Introduction

Carpal Tunnel Syndrome falls into the category of neurological conditions called nerve entrapment disorders and is by far the most prevalent of these disorders. As the term “nerve entrapment” suggests, these disorders show up when a nerve is trapped or compressed between body tissues creating inflammation and impairment of the nerve.

Anatomy

The carpal tunnel is embedded within the underside of the wrist. It is a tunnel, or passage, through which the Median nerve travels on its way to energize and animate the hand and fingers. In addition to the median nerve, the carpal tunnel is comprised of the nine tendons of the forearm muscles that are responsible for bending and flexing of the fingers and thumb. There are also arteries and lymphatic vessels that furnish circulation to the hand located within the tunnel. The bottom and sides of this tunnel are formed by wrist bones and the top of the tunnel is covered by a sinewy band of connective tissue called the transverse carpal ligament. The carpal tunnel is a thickly-packed space about the size of an index finger. The flexor tendons, arteries and median nerve are intended to glide easily past each other during wrist and finger movement.

If the size of the tendon enlarges due to irritation or overuse, or if the carpal tunnel size shrinks because of  an improper use of the carpal bones, the median nerve can become compressed or entrapped by the carpal tunnel. At first, carpal tunnel symptoms often include, pain, numbness, pins and needles, and tinging in the fingers and hand, particularly the thumb and adjacent two fingers.  These symptoms are especially noticeable in the night and often wake people from their sleep as the individual has to sit up in bed and shake-out and/or rub the hands in order decrease these unpleasant feelings.  In addition, activity can cause the hands to feel clumsy or weak, and fatigue easily. Over time, the ability to grasp small objects using the thumb and fingers can be affected dramatically and if left untreated, can lead to total dysfunction of the hand.

The following are general causes and corresponding conditions:

• repetitive and forceful grasping with the hands

• prolonged computer usage especially with poor wrist position

• activities that require repetitive bending of the wrist

• broken or dislocated bones in the wrist which produce swelling

• arthritis, especially the rheumatoid type

• thyroid gland imbalance

• sugar diabetes

• hormonal changes associated with menopause or pregnancy

Although any of the above can can be a contributing factor to Carpal Tunnel Syndrome, in many cases the cause is unknown. However, people who perform jobs that require use of vibration tools and machinery, and/or work in extreme temperatures are often subjected to this condition.  In addition, repetitive housework as seemingly inconsequential as wringing clothes by hand, can bring on carpal tunnel symptoms. However, the continuing increase in computer use is the most compelling explanation for the number of individuals who are suffering with Carpal Tunnel Syndrome today. This is becoming a major concern in the developed world where people of all ages are spending much of their time typing on a keyboard & clicking on a mouse.

Treatment

Competent diagnosis and treatment is vital to relieving the painful and debilitating symptoms of CTS. Your Ventura Chiropractor is highly skilled in the diagnosis and managment of CTS. Chiropractors are well-trained in treating CTS.  Treatment by chiropractor can include ultrasound or low level laser to help reduce inflammation, electro therapy to strengthen weak muscles of the forearm, soft tissue massage to stretch contracted tissues and, of course, adjustments of the dysfunctional joints of the wrist. You might be advised to wear a splint or support, especially at night, to help secure the wrist in a neutral position to decompress the carpal tunnel. Your Ventura Chiropractor will also give you specific exercises to stretch and/or strengthen muscles of the forearm and hand.

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