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. Along with 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. Also within the tunnel are arteries and lymphatic vessels that deliver circulation to the hand. 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 carpal tunnel is a densely-packed space about the size of an index finger. The flexor tendons, arteries and median nerve are designed to glide easily past each other during wrist and finger movement.

If the tendon size increases from inflammation or hypertrophy (growth), or if the carpal tunnel size dimenishes because of  a mechanical dysfunction of the carpal bones, the median nerve can become squeezed or entrapped by the carpal tunnel. The initial symptoms of carpal tunnel syndrome commonly include pain, numbness, paraesthesia (pins and needles) and tingling in the fingers and hands especially the thumb and adjacent two fingers.  These symptoms are especially noticeable in the night and often wake people from their sleep as the individual has to sit up in bed and shake-out and/or rub the hands in order decrease these unpleasant feelings.  In addition, activity can cause the hands to feel clumsy or weak, and fatigue easily. Over time, the ability to hold small objects using the thumb and fingers can be affected dangerously and if left untreated, can lead to total dysfunction 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 make one susceptible to Carpal Tunnel Syndrome, in many cases the cause is unknown. However, people who perform jobs that require use of vibration tools and machinery, and/or work in extreme temperatures are often subjected to this condition.  In addition, repetitive housework as seemingly inconsequential as wringing clothes by hand, can bring on carpal tunnel symptoms. By far the most significant reason for the increase of people suffering with CTS is the continuous rise in the use of computers. The repetitive motions of typing on the keyboard and moving the mouse over extended periods of time is a primary indicator for many people with CTS.

Treatment

Competent diagnosis and treatment is vital to relieving the painful and debilitating symptoms of CTS. Your Chiago Chiropractor is highly skilled in the diagnosis and managment of CTS. Chiropractors are well-trained in treating CTS.  In addition to chiropractic adjustments of the wrist joints, treatment by chiropractor may include inflammation reduction therapy such as ultrasound or low level laser. Electromusclestim can often help to strengthen the weak muscles of the forearm and soft tissue massage is effective in stretching contracted tissues. Your chiropractor may suggest that you wear a splint or support, particularly at night, to aid in the decompression of the carpal tunnel. Your Chicago Chiropractor will also give you specific exercises to stretch and/or strengthen muscles of the forearm and hand.

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