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Introduction

Carpal Tunnel Syndrome is the most well-known nerve entrapment disorder. As the name implies, these conditions occur 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. Wrist bones form the bottom and sides of the tunnel, while the top is shaped by the transverse carpal ligament, a robust band of connective tissue. The diameter of the carpal tunnel is about the same as the index finger making the carpal tunnel a jam-packed space. The flexor tendons, arteries and median nerve are intended to glide smoothly past each other during wrist and finger movement.

If the tendon size increases from inflammation or hypertrophy (growth), or if the carpal tunnel size shrinks because of  a misalignment of the carpal bones, the median nerve can become constricted or entrapped by the carpal tunnel. At first, carpal tunnel symptoms generally include, pain, numbness, pins and needles, and tinging in the fingers and hand, particularly the thumb and adjacent two fingers.  The symptoms are markedly apparent at night, often awakening the sufferer from sleep and making it necessary for the person to “shake out” or rub the hands in an attempt to relieve the unpleasant sensations.  In addition, activity can cause the hands to feel awkward or weak, and fatigue easily. Eventually, gripping small objects using the thumb and fingers can be gravely affected and, without treatment, can result in complete debilitation of the hand.

The following are general 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 can be a contributing factor to Carpal Tunnel Syndrome, in many cases the cause is unknown. Nevertheless, those who work with equipment that vibrates and/or perform their jobs in extreme temperatures often develop carpal tunnel symptoms.  Even household activities as simple as repetitive wringing clothes by hand can help cause this syndrome. By far the most significant reason for the increase of people suffering with CTS is the continuous rise in the use of computers. This is becoming a major concern in the developed world where people of all ages are spending much of their time typing on a keyboard & clicking on a mouse.

Treatment

Competent diagnosis and treatment is vital to relieving the painful and debilitating symptoms of CTS. Your chiropractor is highly skilled in the diagnosis and managment of CTS. Chiropractors are well-trained in treating CTS.  Treatment by chiropractor can include ultrasound or low level laser to help reduce inflammation, electro therapy to strengthen weak muscles of the forearm, soft tissue massage to stretch contracted tissues and, of course, adjustments of the dysfunctional joints of the wrist. Your chiropractor may suggest that you wear a splint or support, especially at night, to aid in the decompression of the carpal tunnel. Your chiropractor will also give you specific exercises to stretch and/or strengthen muscles of the forearm and hand.

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