Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS),  also called occupational neuritis, partial thenar atrophy and median neuritis,  is the occupational disease of the 21st century. You may if you have one of more of the following symptoms: tingling and numbness in the hand, fingers, and wrist; swelling of the fingers; dry palms; blanching (whitening upon pressure) of the hand; or pain so intense that it awakens you at night. In some people CTS causes similar symptoms in the upper arm, elbow, shoulder, or neck.1-2 This condition is growing increasingly common – millions of people now suffer from CTS3.

The carpal tunnel is in your wrist. Your carpal (wrist) bones form a tunnel-like structure – the carpal tunnel – through which pass nine tendons and one nerve – the median nerve. CTS occurs when the nerve is irritated.

Just about anyone can get CTS. Aside from work related aggravations and injuries, fractures, Paget’s disease, multiple myeloma, acromegaly, and gout are other causes. It is often also found in pregnant women, birth control pill users, or those with an underactive thyroid.

Thoracic outlet syndrome (TOS) is a similar condition caused by compression or irritation of the nerves that caused by compression or irritation of the nerves that form the brachial plexus (in the upper back) as they exit the neck. The symptoms include pain, weakness and numbness or tingling in the arm.4 Some researchers believe that the hips and lower (sacroiliac) play a role in the cause while others feel an abnormal thoracic (mid-back) curve is the cause.5

The medical approach to CTS is to stop using the wrist in the same way by wearing a splint to ensure wrist immobilization. Resting, ice, anti-inflammatory, or diuretics were also used.6-7 As many as 500,000 operations a year are performed for CTS8 and recovery from such surgery may take up to several months.9 With these limitations, Robert Mendelsohn, MD, stated: Since the medical treatment for this condition is so unsatisfactory, I have for years been recommending that my patients consult experts in muscle and joint therapy.10

Alternatively, in many people the main problem may be the health of the structural system and that is why anyone suffering from CTS should see a chiropractor to ensure that his/her spinal column and structural system are aligned properly. Subluxations have been observed in many patients who have carpal tunnel or related hand and wrist problems.11-12 In fact, nerve compression in the neck can block the flow of nutrients to the nerves in the arm, shoulder, wrist and related areas, and make them more susceptible to injury (this is called the double crush syndrome).13-14 Not surprisingly, when 1,000 cases of carpal tunnel syndrome were investigated it was found that a large number of those suffering from CTS also had neck arthritis.15

Anyone suffering from carpal tunnel syndrome should see a chiropractor to ensure that their body is free of subluxations. Chiropractic is not a treatment for carpal tunnel syndrome but is a way of rebalancing the body and removing structural stress from the nervous system.

References:

  1. Evanoff B, Dale AM, Deych E, Ryan D, Franzblau A. Risk factors for incident carpal tunnel syndrome: results of a prospective cohort study of newly-hired workers. Work. 2012;41 Suppl 1:4450-4552.
  2. Verghese J, Galanopoulou AS, Herskovitz S. Autonomic dysfunction in idiopathic carpal tunnel syndrome. Muscle Nerve. 2000;23(8):1209-1213.
  3. Bongers FJ, Schellevis FG et al. Carpal tunnel syndrome in general practice (1987 and 2001): incidence and the role of occupational and non-occupational factors. Br J Gen Pract. 2007:36-39.
  4. Narkas AO. The role of thoracic outlet syndrome in the double crush syndrome. Annales de Chirurgie de la Main et du Membre Superieur. 1990;9(5):331-340.
  5. Liebenson CS. Thoracic outlet syndrome: diagnosis and conservative management. JMPT. 1988;11(6):493-499.
  6. O’Gradaigh D, Merry P. Corticosteroid injection for the treatment of carpal tunnel syndrome. Ann Rheum Dis. 2000;59(11):918-919.
  7. Pfeffer GB, Gelberman RH. The carpal tunnel syndrome. In NM Hadler (Ed.), Clinical Concepts in Regional Musculoskeletal Illness. Orlando, FL: Grune & Stratton, Inc. 1987;201-215.
  8. Levine DW, Simmons BP, Koris MJ et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg. 1993:1585-1592.
  9. webmd.com/pain-management/carpal-tunnel/open-carpal-tunnel-surgery-for-carpal-tunnel-syndrome Retrieved on 8/9/14 from webmd.com.
  10. Mendelsohn R. Treating carpal tunnel syndrome. The People’s Doctor. 1982;8(9):7.
  11. Upton ARM, McComas AJ. The double crush in nerve entrapment syndromes. Lancet. 1973;2:329.
  12. Russell BS. Carpal tunnel syndrome and the “double crush” hypothesis: a review and implications for chiropractic. Chiropractic & Osteopathy. 2008; 16(2):1186.
  13. Czaplak S. Impaired axoplasmic transport and the double crush syndrome: food for chiropractic thought. Clinical Chiropractic. January 1993;8-9.
  14. Nemoto K et al. The double lesion neuropathy: an experimental study and clinical cases. Abstract 123, 2nd Int’l. Congress. Boston, MA, October 1983.
  15. Hurst LC et al. The relationship of the double crush syndrome (an analysis of 1,000 cases of carpal tunnel syndrome). J Hand Surg. 1985; 10B:202.