The pain in your wrist has been there for a while. It?s worse at work when you are holding the computer mouse. Your thumb and first finger have been going numb more often. The pain keeps waking you up at night and it is starting to go up your arm. To top it off, you almost dropped your coffee cup again this morning! And what is with that neck pain and tension that is always across the top of your shoulders? You could have carpal tunnel syndrome.
Carpal tunnel syndrome (CTS) is the most common injury suffered by workers in an office environment. According to the Bureau of Labor Statistics, ?disorders associated with repeated trauma account for about 60 percent of all occupational illnesses.? Of all these disorders, carpal tunnel syndrome is the condition most frequently reported. What, exactly, is carpal tunnel syndrome? What are the causes and what are some effective treatment options? Are there any options besides surgery?
The word ?carpus? is derived from the Greek word ?carpos?, which means ?wrist?. Eight individually moving bones, called the carpals, are what make up the wrist. These carpal bones are surrounded by a fibrous band of tissue, called the transverse carpal ligament, which binds them together and supports them. A tunnel is formed by these structures, which the median nerve passes through. When the median nerve gets irritated, it can cause pain, tingling, numbness and weakness of the wrist, index and middle fingers, and the thumb. Some of you may already know how debilitating this condition can be. I have heard some of my patients mention how their productivity at work is reduced, how the pain keeps them awake at night, and how the weakness in their hands will even cause them to drop things like their coffee cup (heaven forbid!). So, if the carpal tunnel is supposed to protect the median nerve, then how does it get irritated? We will explore two of the most common reasons.
Each of the eight carpal bones is designed to move individually. When they are injured, these joints can become stuck, like suction cups. Repetitive stress injuries of the wrist, which occur during activities such as use of a computer mouse or typing for prolonged periods, are the most common in the office environment. When the joints don?t move as they should, friction causes the joint surfaces to become irritated (a.k.a. arthritis) and the tissues that surround the joints become swollen and inflammed. The swelling that encroaches into the tight space of the carpal tunnel is what causes compression and irritation of the median nerve. Therefore, we can assume that if we restore normal motion to the joints of the wrist, then the swelling and inflammation will be reduces, the nerve will be decompressed, and the symptoms will be relieved.
This is being proven to be the case by Chiropractic research. A 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, following three weeks of specific wrist manipulation, a 70% improvement in symptoms was achieved in the chronic carpal tunnel syndrome patients who were studied. It 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. Therefore, while a small percent of patients may still need surgery, it makes sense to try much safer, more effective, and less painful 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.
Doctors of Chiropractic specialize in restoring normal joint motion, most commonly in the spine. Some chiropractors also perform specific manipulation of the extremities, such as the wrists, elbows, and shoulders. To treat carpal tunnel syndrome most effectively, find a chiropractor who manipulates extremities as well as adjusts the spine. Also, ask your potential chiropractor if they utilize therapeutic modalities such as electric muscle stimulation and cervical traction, perform exercise therapy, and prescribe nutritional supplements to help treat your condition. A well-rounded and synergistic approach will give you the best chance of faster and lasting relief.
Dr. Dana Williamson is a chiropractor who specializes 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 is a graduate of Palmer College of Chiropractic and a member in good standing of the Virginia Chiropractic Association.
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