Understanding CTS
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What Are The Causes Of Carpal Tunnel Syndrome?
There are eight bones found in your wrist that form a U-shaped channel that houses several tendons and your median nerve. This channel is known as the carpal tunnel. Your median nerve is responsible for your feeling and your sensation on the palm side of your first 3½ fingers.
Compression or irritation of this nerve as it travels through the carpal tunnel is responsible for the creation of a condition known as Carpal Tunnel Syndrome (CTS). Carpal tunnel syndrome is currently the most common nerve entrapment condition, affecting 3–5% of the general population. Females are affected roughly up to three times more often than males. CTS most often affects adults between the ages of 45 and 60.
Risk Factors Of CTS
CTS can be caused by prolonged wrist flexion and/or repetitive wrist motions like supermarket scanning, keyboard use, carpentry or assembly line work. Exposure to vibration or cold is also known to aggravate the condition or worsen it.
Carpal Tunnel Syndrome is more common in your dominant hand, though bilateral carpal tunnel syndrome, affecting both hands, is also frequently seen. Some risk factors for developing CTS include diabetes, thyroid disease, rheumatoid arthritis, alcoholism, kidney disease, or being overweight. Fluid retention during pregnancy is also a common cause of carpal tunnel symptoms.
What Are The Symptoms Of Carpal Tunnel Syndrome?
Symptoms of CTS include numbness, tingling or discomfort on the palm side of your thumb, index, middle finger and half of your ring finger. This carpal tunnel wrist pain and discomfort can also sometimes extend towards your elbow. The symptoms you experience usually start as nighttime discomfort or waking up with numb hands, but can rapidly progress to a constant annoyance.
Your symptoms are likely aggravated by gripping activities such as holding a book while reading, driving or painting. Early on, your symptoms may be reduced by simply "shaking your hands out." You may sometimes feel as though your hands are tight or swollen. In more severe cases, hand weakness can form.
Two conditions that are often misdiagnosed as carpal tunnel syndrome are thoracic outlet syndrome and cubital tunnel syndrome. Both can produce similar tingling and numbness in the hand and arm. An accurate diagnosis is essential before beginning any carpal tunnel syndrome treatment.
How Is Carpal Tunnel Syndrome Diagnosed?
A thorough clinical assessment is the first step toward effective carpal tunnel syndrome treatment. Common carpal tunnel syndrome tests include the Phalen's Test, where you flex your wrist for 60 seconds to see if symptoms reproduce, and Tinel's Sign, where tapping over the carpal tunnel provokes tingling. A chiropractor can perform these tests in-office and determine whether your symptoms are truly coming from the wrist or from a compressed structure higher up in the neck or shoulder.
How To Treat CTS
Compression of the median nerve found in the carpal tunnel is often accompanied by compression at a second or third site as well. Researchers call this "double crush syndrome." Common "double crush" partners for CTS also involve the spine or muscles in and around your neck, shoulder and forearm.
To help resolve your condition, you should do your best to avoid activities that involve repetitive wrist flexion, i.e. pushups. Grasping the handlebars on your bicycle will likely increase irritation of your condition. We may prescribe a special splint that keeps your wrist in a neutral or slightly extended position that will help with your nighttime symptoms. Carpal tunnel syndrome exercises targeting wrist mobility and nerve gliding can also play an important role in recovery and are often prescribed as part of your care plan.
Chiropractic Treatment for Carpal Tunnel Syndrome
Chiropractic care offers a conservative, non-surgical approach to carpal tunnel syndrome treatment. Our treatment may include joint manipulation of the wrist, elbow and cervical spine, soft tissue therapy, nerve gliding exercises, and activity modification guidance. By addressing compression at multiple sites, including the "double crush" contributors in the neck and shoulder, chiropractic treatment for carpal tunnel aims to reduce symptoms at the source rather than masking them.
Recovering From CTS
If left untreated, carpal tunnel syndrome can cause your forearm to sustain permanent nerve damage. The American Academy of Neurology recommends conservative treatment for carpal tunnel syndrome, like the type provided in our office, before going down the surgical route. Avoiding carpal tunnel syndrome surgery is a common goal for our patients, and conservative chiropractic care has helped many return to pain-free daily activity without going under the knife.
Frequently Asked Questions
Thoracic outlet syndrome and cubital tunnel syndrome are two conditions commonly misdiagnosed as carpal tunnel syndrome. Both produce similar symptoms like hand numbness and tingling, which is why an accurate diagnosis is critical before starting any treatment plan.
Recovery time varies depending on the severity of nerve compression and how long symptoms have been present. Mild to moderate cases often see improvement within 4–8 weeks of conservative care. Your chiropractor will reassess your progress regularly and adjust your treatment plan accordingly.
Double crush syndrome occurs when the median nerve is compressed at two or more locations simultaneously, commonly at the wrist and somewhere along the neck, shoulder, or forearm. This is why treating only the wrist sometimes fails to fully resolve symptoms. A thorough chiropractic assessment looks at the entire nerve pathway, not just the carpal tunnel itself.
