When people hear the term carpal tunnel syndrome (CTS) they often think of hand pain, tingling and numbness, grip weakness, excessive typing, life-long injury, and surgery. Perhaps, CTS has gotten such a bad rap because it is one of the most expensive work related injuries over a lifetime, costing an individual nearly $30,000 in medical bills. Not only is the cost of treating CTS burdensome, its effect on an individual’s ability to perform day to day activities, and job productivity, can weigh heavily on one’s spirit.
While it is true that carpal tunnel syndrome can ultimately result in surgical intervention, it is important to exhaust all conservative treatments first. The first step in treating CTS is to confirm that it is in fact the appropriate diagnosis, and not some other injury or illness with similar symptoms. While mechanical CTS often results from trauma to the wrist, or repetitive stress activities, such as typing with poor ergonomics, working on an assembly line, cleaning, working with hand tools, and sewing/knitting, there are other conditions that mimic CTS, as well. These conditions include hypothyroidism, diabetes, inflammatory arthritis, over-activity of the pituitary gland, and swelling with pregnancy. If these conditions are suspected, simple laboratory and blood tests may be ordered.
While other advanced tests, such as a nerve-conduction velocity study, can be performed, your doctor of chiropractic can often diagnose CTS based on a thorough history and standard physical examination. While CTS can occur in almost anyone, it is three times more prevalent in women. Symptoms usually occur in the dominant hand first, and include burning, tingling, and numbness into the thumb, index, and middle fingers. Symptoms often originate at night, as most individuals tend to sleep with their wrist in a flexed position. This position compresses the median nerve, which originates from the lower neck, traverses down the arm, and enters through the carpal tunnel into the hand. As CTS progresses, grip strength may become reduced, the muscles at the base of thumb shrink, and pain may begin to radiate upward along the path of the nerve. It is because of this that your doctor of chiropractic will not only examine your hands/wrists, but your arms, shoulder, and neck as well.
In the event that you are diagnosed with CTS, it is important to initiate treatment sooner rather than later. Your doctor of chiropractic will likely adjust and/or mobilize the joints of the wrist and hand, as well as the elbow, shoulder, or neck if found to be involved during examination. Typically, stretches and exercises will also be given to aid in removal of inflammation from the area. To assist in maintaining an open carpal tunnel at night, your doctor of chiropractic may also suggest wearing a cock-up splint. This splint will hold the wrist in 15 degrees of extension, the position in which the tunnel is most unobstructed.
Nutritionally, both vitamin B6 and magnesium have been shown to improve nerve function, and reduce symptoms associated with CTS. When dealing with any type of injury, it is also essential to apply ice to the involved area and increase water intake. Water will not only facilitate the removal of inflammation, but helps to maintain proper muscle tone.
Those looking to avoid carpal tunnel syndrome should consider performing on-the-job stretches and exercises, taking frequent breaks from repetitious activities, altering between varying tasks, and utilizing proper ergonomics (e.g. not resting your arm on the edge of the desk while using the mouse).