Do you have carpal tunnel syndrome (CTS)? You may if you are
experiencing one or more of the following: tingling and numbness
in the hand, fingers, and wrist; pain so intense it awakens you
at night along with similar symptoms in the upper arm, elbow,
shoulder, or neck. Currently CTS affects over eight million Americans.
The wrist joint is made up of eight carpal bones that form a
tunnel. Nine tendons and the median nerve pass through this tunnel.
A ligament, called the flexor retinaculum, goes over the top
of the tunnel, enclosing the median nerve and tendons. This ligament
is connected to the carpal bones to keep them in their position.
Carpal tunnel syndrome occurs when tendons, ligaments, or bones
put pressure on the median nerve. The median nerve begins in
the lower part of the neck and runs down the arm to the fingers.
It is common to have pain in the elbow, shoulder, or neck when
CTS is present.
People who perform repetitive motions with the wrist and hand
are at risk to develop CTS. These tasks can cause the tendons
in the tunnel to become inflamed and press against the median
nerve. Arthritis or wrist injuries can cause a carpal bone to
protrude into the carpal tunnel, putting pressure on the median
nerve. Also, fractures, a fall on the hand, or poorly designed
workstations can cause CTS. An injury to the neck can cause the
median nerve to swell and press against the tunnel. Another reason
the median nerve becomes compressed is from forward head posture,
where the head is held forward from the body as it often is when
writing, reading, typing, or studying.
The most common treatment for CTS is to relieve the pain by
wrist immobilization, ice, or drugs. If the symptoms persist,
corticosteriods may be injected into the hand near the wrist,
which may provide temporary relief with a risk of serious side
effects. When these conservative treatments don’t work,
surgery is recommended.
Surgery for CTS is the second most common musculoskeletal surgery,
with well over 230,000 procedures performed annually in the United
States. Surgery will often take six months to a year of rehabilitation
to get the strength back into the wrist and hand. Unfortunately,
due to the body’s own repair mechanisms, many times scar
tissue and adhesions develop and once again close the carpal
tunnel, and puts pressure on the median nerve. Only 23 percent
of all CTS patients were able to return to their previous professions
following surgery.
If one of the eight carpal bones slips into the tunnel, it will
irritate the tendons and eventually the median nerve, causing
Carpal tunnel syndrome. The median nerve can be irritated in
the neck by a spinal vertebra pinching the nerve. Anyone suffering
from CTS should be checked by a chiropractor to ensure their
vertebrae are not putting pressure on the nerves that run down
the arm into the hand. A chiropractor will also check the shoulder,
elbow, and wrist joints to make sure the median nerve is not
being irritated in one of these areas.
Your chiropractor will give you advise about your activities
of daily living and recommend exercises to stabilize the carpal
bones. Controlled clinical studies have found improvements in
wrist strength and range of motion after chiropractic care. Chiropractic
care has helped many people continue on with their careers and
avoid the need for surgery.
— Dr. Ryan Napp
(This information is written for educational purposes and any
questions should be discussed with a health care professional.
Dr. Ryan Napp is a chiropractor at Napp Chiropractic Center in
Fayetteville. For more information or to attend a Half Hour to
Health workshop on Thursday evenings please call 770-716-5228.)
