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Treatment for Carpal Tunnel Syndrome

Many of you know someone who has been diagnosed with carpal tunnel, or you have at least heard of it. This condition can be, to put it frankly, just an annoying pain in the @!%. Most people experience pain or numbness/tingling into the palm of their hand, more commonly into the thumb and first two fingers. The symptoms are usually worse at night or after working a long day at the computer, and may be relieved by "shaking out" the hand. In some instances it can be severe enough to cause weakness of the hands, and you may notice difficulty gripping objects or just a sense of clumsiness.

So what exactly is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a peripheral nerve entrapment of the median nerve (yellow nerve in the picture above), specifically at the carpal tunnel. There are small bones in your wrist (called carpal bones) and a ligament (flexor retinaculum) that actually make a tunnel for the median nerve to pass through, and compression at this area can squish the median nerve, leading to the pain and numbness/tingling felt into the hand. Although direct compression of the median nerve by ganglions, fractures, and dislocations is possible, CTS is more commonly caused by a history of direct external pressure on the carpal tunnel or a history of prolonged wrist use.

A recent CDC study found that women were more than three times more likely to develop work-related carpal tunnel syndrome compared to men.

How is CTS treated?

While there is a belief that surgery is the best treatment option for CTS, a lot of research has come out showing that surgery is not far and away better than alternative options (chiropractic, physical therapy, kinesio-taping, etc.).

A study comparing surgical vs. non-surgical (ie, splint, steroid injection, or physical therapy) outcomes found: “No significant differences at 3 or 12 months” in terms of functional status, symptom severity, and nerve conduction outcomes.

A new study in the Journal of Clinical Biomechanics demonstrated that “mobilization significantly increased carpal tunnel cross sectional area, anteroposterior diameter, and circularity. The median nerve showed similar behavioral tendencies to the tunnel. Both the carpal tunnel and the median nerve became rounder during the technique.” This study shows that adjusting of the carpal bones in the wrist increased the area of the tunnel allowing for an increase in the size of the median nerve.

Another study of 103 patients with mild to moderate carpal tunnel syndrome concluded “the use of neurodynamic techniques in conservative treatment for mild to moderate forms of carpal tunnel syndrome has significant therapeutic benefits.” Specifically, neurodynamic techniques produced significant improvements in nerve conduction, pain, symptom severity, and functional status. Now you may be asking yourself, "what are neurodynamic techniques?" These techniques are types of stretches that focus on moving certain body parts to help move or glide the nerves running through our bodies. Increasing the mobility of nerves helps them become "un-stuck" and increases their ability to perform more properly (example shown in the image below).

How exciting is this?! How great is it to know that alternative treatments to surgery had the same, if not better outcomes in symptom reduction in patients with CTS?

Schedule an appointment today so we can give you the tools you need to decrease CTS symptoms!

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