What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome refers to entrapment of a particular nerve (called the median nerve) within the wrist. This leads to a distinctive pattern of numbness, pain, or pins and needles in the hand. Carpal tunnel syndrome most commonly affects women of child bearing age.
Symptoms of carpal tunnel syndrome include pain, pins and needles, and numbness in the palm of the hand, as well as the thumb, index and middle fingers. Less commonly this can radiate to the elbow, or even shoulder. Often symptoms are worse at night, or on activity. Patients may also notice weakness or clumsiness when gripping things.
Carpal tunnel syndrome is an example of a trapped nerve.
What Causes Carpal Tunnel Syndrome?
One of the most common causes of carpal tunnel syndrome is trauma. This can include repetitive strain injury, such as that seen in typists, or sudden injury, such as a fall onto the hand.
Other causes include pregnancy/menstrual associated fluid retention, lunate subluxation, obesity, and, more rarely, problems such as diabetes, bone tumours, and inflammatory arthropathies.
Often, carpal tunnel syndrome is preceded by minor entrapment elsewhere along the course of the median nerve. This is called a double crush injury, with other possible sites including the neck, shoulder and elbow.
Can Chiropractors Help With Carpal Tunnel?
Chiropractors encounter carpal tunnel syndrome on a regular basis. Fortunately, in many instances it responds very well to chiropractic treatment.
Firstly, at Worcester Chiropractic Clinic, we would assess you using a range of neurological, orthopaedic and provocative tests to determine the cause of median nerve irritation. These tests pinpoint the site and extent of injury.
We would also assess you to ensure that your symptoms didn’t have a systemic cause.
Having done this and established that your symptoms are mechanical in nature, our chiropractors would suggest a short course of chiropractic treatment.
This treatment would likely involve joint manipulation/mobilisation of the neck, shoulder, elbow and wrist. It would also likely include soft-tissue techniques aimed at tissues along the course of the median nerve.
Exercises and advice would also be given. This could range from nutritional considerations to assist nerve healing or reduce fluid retention, to occupational advice.
What if my Chiropractor Can’t Help?
Alternative options for the treatment of carpal tunnel syndrome include injection therapy and surgery.
Injection therapy consists of a steroid injection into the wrist. This usually gives short term relief, but symptoms can return.
Surgery for carpal tunnel syndrome is a minor and relatively effective procedure. Performed under local anaesthetic, the ligamentous floor (or flexor retinaculum) of the carpal tunnel is partially cut. This widens the carpal tunnel, decreasing pressure on the median nerve.
In the cases requiring surgical management, it is still important the underlying cause of the carpal tunnel syndrome is addressed.
This might mean wrist exercises, occupational adaptations, diuretics or treatment and rehabilitation of neck and shoulder factors.