Carpal tunnel syndrome is caused by compression of the median nerve at the wrist as it passes through the carpal tunnel, a narrow passageway at the base of the hand. Symptoms of carpal tunnel syndrome can vary from intermittent numbness and tingling in the first three to four digits of the hand; sharp electrical pain possibly accompanied by weakness; and loss of dexterity in the forearm and hand. Fine motor control may be affected — individuals may have difficulty putting on jewelry and closing buttons.
Carpal tunnel syndrome is usually caused by repetitive motions involving the fingers, wrists and forearms. It affects three times as many women as men. There may be a genetic predisposition for this condition. It more often afflicts those with diabetes and thyroid conditions.
Treatment outcome improves with the early recognition and diagnosis of carpal tunnel syndrome. One of the most common signs is numbness and tingling of the hands that resolve upon awaking. This feeling is often relieved by shaking your hands out. Diagnosis of carpal tunnel can be established with a thorough exam by your chiropractic physician. The severity of carpal tunnel condition can be established by electrodiagnostic tests including nerve conduction velocity and EMG.
Common medical treatment for this includes cortisone injections and surgery. However, the benefits of these treatments are short-lived if no modification to ergonomics or lifestyle is made. Injections and surgery can be avoided and long-term relief can be achieved if conservative treatment is tried first.
Conservative treatment includes ergonomic modification of workstation. For jobs that require long periods of desk work, elbow angle needs to be addressed by adjusting chair and desk height. Chair height should be adjusted so that the thigh is parallel to the floor. These adjustments should allow individuals to flex their elbows at 90 degrees with the shoulders in a relaxed, non-elevated position. Wrist support when using the keyboard and mouse.
Other treatments to continue with activity and ergonomic modification include:
- Vitamin B6 therapy
- Splinting of wrist(s)
- Chiropractic wrist manipulation
- Myofascial release to relax tight muscles in the forearms, wrists and hands.
- Therapeutic exercises to stretch the ligaments that create the ceiling of the carpal tunnel
- Ultrasound therapy
- Kinesio taping
- Anti-inflammatory supplements (Omega 3’s, enzymes, boswellia, turmeric)
When these therapies are used, particularly in the early stages of the disease process there is a very low risk that further or more aggressive treatments will be required. If you find yourself with symptoms of Carpal Tunnel Syndrome remember that early treatment is key to avoiding aggressive treatments later.