CARPAL TUNNEL SYNDROME
The carpal tunnel syndrome (CTS) is caused by the compression or entrapment of a nerve (the median nerve) in the palm (volar) surface of the wrist. This nerve is situated between tendons (longitudinal) of the forearm muscles that flex the hand, and a ligament (transverse superficial carpal). There are no muscles in the wrist to impact the median nerve. It is the longitudinal tendons and the transverse superficial ligament that forms the carpal tunnel. When the normal structures are altered due to repetitive motions of the wrist and arms, or by a direct trauma, the tissues can become swollen with an accumulation of fluid.
It is this change in the tunnel structure that causes the compression or entrapment of the median nerve, which causes the pain and at times numbness (paraesthesias) in the palm of the hand and wrist, and at times into the forearm.
The carpal tunnel syndrome (CTS) is relatively common and usually affects more women than men. The condition has become more prevalent over the years, due to the occupations that require repetitive motion wrist flexion. Occupations, such as computer operators, typists, packers in the meat and poultry industries and assembly line workers are greatly at risk.
It is the repetitive wrist and arm motions that are so necessary in these occupations that play havoc on the normal structures of the carpal tunnel, causing these structures to be altered in an abnormal way, thus causing the compression or entrapment of the median nerve. At times these structural changes can be brought about by hormonal or metabolic changes that can occur in such conditions as, diabetes, hypothyroidism, rheumatoid arthritis and pregnancy.
Very often individuals with pains in the hand, wrist and forearm automatically assume they have carpal tunnel syndrome. This is an easy assumption to make because almost everyone has heard the term "carpal tunnel" and equate any pain in the wrist or hand with it. There are several other conditions that often mimic the symptoms of carpal tunnel syndrome that often results in the misdiagnosis of the condition, especially when self-diagnosed.
It is for this reason that the individual experiencing the symptoms associated with carpal tunnel syndrome (CTS) seek professional consultation from their Chiropractor or physician to confirm a positive diagnosis, that, they do indeed have carpal tunnel syndrome (CTS). It will be up to the healthcare practitioner to differentiate between such conditions as, myofascial syndromes, thoracic outlet syndromes, brachial plexus disorders and nerve compressions involving other nerves. These nerve compressions may at times be due to an abnormal growth (tumor), or overgrowth of bone (spur), as found in arthritic conditions.
The Chiropractor or physician will use several orthopedic tests in his examination, and if necessary recommend x-ray or an MRI to arrive at his/her diagnosis. Once a definitive diagnosis of carpal tunnel syndrome has been made, they will then recommend an ongoing treatment regime. The physician in all likelihood will first suggest non-steroidal anti-inflammatory agents (NSAIDS), for pain control, and an immobilization splint. If the condition does not improve, more aggressive treatments, such as steroid injections will be tried. In extreme cases, surgery will then be recommended.
The Chiropractor will probably start the patient with a regime of physiotherapy and flexibility exercises where indicated. He/she will also make recommendations in how to make ergonomic changes in their place of employment and in the home. These changes can be extremely important in long-term relief of the pain associated with carpal tunnel syndrome (CTS), and preventing its return.
The patient with carpal tunnel syndrome (CTS) must take the initiative, firstly by following their doctors directions, and secondly to help themselves, at home and on the job. At the place of their employment, a survey needs to be made of the job they are doing. What is it at the job that is causing the condition in the first place? For computer operators, typists, etc., a simple change as using a special wrist pad on the keyboard can make the difference. For assembly line workers, changing jobs with another employee several times during the workday will help them and the other worker without interfering with production. It is only the individual who can determine the causative factors involved.
Wearing a brace for short periods of time can be helpful in allowing the healing process. However, wearing the brace constantly for a long period of time can be counterproductive in that it preventives maintaining the flexibility of the tissues involved. Passive movements and mild exercises to maintain flexibility will prevent the formation of adhesions and subsequent scarring. The proper orthopedic brace should only be worn during extreme activity, or at work that requires constant repetitive use of the hands and arms.
When the carpal tunnel syndrome patient is at rest, they can use various modalities to help alleviate any pain or discomfort. I have found that by having them soak their hand and wrist in cool water to which a half cup of white vinegar has been added will help reduce swelling and calm the inflamed tissues. Moving the wrist up and down, and rotating it while being soaked is a good way to passively exercise it, just do not do it constantly. Give it a chance to rest between movements. After the soak, applying a good analgesic gel, such as BIOFREEZE can be greatly beneficial for the relief of pain and discomfort.
Another worthwhile modality that is worth a try may be the use of magnet therapy. It has been shown that magnets help in improving circulation and restoring range of motion. When wearing a wristband, using "MAGNE SYSTEMS" wristband (product to be introduced shortly) incorporates the therapeutic use of the band with the magnet therapy. If a wrist splint is necessary, that also is available. For the golfer, a special magnet glove can be of great benefit. These products will help increase the circulation to these stressed tissues. Increasing the circulation will help in eliminating toxins and speed the healing process.
As you can see, there are many ways to help carpal tunnel syndrome (CTS). However it is extremely important not to let this condition progress to the stage where it becomes impossible to treat it in a passive manor. When allowed to reach a more chronic stage with formation of scar tissue, causing severe pain and sensory symptoms such as light touch perception, a more aggressive approach may be needed. You must try to prevent reaching this stage at all costs. Become aggressive in your own treatment and stay with it until your symptoms subside, and you are well again.