Carpal Tunnel Pain and Chiropractic
Introduction
Carpal Tunnel Syndrome is the most common nerve entrapment disorder. As the name infers, these conditions occur 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 situated 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. Also within the tunnel are arteries and lymphatic vessels that bring circulation to the hand. 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 without friction 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 decreases because of an improper use of the carpal bones, the median nerve can become compressed or entrapped within the carpal tunnel. The early symptoms of carpal tunnel syndrome usually include pain, numbness, paraesthesia (pins and needles) and tingling in the fingers and hands especially the thumb and adjacent two fingers. The symptoms are markedly apparent at night, often awakening the sufferer from sleep and making it necessary for the person to “shake out” or rub the hands in an attempt to relieve the unpleasant sensations. In addition, activity can cause the hands to feel awkward or weak, and fatigue easily. Over time, the ability to grip small objects using the thumb and fingers can be affected dramatically and if left untreated, can lead to total dysfunction of the hand.
Some prevailing 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
Although any of the above can can be a contributing factor to Carpal Tunnel Syndrome, in many cases the cause is unknown. 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. By far the most significant reason for the increase of people suffering with CTS is the continuous rise in the use of computers. 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. I as, a Ventura Chiropractor has many years of experience in this area. Chiropractors are well-trained in treating CTS. 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. 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.
