Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is not a disorder with a simple cause and a simple cure. Rather, CTS is a set of signs and symptoms relating to a wide range of problems that involve pain, swelling and inflammation in the hand and forearm.

Those affected by CTS often complain of an aching pain in the upper arm or forearm, accompanied by tingling and numbness or weakness in the thumb, index, middle or ring fingers. Often the symptoms get more severe at night, causing patients to wake from a deep sleep with a burning sensation in their hand. People with CTS also complain that everyday activities such as holding a pen or picking things up become more and more difficult.

CTS develops when there is compression of the median nerve, which runs through a space in the wrist called the carpal tunnel. To understand how this happens, imagine wearing a bracelet that is too small for your arm. Such a bracelet would constrict the soft tissues around your wrist, impinging on the carpal tunnel and the median nerve within.

A situation similar to the wearing of a tight bracelet can develop when you perform prolonged activities that involve the hand and forearm, such as typing or using hand tools. Activities which involve extensive wrist flexion (bending the wrist upward when the palm is facing up, as if you were lifting a table) and wrist extension (bending the wrist upward when the palm is facing down, as if you were waving to someone) can lead to inflammation in the tendons. Like the bracelet, this inflammation compresses the carpal tunnel.

Even if typing and using hand tools are not in your day-to-day routine, such inflammation can still affect you. Traditionally, health-care providers considered CTS to be a work-related disorder, with typing and repetitive strain being the main culprits. It is now known, however, that factors such as pregnancy, obesity, rheumatoid arthritis and thyroid disease can also predispose people to swelling in the carpal tunnel, putting them at risk of getting CTS.

Often the underlying cause is a misalignment of one or more joints of the neck, shoulder, elbow, or wrist. Many doctors treat only the carpal tunnel symptoms because they don’t understand the true underlying cause, and too often surgery is performed when non-invasive techniques can be successful. If you have any of the symptoms of CTS, I encourage you to have an exam by a doctor of chiropractic. Treatment of CTS by a chiropractor may include adjustment of the bones of the neck, upper back, elbow and wrist, trigger point therapy, and various electrical therapies to decrease inflammation.