What is Carpal Tunnel Syndrome?
The carpal tunnel is formed by the 8 bones in your wrist called your carpals and the fibrous fascial connection which support them. This connection creates a tunnel between the fibrous tissue and carpals which allows the median nerve and forearm tendons to run through. When the nerve is compressed or the tunnel shrinks, it can cause neurological symptoms in the hand.
Hand or wrist pain that is worse at night
Numbness, tingling, burning, or pain into the 3-4 fingers on the thumb side
Weakness in grip strength or pinch strength
Difficulty opening jars or turning door handles
Symptoms provoked from computer work or driving
The most common reasons for carpal tunnel include repetitive flexion and extension activities that lead to inflammation in the tendons which decrease the nerve’s space. Various types of arthritis, pregnancy, physical trauma, diabetes, lupus, and space occupying legions are also all causes. Women in their 40’s and 50’s tend to have a higher incidence and it can manifest unilaterally or bilaterally.
How can chiropractors help?
Diagnosing carpal tunnel and ruling out other areas of nerve entrapment is the first step in chiropractic care. Cervical radiculopathies or thoracic outlet compressions can also mimic hand neuropathy symptoms. The median nerve can be entrapped in other areas throughout your arm such as the pronator teres, ligament of struthers, or the biceps aponeurosis. Once Chiropractors ruled out other areas of entrapment, they will include a variety of adjustments to the carpal bones as some may be subluxated and compressing the nerve. Soft tissue modalities such as Active Release Technique (ART) and Graston can be used on the flexor tendons, flexor muscles, and flexor retinaculum to decrease the tension and hypertonicity.
Nerve gliding exercises are also a great way to mobilize the nerve for efficient gliding through the tunnel. Your chiropractor may recommend a wrist brace for support and activity modifications to reduce flareups. If symptoms do not improve, going to your general practitioner and discussing surgical options are the next step.