imagesVMU3U24WCarpal Tunnel Syndrome is a painful condition that affects a specific nerve in the hand and wrist called the median nerve. The carpal tunnel is a narrow passageway formed by the carpal bones of the wrist and an overlying ligament. The median nerve and nine tendons pass through the tunnel and are often irritated by repetitive hand and wrist movements, such as working at a computer, assembly line, or with power tools. This irritation results in pressure on the median nerve, excessive inflammation and painful symptoms. People often describe the pain and numbness to be so intense that it wakes them up at night. The first symptoms of carpal tunnel syndrome often involve numbness, tingling or burning typically in the thumb, index finger, middle finger and half of the ring finger. Shooting pain in your wrist or forearm may follow, and your grip may become weak. 

Diagnosis of carpal tunnel is usually determined through a history/consultation, clinical findings and electrodiagnostic nerve testing.  Numbness in the distribution of the median nerve, symptoms that occur at night, loss of muscle mass around the thumb and an inability to discriminate between two points around the hand, are the standard clinical diagnostic criteria. 

Carpal tunnel syndrome can be misdiagnosed. It is important to remember that not all painful sensations in the hand, wrist, or forearm are carpal tunnel syndrome. Joint and muscle problems in the forearm, shoulder and/or neck can mimic carpal tunnel syndrome and lead to inappropriate treatment such as surgery. A thorough examination is critical in order to properly diagnose carpal tunnel syndrome.  Oftentimes, a combination of factors contributes to the pain and discomfort that may appear to be carpal tunnel syndrome.

Predisposing factors to carpal tunnel syndrome include fluid retention, rheumatoid arthritis, fractures, obesity, diabetes, pregnancy and hypothyroidism. Hobbies such as gardening, needlework, golfing and canoeing can sometimes bring on the symptoms. Women are more likely to develop carpal tunnel syndrome than men and it also tends to be hereditary. 

There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on your hands and wrists by taking the following precautions: Take frequent breaks. Give your hands and wrists a break by gently stretching and bending them periodically. Keep your wrists straight when using tools and avoid flexing and extending your wrists repeatedly. A relaxed middle position is best. If you use a keyboard, keep it at elbow height. Improve your posture while at work and remember to sleep with your wrists straight.

If you develop carpal tunnel syndrome, conservative treatment consists of chiropractic adjustments to the wrist, stretching of specific muscles, exercises to stretch the median nerve and wrist splinting while you sleep. NSAIDs, such as ibuprofen or tylenol,  may help relieve pain from carpal tunnel syndrome in the short term, but are not recommended for continued use.
Corticosteroids injections may be utilized to decrease inflammation and pain during conservative treatment. If your symptoms are severe or persist after trying nonsurgical therapy, endoscopic surgery may be the most appropriate option. 

Middle Tennessee Chiropractic and Sports Injury utilizes chiropractic care, nutrition and functional rehabilitation exercises to help patients conquer pain and enjoy healthier lives.

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