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Carpal Tunnel Syndrome

Written by: Kristen Bentson, DC, MS

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy-meaning a common condition where a nerve is trapped somewhere along its course. It is characterized by pain, numbness and/or tingling felt in the wrist and hand (specifically the palm side of the hand into the thumb and fingers-but not the little finger) or radiating pain up into the arm. The pain may become increased when the wrist is flexed or bent. The cause of this discomfort is irritation or damage to the median nerve. Along its course to the hand, the median nerve passes through a narrow and rigid tunnel (called the carpal tunnel) made of bone and ligament. Overuse of the wrist (as in sewing, playing piano, or repetitive activity) or injury to this tunnel may result in damage or irritation to the median nerve producing carpal tunnel syndrome. Carpal tunnel is also common in pregnancy due to fluid retention and hormonal changes. The median nerve may be compressed or entrapped anywhere along its path; you may be interested to know that there are 7 locations (in addition to the carpal tunnel) where the median nerve could be compressed. For this reason, it is important to establish the location of entrapment before treatment (especially if you are considering surgery).

How is carpal tunnel syndrome diagnosed?

In order to prevent permanent damage to the median nerve early diagnosis is essential.
The first (and perhaps most important) step is a thorough history and physical exam of the neck, shoulder, forearm, wrist and hand. Your chiropractors will also perform specific orthopedic and neurological tests that are effective in establishing a diagnosis. In order to confirm the diagnosis of CTS, a nerve conduction study may be performed. Other tests may include diagnostic your chiropractor might order include ultrasound and MRI.

What are the options for treating carpal tunnel syndrome?

Carpal tunnel syndrome is commonly treated at Lehigh Valley Chiropractic. Our chiropractors offer treatment strategies that consist of manual therapy (including Active Release Technique), therapeutic (stretching/strengthening) exercise, chiropractic manipulation, ultrasound and ergonomic assessment/advice. While at home, RICE (rest, ice, compression, elevation) is helpful. Also, your chiropractor may recommend a wrist brace to wear at night. Other conservative methods that are not provided at LVC (but may be worth trying) are acupuncture and yoga.  On the less conservative end of the spectrum, certain medications and local corticosteroid injections may be effective in reducing pain short term. The most invasive, last resort for pain resulting from carpal tunnel syndrome is surgery. Even when surgery goes well (it is estimated that about 60% of surgeries result in full recovery), symptoms may return within two years. Complications from surgery include scarring, infection, pain, stiffness, loss of motion, and nerve damage. That being said, if you are suffering from CTS, explore conservative options first. So many patients have experienced the lasting benefits of the treatments provided at Lehigh Valley Chiropractic. We want you to join them-It’s your turn to experience relief!!

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