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 located 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 contains the nine tendons of the forearm muscles that are responsible for bending and flexing of the fingers and thumb. Also within the tunnel are arteries and lymphatic vessels that deliver circulation to the hand. 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 diameter of the carpal tunnel is about the same as the index finger making the carpal tunnel a densely-packed space. The flexor tendons, arteries and median nerve are intended to glide without friction past each other during wrist and finger movement.

If the tendon size increases from inflammation or hypertrophy (growth), or if the carpal tunnel size dimenishes due to  a mechanical dysfunction of the carpal bones, the median nerve can become constricted or entrapped by the carpal tunnel. At first, 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 awkward or weak, and fatigue easily. Over time, the ability to hold small objects using the thumb and fingers can be affected dangerously and if left untreated, can lead to total dysfunction of the hand.

Some accepted causes and associated conditions are:

• 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.  In addition, repetitive housework as seemingly inconsequential as wringing clothes by hand, can bring on carpal tunnel symptoms. By far the most significant reason for the increase of people suffering with CTS is the continuous rise in the use of computers. 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

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.  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 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.