You have pain in your wrist. Its been like this for a while, but you ignore it and hope it just goes away. It gets worse when you hold the computer mouse at work. Your thumb and index finger have been going numb lately and you almost dropped your coffee cup again this morning! The pain keeps waking you up at night and it?s starting to make its way up your arm. And why do you have that neck pain and tension across the top of your shoulders? Could you have carpal tunnel syndrome?
Carpal tunnel syndrome (CTS) is the most common injury suffered by office workers. In fact, ?disorders associated with repeated trauma account for about 60 percent of all occupational illnesses, ? according to the Bureau of Labor Statistics. Of all these disorders, carpal tunnel syndrome is the condition most frequently reported. If you work in an office environment, most likely you know at least one person who has or has had carpal tunnel syndrome. But what, exactly, is carpal tunnel syndrome? What causes CTS? And what are some of your treatment options, besides surgery?
?Carpos? is a Greek word, which means ?wrist?. It is from this word that we derive the word ?carpus? or ?carpal?. Thus, the carpal bones are eight individually moving bones that make up the wrist. These bones are supported by a fibrous band of connective tissue called the transverse carpal ligament. The carpal ?tunnel? is created by the binding together of these structures, which surround and protect the median nerve as it passes from the arm to the hand. Irritation of the median nerve causes any combination of pain, tingling, numbness, or weakness of the wrist, thumb, index finger, or middle finger. Those of you who experience these symptoms know how debilitating they can be. My patients have told me that it reduces their work productivity, keeps them up at night, and even causes them to drop things (like their coffee cup, heaven forbid!). How, then, does the median nerve become irritated? We will explore two of the most common causes.
The eight carpal bones of the wrist are designed to move individually. One or more of these joints can become stuck like a couple of suction cups when they are injured. This is usually due to repetitive stress which occurs during such activities as typing and using a computer mouse for prolonged periods. When the joints get stuck, it causes irritation to the joint surfaces (a.k.a. arthritis) and the surrounding soft tissues become inflammed and swollen. Its this swelling that infiltrates the tight space of the carpal tunnel and causes compression and irritation of the median nerve. So, it makes logical sense that if we restore normal motion to the joints of the wrist, then the swelling will decrease in the carpal tunnel, the pressure on the medial nerve will be relieved, and the symptoms will be resolved.
Chiropractic research is proving this to be the case. One study published in the journal Manual Therapy (by Tal-Akabi A, Rushton A., 2000 Nov; 5(4):214-22, Bern Switzerland) shows that, on average, chronic carpal tunnel syndrome patients get 70% improvement in their symptoms after undergoing three weeks of specific wrist manipulation. This study also demonstrated that only 14% of the group who received manipulative therapy, went on to have their scheduled surgery, whereas 86% of the control group (the group that did not receive any manipulative treatment) went on to have their scheduled surgery. Thus, while a small percent of patients may still need surgery, it makes sense to try less painful, much safer, and very effective conservative treatment, like specific wrist manipulation, before making the trip to the surgeon.
But, that isn?t the whole story. The nerves that exit between the joints of the lower region of the neck and upper back control all of the functions of the shoulders, arms, wrists, and fingers. Where these nerves exit between the neck bones is the first place that there can be interference between the brain?s communications with the arms. Like vines that form smaller branches, these spinal nerves extend through the arms to the wrist and hand, one of which becomes the median nerve. It is vitally important that we trace any form of interference back to its source, usually at the spine; otherwise results from any form of treatment will only be temporary. Like the wrist bones, the spinal joints also need to move individually. Otherwise, inflammation and swelling of the soft tissues around the joint can cause pinching, choking, or irritation of the spinal nerves, which can cause pain, numbness, tingling, or weakness anywhere along the branches of the shoulder, arm, wrist, or hand. That is why it is so important to have your neck examined and treated, as well as your wrist.
Chiropractors are doctors who specialize in the restoration of normal joint motion, most commonly in the spine. Some chiropractors also perform specific manipulation of the extremities, such as the shoulders, elbows, wrists, and fingers. To treat carpal tunnel syndrome most effectively, I suggest you find a chiropractor who manipulates extremities as well as the spine. Also, ask your potential chiropractor if they perform exercise therapy, utilize therapeutic modalities such as electric muscle stimulation and cervical traction, and prescribe nutritional supplements to help treat your condition. In my experience, a well-rounded approach will give you the best chance of faster, longer lasting relief.
Dr. Dana Williamson is a specialist in natural treatment solutions for the relief of carpal tunnel syndrome. He has been practicing at his Chiropractic Centers of Virginia | Richmond and Mechanicsville offices since 2001. He graduated from Palmer College of Chiropractic in Davenport, Iowa and is a long standing member of the Virginia Chiropractic Association.
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