Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
What is it?
Carpal tunnel syndrome CTS happens when one of the nerves in the wrist—the median nerve—is compressed or squeezed as it crosses from the forearm to the hand through the carpal tunnel.
What are the Symptoms?
If you have carpal tunnel syndrome the first symptoms are usually very subtle—mild pain, numbness, or tingling in the hand or fingers that comes and goes. It is usually just an annoyance at first. But, if ignored long enough, things eventually get worse and will impact your function and quality life. You eventually end up with pain, numbness, or tingling—or all three—in part of your hand, thumb, index finger, middle finger, and the thumb-side of the ring finger. These are the most common symptoms. You may have pain radiating into the forearm and even the shoulder and neck. As it progresses you experience weakness and/or clumsiness in grabbing and holding onto things. Opening jars gets harder as the days go by. Doing up the buttons on your shirt becomes increasingly difficult until you can no longer wear button down shirts.
What are the Causes?
The underlying cause of carpal tunnel syndrome can be obvious and easy to trace, such as an injury to the wrist, or the cause of the condition can be the result of cumulative trauma from months or years or repetitive strain caused by working with vibrating tools or poor ergonomics. Another cause can be the result of swelling/inflammation from conditions like arthritis, thyroid disease, pregnancy, or diabetes. In many patients, there are several factors at play, which all must be treated in order to obtain a successful outcome.
How do you know if you have carpal tunnel syndrome?
This is not something you can easily determine on your own. A skillfully taken patient history will provide 80% of the information needed to determine if it is carpal tunnel syndrome you are actually dealing with… there are other tunnels there! Proper evaluation using provocative tests (tests that aggravate the condition), neurological tests for sensation (sharp vs dull, warm vs cold), and testing muscle tone and strength are all important and usually enough to make the diagnosis. More advanced electrodiagnostic tests (EMG/NCV or electromyogram/nerve conduction velocity) can quantify the severity of carpal tunnel syndrome and verify the diagnosis. However, these are very time consuming, costly, and rarely necessary.
What is the Treatment?
In our practice we have been treating carpal tunnel syndrome for years. While technology and modalities have advanced, the one treatment that has stood the test of time and has been shown to be important in all cases is adjusting the spine. In addition to spinal adjusting we also utilize pulsed radio frequency neuromodulation (this is a game changer), super-pulsed cold laser, electrical stimulation therapies, and neuromuscular re-education. What is used and to what degree will depend on the individual case.
What you can do?
To help things along you may need to wear a wrist splint or brace at night or during certain activities to keep the stress of the carpal tunnel. You might also be instructed to take certain supplements—systemic enzymes, vitamin D, ATP support—to bring the inflammation down and help the healing process of the nerves.
While then evidence indicates that these conservative treatments are the way to go, it’s important to realize that they work best when utilized early. The longer you wait the more treatment and time will be required. The longer you leave it, the more likely surgery will become your only option—probably not the best way to go. We’ve seen the results of these surgeries—the good, the bad, and the ugly.
While we can’t make any promises we are confident that if you have carpal tunnel syndrome and have not had surgery we can help you with our treatment program. We have seen:
- Pain decrease (The fire is put out)
- Normal sensation return (No more numbness)
- Grip strength return (No more dropping dishes)
- Fine motor control return (Think doing up shirt buttons)
- Muscles that had shrunk return close to normal size (No more “ape hand”—those who have seen it know what I mean here)
- Cases of very close to 100% recovery
So, if you are dealing with bothersome symptoms in you hand and/or wrist don’t just shake it off and carry on. Contact us and schedule an evaluation. You’ll be glad you did!