Treatment guidelines for CTS recommend a non-surgical approach, and this is where chiropractic comes in! A wrist night splint is typically recommended since sleep interruption due to numbness is VERY common as we cannot control our wrist position when we sleep. Ice (not heat) is best as it reduces swelling (see #3 above). Rubbing an ice cube (or Dixie cup of ice) over the palm-side of the wrist works well. First, you will feel COLD followed by BURNING, then ACHING, and finally NUMBNESS (“C-BAN”). At this point STOP, as the next stage of cooling is frost bite! Do this three times a day or as directed. Your doctor of chiropractic will also talk to you about taking “mini-breaks” at home and/or at work and teach you exercises or stretches that can be performed during these breaks! A work station assessment is often very helpful as sometimes a simple change in work position or method can reduce wrist strain considerably. Your doctor of chiropractic may also perform manipulation to the small joints of the hand, wrist, elbow, shoulder, and neck as indicated in each specific case. He or she may also perform soft tissue release techniques to the muscles and soft tissues of the forearm, shoulder, and neck regions as needed. Surgery should be the LAST step in the treatment process, used only if all other non-surgical options have been tried without success.