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Moving Toward Better Health

The official blog of Konicki Schumacher Chiropractic

26
Feb

Carpal Tunnel Syndrome

Posted by Dr. Tom Konicki
Dr. Tom Konicki
Dr. Thomas Konicki earned his B.S. in Biology at the University of Cincinnati and then went on to the Los Ange...
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in Orthopedic Conditions/Injuries

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Dear Dr. Konicki,

Question: My wrists and hands hurt and go numb. I think I have carpal tunnel syndrome. What exactly is that?


Answer: Carpal Tunnel Syndrome (CTS) occurs when the median nerve passes through your wrist and is compressed. This results in pain, numbness, weakness and difficulty using your hand. This is the most common area for pinched nerves in your upper extremity.


The carpal tunnel is made up of wrist (carpal) bones covered by a ligament. Some people have smaller tunnels, making them more susceptible to nerve compression. Other causes include injury to the wrist, hypothyroidism, diabetes, inflammatory arthritis, fluid retention during pregnancy or menopause and repetitive use of the hand. CTS is common in assembly-line workers, such as those performing the same motion over and over again. Contrary to popular belief, people who spend many hours on computers are not at increased risk for CTS.

Various symptoms include burning, tingling, itching, numbness, sharp stabbing pains, weakness and a sense of swelling in your palm, thumb, index and middle fingers. You may have difficulty performing delicate tasks, such as sewing or even buttoning your clothes. As CTS progresses, you may have a wasting of the muscles in your thumb.

The carpal tunnel is on the palm side of your wrist. If you have pain on the backside of your hand, you do not have carpal tunnel.

Pain or numbness at night is a common feature. Many people sleep with their wrists bent forward, pinching the nerve. Wearing wrist splints at night may prevent this.

CTS is diagnosed by a physical examination of your neck, shoulder, arm and hand. It is too easy to say that you have carpal tunnel, when in fact you may be pinching your nerve somewhere else. A pinched nerve in your neck may mimic carpal tunnel. The median nerve itself can be pinched in your elbow/forearm as well as your wrist.

Sometimes electrodiagnostic tests, such as nerve conduction velocity testing are used to help confirm the diagnosis. It is crucial to know exactly where your nerve is being pinched to have effective treatment.

Treatment consists of resting your hand and wrist. Sometimes, splinting the wrist during the day is necessary to allow things to settle down. Ultrasound treatments and ice packs can reduce swelling. Consult your doctor concerning medication or injections. Lastly, vitamin B6 may help as well.

Chiropractors manipulate the carpal tunnel itself to help open this up and relieve pressure on the nerve. Specific massage to ligaments and muscles in the forearm can also help. In more severe cases, surgery may be indicated. The surgeon cuts the ligament covering the carpal tunnel to relieve the pressure.

If your treatment is not working, your median nerve may be compressed further up your forearm near the elbow. A muscle called the pronator teres is the second most common place to pinch this nerve. I find that this is often overlooked and it is just assumed that the carpal tunnel is causing all your problems.

Stretching is a key component in controlling or even preventing carpal tunnel. Hold your arm straight out with your elbow locked, palm up and now reach with your other hand to pull your fingers backwards. This is the opposite of flexing your wrist and will help you stretch muscles, ligaments and tendons that can compress your nerve.

CTS is important to treat early and not let it go. You will get your best results and avoid permanent nerve damage. See your chiropractor or doctor if you are concerned.

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