Introduction
Carpal Tunnel Syndrome is the most common nerve entrapment disorder. As the name implies, 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 positioned 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 is comprised of the nine tendons of the forearm muscles that are responsible for bending and flexing of the fingers and thumb. There are also arteries and lymphatic vessels that furnish circulation to the hand located within the tunnel. The bottom and sides of this tunnel are formed by wrist bones and the top of the tunnel is covered by a strong 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 expected 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 an improper use of the carpal bones, the median nerve can become constricted or entrapped by 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
Although any of the above can predispose one 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. In addition, repetitive housework as seemingly inconsequential as wringing clothes by hand, can bring on carpal tunnel symptoms. However, the continuing increase in computer use is the most compelling explanation for the number of individuals who are suffering with Carpal Tunnel Syndrome today. 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, an Orlando 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 help retain the wrist in a neutral position to decompress the carpal tunnel. Your Orlando Chiropractor will also give you specific exercises to stretch and/or strengthen muscles of the forearm and hand.