Carpal Tunnel Syndrome

Have you ever had pain or numbness/tingling in the hand which are worse at night so that you shake your hand in the morning to relieve the pain? Do you have weakness in the hand or clumsy when opening jam jars or trying to grip the steering wheel? Carpal tunnel syndrome has its name from its anatomical location. There is a nerve compression of the median nerve as it runs through a “tunnel” created by the transverse carpal ligament and the carpal (wrist) bones.

Carpal Tunnel Syndrome is a condition where the median nerve which travels through the wrist is being compressed, causing pain and numbness in the hand. The median nerve, or carpal tunnel, contains a bundle of tendons that control finger movement. Carpal Tunnel Syndrome stems from prolonged repetitive use of this nerve.

The compression present in carpal tunnel syndrome (or ‘pinched nerve’) does not always occur at the wrist. A pair of nerve roots emerges from the spinal cord at each vertebral level of the spine and the median nerve is formed by several nerve roots emerging from the lower neck. From there, the median nerve travels down the arm to the wrist and hand and can become entrapped anywhere along its path.

It is important to remember that not all wrist pain is attributable to Carpal Tunnel Syndrome. Symptoms of Carpal Tunnel Syndrome such as shooting pain, weakness and tingling may also be the result of subluxations in the neck, nerve entrapment in the elbow or a previous autoimmune injury. Thorough examination by a chiropractor can determine whether your wrist pain is due to Carpal Tunnel Syndrome or another musculoskeletal condition.

Symptoms:

There are many identifiable symptoms of Carpal Tunnel Syndrome. Most carpal tunnel symptoms most often affect the hand particularly the thumb and first two fingers but they can spread with shooting pain through the forearm and shoulder. This pain is most often at its worst in the evening. Symptoms include:

• Numbness or pain in your hand, forearm, or wrist that awakens you at night. (Shaking or moving your fingers may ease this numbness and pain.
• Occasional tingling, numbness, “pins-and-needles” sensation, or pain. The feeling is similar to your hand “falling asleep.”
• Numbness or pain that gets worse while you are using your hand or wrist. You are most likely to feel it when you grip an object with your hand or bend (flex) your wrist.
• Occasional aching pain in your forearm between your elbow and wrist.
• Stiffness in your fingers when you get up in the morning.
• With moderate or severe carpal tunnel symptoms, you may have numbness or reduced strength and grip in your fingers, thumb, or hand. It may be hard to:
• Simple hand movements, such as brushing your hair or holding a fork. You may accidentally drop objects.
• Pinch an object between your thumb and first finger. (This is called loss of pinch strength.)
• Use your thumb while doing simple tasks such as opening a jar or using a screwdriver. With long-term carpal tunnel syndrome, the thumb muscles can get smaller and weaker (atrophy).

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is caused by compression of the nerve that controls sensation and movement in the hands (median nerve) and it’s most commonly developed in people aged 40-60, particularly women.

It isn’t known why the median nerve becomes compressed in most cases, although certain things are thought to increase the risk of Carpal tunnel syndrome, such as:

• Strenuous, repetitive using the wrist in full flexion and extension such as keyboard typing
• a family history of Carpal tunnel syndrome
• Fluid retention in pregnancy – up to about 50% of pregnant women develop Carpal tunnel syndrome
• injuries to the wrist
• other health conditions, such as diabetes and rheumatoid arthritis
• Certain lifestyle factors such as cigarette smoking and high caffeine and alcohol use

AmeriCare Pain & Rehab Center Can Help

There are many helpful Carpal Tunnel Syndrome remedies. While some medical professionals suggest surgery to remove the pressure on the nerves, more conservative and less invasive and painful options are available. Treatment at AmeriCare Pain & Rehab Center may involve joint manipulation or mobilization, massage, stretching, trigger point therapy, splinting, rehabilitative exercises, ice and heat.

Sometimes specific stretching exercises are used to allow more flexibility of the wrist. Your wrist joints, and the muscles that move the hand, are integrally linked. Disturbance in one system will over time affect the other area. When you have pain, you tend to move your wrist much less.

Some patients even use braces and splints to reduce movement almost completely. While this can be necessary for a few patients in the short term, over time it just makes the muscles inflexible and progressively weaker. This can lead to a vicious cycle producing even greater pain, which makes you move less. This cycle needs to be broken in order to regain function of the wrist again.

It is important to mobilize the joints of the wrist and stretch the shortened muscles. It is also important to have a correct diagnosis before beginning treatment.

At AmeriCare Pain & Rehab Center, we monitor the progress of any splinting, and recommend alternative treatments if splinting is not the preferred option. Behavior modification may be necessary, and advice can be given by the doctor as to how to implement changes in your work and daily life. Paying attention to proper ergonomic principles and posture can also help overcome Carpal Tunnel Syndrome.

Looking at your carpal tunnel symptoms in a comprehensive way can address many of the quality of life symptoms. Just covering up the pain with medications and not using your wrist anymore doesn’t really seem practical. Taking large amounts of pain and anti-inflammation drugs (NSAIDs) can cause undesirable side effects. Stomach bleeding and irritation occurs in too many patients. In rare cases kidney and liver problems can develop.

We can diagnose the cause of your carpal tunnel symptoms. The examination may include x-rays the rule out certain diseases and to check the alignment of the wrist bones and neck vertebrae. Sometimes it’s the wrist that needs to be mobilized, and in other cases the neck is more the cause of the problem. With adjunctive manual techniques such as exercise, stretching, and deep tissue work, this combined approach can provide relief for many sufferers with this difficult problem.

So, if you think you may be suffering from Carpal Tunnel Syndrome call us at:

713-22-Ameri (222-6374)

to schedule an appointment. At AmeriCare Pain & Rehab Center we are dedicated to getting you out of pain and back to feeling good again. Most forms of insurance accepted.