Where is the carpal tunnel?
There is an arc of bones on the outer side of your wrist, and a narrow passageway on the palm side. This passageway is your carpal tunnel, and lots of things have to pass through it for your hand to work, including tendons, nerves, arteries and veins. There is very little space, so any pressure within that narrow space can make itself felt as discomfort in the hand.
What does Carpal Tunnel Syndrome feel like?
You may have some or all of the following symptoms-
- Weakness, numbness or achiness in the hand, sometimes going up into the forearm.
- Reduced grip strength
- Pins and needles in the hand.
But have you really got Carpal Tunnel Syndrome?
I often see patients who’ve been told they have Carpal Tunnel Syndrome, but when I examine their wrist I find that the cause of the problem lies elsewhere. This makes a big difference to how I treat them. To get a good result I focus on the root of the problem, and that might be somewhere else in the body, for example the neck, shoulder or arm.
How can you find out if it really is CTS?
The symptoms tend to be the same, regardless of whether you have ‘true’ CTS, so it’s advisable to get a diagnosis from someone who fully understands the anatomy of the wrist. As a chiropractor I’m trained to understand the anatomy of the nervous system, muscles, joints and ligaments of the whole body, not just the back. Equally you might consult a reputable osteopath or physiotherapist. Before making an appointment, ask if that therapist has had success treating cases of CTS before, or ask for a recommendation among your friends.
Why is a diagnosis of CTS so prevalent?
CTS is a common default diagnosis for people with pins and needles and hand pain. Unfortunately, there is a tendency to go straight to anti-inflammatory drugs and steroid injections followed by surgery, but this can often be avoided.
What does the neck have to do with CTS?
More than one thing can affect the nerve signals going into the hands, because obviously they originate all the way up in the brain. For example-
- Poor posture stretching the nerve.
- Problems in the neck where the nerve which supplies the hand emerges from the brain.
- Entrapment of the nerve in the shoulder or arm.
- Referred pain from other structures in the shoulder or arm.
In cases like this, steroid injections and surgery will make little difference.
What is double crush?
The nerve to the hand can be more susceptible to compression at the wrist if it is also pinched or irritated at neck level. This is what’s known as ‘double crush’.
If you do have ‘real’ Carpal Tunnel Syndrome, why has it flared up?
It might be caused by one or more of the following problems in the wrist-
- Inflammation in the tendons
- Arthritis in the joints
- Fluid retention, for example during pregnancy
- One of the above plus the afore mentioned ‘double crush’.
If you don’t have ‘real’ CTS, what’s causing your symptoms?
It might be one of the following-
- Disc problems in the neck
- Injuries of the neck, shoulder, elbow or wrist
- Thoracic Outlet Syndrome
- Occasionally, vitamin B deficiency. (Consult your GP if you think this might apply to you.)
There do exist other, rarer causes of pins and needles in the hand, but you would be assessed for these too at your first chiropractic appointment.
Given that discomfort in the hand can be caused by any of the above, sufferers need a proper diagnosis before committing to steroid injections or surgery, neither of which is without risk. Chiropractors are qualified to assess the causes of CTS. If I consider that a patient’s CTS will benefit from steroid injections or surgery, I will make the appropriate referral.
How I treat hand pain.
If you came to me with symptoms of Carpal Tunnel Syndrome, first I would assess you to see if any of the above factors are contributing to your discomfort. Then I would work on restoring proper movement to the neck, shoulder, elbow and wrist with some of the following.
- Correcting postural strain with hands on treatment.
- Chiropractic adjustments (to find out what that looks like, click here and scroll down to the video.)
- Ergonomic advice
- Stretches and exercises
- Instrument assisted soft tissue mobilisation to help reduce tension in the fascia and break down any scar tissue.
- Other soft tissue techniques
Ways that you can help yourself.
- Here is a link to 5 simple stretches that you can do to ease your symptoms.
- If you sit a lot (at work, in your car) make sure that you sit upright. Click here to find out what that consists of.
- Look at the ergonomics of your desk. This web page provides guidelines on the correct height of computer screens etc. It doesn’t have to be expensive, you can prop it up on books.
- Try buying a differently shaped mouse, such as those available here.
- You might consider vitamin B supplements, consult your GP.
If you live in the Tynedale area and are seeking relief from symptoms of Carpal Tunnel Syndrome, phone Hexham Family Chiropractic for an appointment. If you don’t live nearby and would like to find a chiropractor, you might be interested to read this article, in which I explain how to choose a good one.