Carpal Tunnel Syndrome occurs when the median nerve is pinched or inflamed at the wrist. The carpal tunnel is at the base of the palm of your hand and is made of bones, tendons, and a thick ligament that surround the median nerve. The pinching or irritation of the median nerve can cause pain, numbness or tingling in the fingers.

The tunnel where the nerve passes into the hand is small and any thing that can cause a decrease in this tunnel can irritate the nerve. The carpal tunnel can be compressed or pinched during by repetitive activities like typing, hammering, or throwing. It is believed that the repetitive action at the wrist joint causes irritation of the nerve. The nerve can also be impinged upon or irritated after a wrist fracture, dislocated joint or ligament injury. Pregnancy, obesity, arthritis and hypothyroidism are other common causes of carpal tunnel syndrome.

CTS is the most commonly occurs in females in the age groups of 30-50. A significant number of women develop carpal tunnel nerve problem during pregnancy. Other individuals more prone to carpal tunnel syndrome include golfers, secretaries, carpenters, and weightlifters. Current data indicate that carpal tunnel is an important cause of missed work and long term disability.

CTS usually presents with pain in the thumb, middle and index fingers. Besides pain, some individuals complain of numbness, tingling and loss of strength in the wrist injuries have a range of similar symptoms including pain, numbness, a tingling sensation, and loss of grip strength. The symptoms are most frequent when the wrist/hand is in use. Occasionally the pain will come on at night. In long term cases, the muscles of the hand waste away from lack of use. In the majority of cases, only one wrist is affected but bilateral involvement is not unheard of.

The diagnosis of carpal tunnel syndrome is made by a combination of a physical examination, wrist x rays and nerve conduction studies. X rays of the wrist are done to make sure there is no mass/bone fragment impinging on the nerve. During the physical exam, maneuvers can help make a diagnosis of carpal tunnel syndrome. The diagnosis is almost always confirmed by nerve studies which help locate the site of the irritation/impingement.

CTS is a painful disorder and quite debilitating. The earlier it is treated, the shorter is the time to recovery.

The initial treatment of Carpal tunnel syndrome is always with the use of splints, which support the wrist and stabilize the joint. This helps the nerve irritation and reduces the symptoms. It is highly recommended that individuals wear the splint at night. For those who continue to work, the splint must be worn during the day. Over the counter anti inflammatory drugs may be required to help control the pain and nerve inflammation.

When carpal tunnel syndrome is more advanced, injection of steroids into the wrist to decrease inflammation may be necessary.

When the pain has subsided with the use of splints, various chiropractic manipulations have been shown to be an effective method of carpal tunnel treatment. These manipulations are done several times on a weekly basis and continue for 5-6 weeks.

Chiropractic joint manipulation and mobilization of the wrist and hand, stretching and strengthening exercises, soft-tissue mobilization techniques, acupuncture and even stress relief with yoga can be helpful.

Surgery is recommended when all conservative methods to control the symptoms fail. The surgeon releases the ligament covering the carpal tunnel. The majority of patients recover completely after treatment, and the recurrence rate is low. Proper posture and movement as instructed by your doctor of chiropractic can help prevent CTS recurrences.

Without treatment, continued irritation and pressure on the median nerve results in ongoing symptoms and the affected hand will be disabled. Conservative management helps more than 50-60% of patients with a relief of symptoms. For those who undergo surgery, the majority will become asymptomatic in no time and recurrences are rare.

To prevent the onset of carpal tunnel syndrome, one should be aware of repetitive motions at the wrist and limit these movements. Whenever possible, the wrist should be relaxed at work and placed in a neutral position if one is working on a key board. For those whose work requires repetitive motion, early wearing of a splint is highly recommended.