Introduction
Carpal Tunnel Syndrome falls into the category of neurological conditions referred to as nerve entrapment disorders and is easily the most common of these disorders. As the term “nerve entrapment” suggests, these disorders show up when a nerve is trapped or compressed between body tissues creating inflammation and impairment 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. Along with 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 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 heavy band of connective tissue called the transverse carpal ligament. The carpal tunnel is a thickly-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 tendon size increases from inflammation or hypertrophy (growth), or if the carpal tunnel size decreases due to an improper use of the carpal bones, the median nerve can become squeezed or entrapped within the carpal tunnel. At first, carpal tunnel symptoms often 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. The hands can also feel inept, weak and fatigue easily with activity. Eventually, grasping small objects using the thumb and fingers can be seriously affected and, without treatment, can result in complete debilitation 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 instrumental in contributing to the symptoms of Carpal Tunnel Syndrome, often the actual root cannot be found. Nevertheless, those who work with equipment that vibrates and/or perform their jobs in extreme temperatures often develop carpal tunnel symptoms. 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
Competent diagnosis and treatment is vital to relieving the painful and debilitating symptoms of CTS. Your Ventura Chiropractor is highly skilled in the diagnosis and managment of CTS. Chiropractors are well-trained in treating CTS. 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. Your chiropractor may suggest that you wear a splint or support, particularly at night, to help hold the wrist in a neutral position to decompress the carpal tunnel. Your Ventura Chiropractor will also give you specific exercises to stretch and/or strengthen muscles of the forearm and hand.