The eight bones of your wrist form a U-shaped channel that houses several tendons and your Median nerve. This channel is called the Carpal tunnel. Your median nerve is responsible for sensation on the palm side of your first 3 ½ fingers. Compression or irritation of this nerve as it travels through the carpal tunnel causes the condition known as "Carpal tunnel syndrome". Carpal tunnel syndrome is the most common nerve entrapment, affecting 3-5% of the general population. Females are affected two or three times more frequently than males. Carpal tunnel syndrome most often affects adults age 45-60. Carpal tunnel syndrome can be brought on by prolonged wrist flexion and/or repetitive wrist movements like supermarket scanning, keyboard use, carpentry or assembly line work. Exposure to vibration or cold may also aggravate the condition. Carpal tunnel syndrome is more common in your dominant hand but frequently affects both hands. Some risk factors for developing carpal tunnel syndrome include diabetes, thyroid disease, rheumatoid arthritis, alcoholism, kidney disease and being short or overweight. Fluid retention during pregnancy is a common cause of carpal tunnel symptoms. Symptoms of carpal tunnel syndrome include numbness, tingling or discomfort on the palm side of your thumb, index, middle finger and half of your ring finger. The discomfort can sometimes extend towards your elbow. The symptoms usually begin as nighttime discomfort or waking up with numb hands but can progress to a constant annoyance. Your symptoms are likely aggravated by gripping activities like reading the paper, driving or painting. Early on, your symptoms may be relieved by "shaking your hands out". You may sometimes feel as though your hands are tight or swollen. In more severe cases, hand weakness can develop. Compression of your median nerve in the carpal tunnel is often accompanied by compression at a second or third site as well. Researchers call this "double crush syndrome." Common "double crush" partners for carpal tunnel syndrome involve the spine or muscles in your neck, shoulder and forearm. To help resolve your condition, you should avoid activities that involve repetitive wrist flexion, i.e. pushups. Grasping the handlebars on your bicycle will likely cause irritation of your condition. Our office may prescribe a special splint that holds your wrist in a neutral or slightly extended position that will help with your nighttime symptoms. If left untreated, carpal tunnel syndrome can result in permanent nerve damage. The American Academy of Neurology recommends conservative treatment, like the type provided in our office, before considering surgical alternatives.
Here is a brief description of the treatments we may use to help manage your problem.
Joint Manipulation
Your chiropractor has found joints in your body that are not moving freely. This can cause tightness and discomfort and can accelerate unwanted degeneration i.e. arthritis. Your chiropractor will apply a gentle force with their hands, or with hand held instruments, in order to restore motion to any "restricted" joints. Sometimes a specialized table will be used to assist with these safe and effective "adjustments". Joint manipulation improves flexibility, relieves pain and helps maintain healthy joints.
Therapy Modalities
We may apply electrotherapy modalities that produce light electrical pulses transmitted through electrodes placed over your specific sites of concern. These comfortable modalities work to decrease your pain, limit inflammation and ease muscle spasm. Hot or cold packs are often used in conjunction, to enhance the effect of these modalities. Another available option is therapeutic ultrasound. Ultrasound pushes sound vibrations into tissues. When these vibrations reach your deep tissues, heat develops and unwanted waste products are dispersed.
Myofascial Release
Overworked muscles often become tight and develop knots or "trigger points". Chronic tightness produces inflammation and swelling that ultimately leads to the formation of "adhesions" between tissues. Your chiropractor will apply pressure with their hands, or with specialized tools, in order to release muscle tightness and soft-tissue adhesions. This will help to improve your circulation, relieve pain and restore flexibility.
Therapeutic Exercise
Muscle tightness or weakness causes discomfort and alters normal joint function, leading to additional problems. Your chiropractor will target tight or weak muscles with specific therapeutic stretching and strengthening to help increase tissue flexibility, build strength, and ease pain. Healthy, strong, and flexible muscles may help prevent re-injury.