Condition Highlight: Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is something that comes up quite a bit in a chiropractic office. We hear it all the time, “my wrist has started to hurt me… can you do anything to help with that?” Carpal Tunnel Syndrome affects many and can be quite debilitating when it comes to work or other activities of daily living. I am always so happy when patients do bring it up because there is quite a bit a chiropractor can do to help improve the symptoms of Carpal Tunnel Syndrome.
What is Carpal Tunnel Syndrome?
Let’s go over the basic anatomy. The Carpal Tunnel is passageway for the Median Nerve and the flexor tendons (the structures that allow you to bend your fingers). The tunnel sits between the eight carpal bones of the wrist and the flexor retinaculum (also known as the carpal ligament), which is a strong, fibrous band. If you look at your wrist you can see that this is a fairly small space for all of these structures to reside in. Carpal Tunnel Syndrome occurs when there is swelling inside of this small space, overcrowding the area and putting pressure on the Median Nerve, which supplies the thumb, pointer, middle, and ring fingers. This pressure can cause pain, numbness, tingling, and even weakness. Basically, nerves don’t like to be compressed, they need their space.
Symptoms of Carpal Tunnel Syndrome
Symptoms can occur gradually which is often why they are ignored for so long. Symptoms can include:
- Numbness, tingling, or burning in the hand or fingers
- Pain in the wrist or forearm
- Weakness in the wrist or hand
Causes of Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is usually multi-factorial. Mostly it is caused by over or excessive use by doing repetitive motions. Repetitive motions can aggravate the wrist joint causing swelling and Carpal Tunnel irritation. Other causes include genetics (Carpal Tunnel Syndrome can be hereditary), pregnancy (due to the increase in swelling), or other health conditions, such as rheumatoid arthritis.
What can a Chiropractor do to help with Carpal Tunnel Syndrome?
Chiropractors can be helpful firstly by considering differential diagnoses and providing the right diagnosis. For example, the nerve impingement causing hand numbness may not be from the carpal tunnel at all but rather a condition in the cervical or thoracic spine. Chiropractors will perform different orthopedic tests to help find a diagnosis.
If it is truly Carpal Tunnel Syndrome, your chiropractor will help build a treatment plan that works for you. This treatment plan may include adjusting the wrist, therapeutic ultrasound, cold laser, cryotherapy, kinesiotaping, trigger point therapy, bracing, advising stretches and exercises, and giving supplements that reduce inflammation. There is quite a bit that a chiropractor can do to help alleviate Carpal Tunnel Syndrome. If the Carpal Tunnel Syndrome is advanced or not responding to conservative care your chiropractor may refer you out for an orthopedic or surgical consult, as things like surgery or steroid injections are options for debilitating Carpal Tunnel Syndrome.
An April 2018 study found that manually mobilizing the carpal bones significantly increased the dimension of the carpal tunnel (Bueno-Gracia, et al 2018). Manual mobilization is what chiropractors do!
Is there anything I can do to reduce my risk of Carpal Tunnel Syndrome?
- Reduce overall inflammation in the body and maintain a normal weight by eating a healthy diet
- Supplement with Omega 3 fatty acids to reduce inflammation
- Evaluate the ergonomics of your work station, see if there are ways it can be improved
- Stretch the wrist while working. Ask your chiropractor what stretches you should do and take regular stretching breaks at work
Resources:
Carpal tunnel syndrome
https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603. Accessed on 05/02/2018
Dimensional changes of the carpal tunnel and the median nerve during manual mobilization of the carpal bonesElena Bueno-Gracia-Alazne Ruiz-De-Escudero-Zapico-Miguel Malo-Urriés-Michael Shacklock-Elena Estébanez-De-Miguel-Pablo Fanlo-Mazas-Santos Caudevilla-Polo-Sandra Jiménez-Del-Barrio – Musculoskeletal Science and Practice –April 2018. 4;36:12-16
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