Introduction

Carpal Tunnel Syndrome is the most prevalent nerve entrapment disorder. As the name infers, these conditions come about when a nerve is trapped or constricted between other tissues of the body causing irritation and dysfunction of the nerve.

Anatomy

The carpal tunnel is positioned in the underside of the wrist and is a passageway in which the median nerve travels through on its way to innervate the hand and fingers. In addition to the median nerve, the carpal tunnel includes 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 supply circulation to the hand located within the tunnel. Wrist bones form the bottom and sides of the tunnel, while the top is shaped by the transverse carpal ligament, a strong band of connective tissue. The carpal tunnel is a densely-packed space about the size of an index finger. The flexor tendons, arteries and median nerve are designed to glide smoothly 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 dimenishes due to  a mechanical dysfunction of the carpal bones, the median nerve can become compressed or entrapped within the carpal tunnel. In the beginning, carpal tunnel symptoms mainly 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 grip small objects using the thumb and fingers can be affected dangerously and if left untreated, can lead to total dysfunction of the hand.

The following are typical 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

Though any of the causes and conditions listed can be partly responsible for Carpal Tunnel Syndrome, often the actual root cannot be found. 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.  Even household activities as simple as repetitive wringing clothes by hand can help cause this syndrome. 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. The repetitive motions of typing on the keyboard and moving the mouse over extended periods of time is a primary indicator for many people with CTS.

Treatment

Proper diagnosis and management of this condition is essential in order to curtail the disabling symptoms associated with the advancement of CTS. Your Ventura Chiropractor has many years of experience in this area. Chiropractors are equipped to deal with this problem and can offer many sufferers with relief.  In addition to chiropractic adjustments of the wrist joints, treatment by chiropractor may include inflammation reduction therapy such as ultrasound or low level laser. Electromusclestim can often help to strengthen the weak muscles of the forearm and soft tissue massage is effective in stretching contracted tissues. Your chiropractor may suggest that you wear a splint or support, particularly at night, to aid in the decompression of the carpal tunnel. Your Ventura Chiropractor will also give you specific exercises to stretch and/or strengthen muscles of the forearm and hand.