Carpal tunnel syndrome (CTS) occurs when the mobility of the median nerve is narrow as it passes through the wrist. This can lead to symptoms in parts of the hand and fingers such as numbness, tingling, pain, and weakness. CTS arises following an acute injury, the disorder often progresses subtly over time due to an accumulation of micro traumas. Acute injuries can consist of a wrist fracture, hormonal changes, and/or pregnancy. Hence the term cumulative trauma disorder (CTD).
A carpal tunnel is a busy place with several tendons passing through that help move the digits of the hand. Each tendon is covered by a sheath that provides lubrication so the tendons can easily slide past one another and other tissues in the wrist. The structure of the wrist didn’t evolve to cope with the various repetitive motions that can occur in modern life. As the tendons in the wrist slide back and forth, heat can build up. The heat stimulates inflammation and reduces the available space in the tunnel. This can place pressure on the median nerve and lead to the symptoms associated with CTS. That’s why families can have a history of CTS because of having a smaller carpal tunnel. Women also tend to have a tighter carpal tunnel, so they may be more prone to the condition.
Managing Cumulative Trauma Disorder
Generally, taking a break and having adequate rest can allow time for the inflammation to subside. However, many people will continue repetitive motions leading to very small injuries within the carpal tunnel that doesn’t fully heal. Over time, this can reduce the threshold at which inflammation arises. It contributes to why CTS patients may start experiencing symptoms after a short time when they were formerly able to carry out activities longer.
When managing a case of CTS resulting from CTD, the goals of treatment include reducing inflammation and restoring normal motion to the affected wrist. In addition to manual therapies, physical therapy modalities, and exercise instruction to help the wrist move properly. Chiropractors may instruct the patient on dietary approaches to reduce inflammation with ice and heat. Wear a nocturnal wrist splint, modify job activities, and take frequent breaks if needed. Additionally, they will examine the full course of the median nerve. It’s common for the nerve to be entrapped at multiple sites, and these will all need to be addressed for a satisfactory result. The chiropractor will also review the patient’s history for potential non-musculoskeletal contributing factors. If needed, chiropractors will work in coordination with allied healthcare professionals.
