Carpal Tunnel Syndrome

Symptoms by body part:

Lateral Hand/Carpal
Acute Pain
Medial Hand/Carpal
Acute Pain

Carpal tunnel syndrome is a condition in which the median nerve is compressed at the wrist in the area known as the carpal tunnel. The carpal tunnel is a passageway formed in the wrist located between the carpal bones and the overlying transverse carpal ligament (called the flexor retinaculum). The tendons for the flexor muscles of the hand also travel through this opening. The median nerve supplies innervation to the palmar surface of the thumb and into the 2nd, 3rd and half of the 4th digits and the fingertips.

What causes it?

Carpal tunnel syndrome is typically caused by repetitive use/motion of the wrists and hands, trauma, restrictions in the joints due to abnormal angulation, increased muscular tone in the upper body, or by increased fluid levels in the body (such as with pregnancy) which increase the pressure in the small space in the wrist, compressing the median nerve.

A number of factors can cause this to occur, these include:

  • Posture
    • internally rotated shoulder
    • increased flexion and internal rotation of the elbow
    • increased flexion at the wrist
  • Cervical spine contributions (median nerve roots)
  • Upper thoracic spine/rib restrictions (first rib compression region where brachial plexus exits to supply the upper extremity)
  • Brain hemisphericity which creates abnormal muscular patterns leading to increased tone in the flexor muscle groups of the upper extremity

Common symptoms of carpal tunnel syndrome:

  • Pain in wrist, hand or forearm that can wake you up at night
  • Tingling/numbness in hand (in the area of the thumb pad, thumb, index, middle and half of the ring finger)
  • Muscle weakness in the thumb, and first three fingers
  • Muscle wasting (a decrease in the prominence of the pad of the hand)
  • Associated shoulder painAssociated neck pain

How can we treat it?

Once we determine the source of the symptoms via a thorough examination we can treat your particular condition appropriately. First and foremost it is important to address all involved joints and muscles in order to remove the compression on the median nerve and allow for the body to regain normal function. Treatment usually consists of chiropractic adjustments to increase motion in the affected joints, neuromuscular re-education, myofascial mobilization techniques, electrical muscle stimulation, cold laser therapy, home stretches and strengthening exercises. If a brain hemisphericity (an imbalance in the brain’s firing) is the cause of your symptoms treatment will consist of a variety of both musculoskeletal and neurological rehabilitation in order to appropriately upregulate the frequency of firing in the affected region to properly control muscle tone and joint biomechanics.