When a person experiences pain, numbness, tingling, and/or weakness in the hand, they may assume it’s carpal tunnel syndrome (CTS). CTS is the most common and well-known peripheral neuropathy. Unfortunately, many healthcare providers may also jump to the same conclusion, and care may focus on the hand and wrist. One problem with this approach is that the patient may have several conditions that contribute to their carpal tunnel symptoms. The other conditions will also need to be addressed for a satisfactory result.
What is CTS
The carpal tunnel itself is very small in diameter. Anything that causes swelling or inflammation can result in an even tighter space that the median nerve must pass through. To innervate the thumb, index finger, middle finger, half the ring finger, and much of the palm. If the patient has a job or hobby that involves frequent, repetitive hand movements or the use of power tools, then they may be advised to take more breaks. This allows the wrist to rest or to make changes to its tool or movements. For example, a 2022 study reported that using power tools with the wrist in a non-neutral position increases pressure in the carpal tunnel.
The patient’s history may also indicate non-musculoskeletal factors that may contribute to their symptoms, such as diabetes, birth control, hypothyroidism, vitamin D deficiency, etc. When this is the case, the doctor of chiropractic may co-manage the patient with their medical physician.
Symptoms & Treatment for Pain Reduction
It’s also important to keep in mind that the median nerve doesn’t exist only in the wrist and hand. The median nerve originates in the neck and contains branches from the C6 to T1 nerve roots. It passes through the shoulder, elbow, and forearm before reaching the carpal tunnel. If the mobility affects the nerve at any of these sites, the patient may report similar symptoms as CTS. Worse, there could be median nerve entrapment at the wrist and one or more of these other areas. This is why chiropractors will check the full course of the median nerve when examining a new patient for CTS. A survey of 1,001 individuals in a metropolitan area in 2017 found that nearly 6% experienced symptoms associated with ulnar nerve entrapment.
Once the patient’s chief complaint is uncovered, treatment can begin to reduce inflammation and improve joint mobility. Treatment may include manual therapies, home exercises, activity/work modifications, nocturnal wrist splinting, vitamin/supplement recommendations, and even co-managing the patient with an allied healthcare provider. All with the aim to return the patient to their normal work and life activities as soon as possible. However, it’s important to note that patients may experience faster improvement if their condition is addressed early in the course of the disease. So don’t wait until your hand and wrist symptoms become unbearable before seeking care.
