“Do I have Carpal Tunnel?”

The short answer is yes, you have two of them. Everyone does. The real question is “Do I have Carpal Tunnel Syndrome”? A subtle, but important distinction.

Carpal Tunnel syndrome is a painful condition in which the Median nerve is irritated as it passes through the tunnel in the wrist. This tunnel is made up of a bony arch of two rows of four bones (the carpal bones) with a tendon called the flexor retinaculum stretched over the top. The tunnel is about the size of the tip of your index finger. In that space, there are 9 flexor tendons that connect wrist muscles to the fingers and the median nerve. It’s a pretty tight space.

The only way you can get carpal tunnel syndrome is if something in the canal bets bigger (like a tumor or swelling from pregnancy) or the canal gets smaller when one of the wrist bones misaligns. This can happen in traumas (car wrecks, slips and falls on outstretched hand) or overuse (lots of pushups, typing or repetitive use injuries such as typing or carpentry). When this occurs, the median nerve can get irritated and cause the symptoms of carpal tunnel syndrome. These symptoms can include pain, tingling and weakness in the thumb, index and middle fingers. If you have symptoms elsewhere in the hand or wrist it’s probably something else and not carpal tunnel syndrome.

Several treatment options are available to you. “Cock up” wrist splints will compress the wrist and put it into extension. Nerve conduction studies have shown that this position actually increases the tension and pressure on the nerve. Steroid injections may temporarily decrease swelling but may cause some unpleasant side effects. In some cases, an orthopedic surgeon may decompress the nerve by cutting the flexor retinaculum. Unfortunately, this act of cutting tissue leads to scar tissue formation, which takes up space and that was the problem in the first place. The surgery can also destabilize the wrist predisposing it to arthritis changes later in life.

The chiropractic approach involves skilled manipulation of the misaligned carpal bones and supportive therapies and rehabilitative exercise along with lifestyle counseling to help eliminate the cause of the problem. No drugs, no surgery.
Which will you choose?


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