Prevention and Treatment of Carpal Tunnel Syndrome

By: Erin E. Ducat DC, CSCS, FIAMA, CKTP

Carpal tunnel syndrome (CTS) is an irritation of the median nerve in the wrist where it passes through the carpal tunnel, bones and ligaments in the wrist through which the nerves and tendons to the hand pass. When the carpal tunnel is inflamed, the median nerve may be compressed and irritated.

Those who are more prone to CTS are those whose professions or hobbies cause repetitive stress to the wrist. Professions with a higher incidence of CTS include typists, carpenters, cashiers, factory workers, and other professions that require continuous use of the wrist in awkward positions or under pressure. Hobbies that can irritate the carpal tunnel include golfing, rowing, or running on a treadmill with too much weight/reliance on handles. There are also physical conditions which may make a person more prone to CTS: pregnancy, thyroid problems, diabetes, rheumatoid arthritis, and increased weight.

Carpal Tunnel Syndrome

Symptoms

  • Tingling, numbness, and/or weakness in hands
  • Pain in fingers or palm—mostly of the thumb, index, middle and ring finger. If the little finger is affected, it may be another nerve that is pinched.
  • Pain in forearm, possibly up to shoulder
  • Pain that wakes you from sleep
  • Difficulty gripping objects, especially small objects

Prevention

  • Take frequent breaks and gently stretch your wrists and hands
  • Avoid excessive bending of the wrists for tasks such as typing
  • Watch your posture
  • Stop any activity that causes wrist, hand, or finger tingling, pain, or numbness
  • Avoid clothing and jewelry that fits tightly around the wrist
  • Ask about splints if you are concerned about carpal tunnel syndrome or if you are in a high risk occupation

Treatment

Because there are a variety of conditions that can cause symptoms that mimic carpal tunnel syndrome and because there are a number of possible reasons you may be experiencing pain, a variety of treatment options may be considered. The decision on which treatment should be used will be based on your preferences, examination findings, experience treating patients with similar conditions and the best available scientific evidence.

Exercises that may benefit CTS are those that exercise the hand and wrist. These exercises and stretches may help by strengthening the muscles of the wrists, hands, neck, and shoulders. Increased blood flow may also be beneficial. Loosening and stretching the carpal ligaments may also ease pressure in the carpal tunnel. The exercises you are to perform will be discussed following examination and orthopedic testing to determine your specific needs.

Chiropractic Manipulation of the carpal tunnel, wrist, cervical spine, or other area may benefit those with CTS. Also called adjustments, manipulation may relieve the pressure in the carpal tunnel and improve function of the joints.

Acupuncture involves the insertion of very fine needles into the skin at points determined based on the condition being treated. An average of 5 to 15 needles are used in each treatment. Acupuncture has been used for centuries and the theory behind it is that the needles can correct and improve the body’s flow of energy (called Chi). In addition to the needles, forms of acupuncture can incorporate pressure, electric currents, laser, or heat.

Muscle Release Techniques is a form of deep massage therapy that addresses chronic scar tissue and adhesions that build up from years of improper muscle strength. It can be done manually by the doctor or massage therapist or through the use of Asian tools, called “Gua Sha.”

Kinesiotape is a form of athletic taping that uses an elasticized tape to support the joints and minimize recovery time.

Your Alternatives

Your condition may be best treated using both chiropractic treatments and other treatment from additional healthcare professionals. If your condition requires it, a direct referral for treatment may be made to medical, surgical or other healthcare providers.

Surgery is sometimes prescribed for treatment of severe carpal tunnel syndrome. The goal of surgery is to reduce pressure on the median nerve by partial severing of the soft tissue band of the carpal tunnel.

Steroid Injections may reduce inflammation and therefore provide relief of CTS symptoms. Steroids can be given by injection or orally. Steroid injections may increase pain temporarily, and subsequent pain relief is temporary. Oral steroids may provide longer relief than injections. Diabetics should not take steroids.

The information provided is for educational purposes only; diagnosis and treatment decisions should not be based solely on this information but should include your doctors training and experience and your own personal preferences. Treatment decisions should be made between a doctor and the patient. The appropriateness of any treatment for a specific condition can only be determined by your treating doctor. The information provided in this review was created on 1/28/2008; research may have been published since this date that may influence the statements made. The information provided should not be considered an endorsement by the Foundation for Chiropractic Education and Research (FCER) nor the treating doctor for any product, procedure, or therapy.

Published 11/01/2008.