Carpal Tunnel Syndrome… In a Nutshell

Here it is: carpal tunnel syndrome (CTS) in a nutshell!

WHAT: CTS is caused by an injury to the median nerve (MN) as it travels through the wrist.

WHERE: The eight small carpal bones and a ligament form a tunnel in which tendons and nerves pass through to reach the hand.

HOW: The MN gets pinched/irritated from repetitive stress.

WHY: The tunnel is tight as it includes the MN and nine rapidly moving muscle tendons!

PROGRESS: CTS usually starts slow and often progresses over weeks, months, even years.

SYMPTOMS: Pain, numbness, tingling, and/or weakness of the hand, sparing the little finger.

PROGNOSIS: CTS is easier to treat shortly after it starts, and waiting too long to seek care may lead to worse outcomes.

RISK FACTORS: 1) family history (genetics); 2) women are more likely to suffer from CTS than men; 3) age over 50; 4) manual jobs; 5) pregnancy; 6) conditions like diabetes, hypothyroid, rheumatoid arthritis (RA), osteoarthritis, autoimmune diseases (includes RA, certain types of thyroid disease), gout, kidney disease (especially dialysis patients), Down syndrome, amyloidosis, acromegaly, tumors on the median nerve; 7) medications (those that affect the immune system such as interleukin-2, possibly corticosteroids), anti-clotting drugs such as warfarin, hormone replacement, BCPs; 8) obesity; 9) smoking; 10) alcohol abuse; and 11) trauma/injuries (fractures, tendonitis).

TREATMENT: Ideally, treatment should begin as soon as possible after symptoms first start, but this RARELY occurs due its slow and gradual onset. Non-surgical care includes anti-inflammatory care (ice, anti-inflammatory nutrients—ginger, turmeric, bioflavonoids; NSAIDs like ibuprofen), wrist splinting (primarily at night), corticosteroid injections, job/ergonomic modifications, exercises (yoga, stretching, strengthening, and aerobic fitness), low level laser therapy, ice, acupuncture, and chiropractic care. Chiropractic care includes MANY of the above PLUS manual therapies applied to the neck, shoulder, arm, wrist, and hand.