The pain in your wrist has been there for a while. It's worse at work when you are holding the computer mouse. Your thumb and first finger have been going numb more often. The pain keeps waking you up at night and it is starting to go up your arm. To top it off, you almost dropped your coffee cup again this morning! And what is with that neck pain and tension that is always across the top of your shoulders? You could have carpal tunnel syndrome.
The most common injury suffered by workers in an office environment is carpal tunnel syndrome (CTS). According to the Bureau of Labor Statistics, "disorders associated with repeated trauma account for about 60 percent of all occupational illnesses." Carpal tunnel syndrome is the condition most frequently reported out of all these disorders. So, what is carpal tunnel syndrome? What are the causes? Besides surgery, what are some effective treatment options?
The word "carpus" is derived from the Greek word "carpos", which means "wrist". Eight individually moving bones, called the carpals, are what make up the wrist. These carpal bones are surrounded by a fibrous band of tissue, called the transverse carpal ligament, which binds them together and supports them. A tunnel is formed by these structures, which the median nerve passes through. When the median nerve gets irritated, it can cause pain, tingling, numbness and weakness of the wrist, index and middle fingers, and the thumb. Some of you may already know how debilitating this condition can be. I have heard some of my patients mention how their productivity at work is reduced, how the pain keeps them awake at night, and how the weakness in their hands will even cause them to drop things like their coffee cup (heaven forbid!). So, if the carpal tunnel is supposed to protect the median nerve, then how does it get irritated? We will explore two of the most common reasons.
The eight carpal bones of the wrist are designed to move individually. One or more of these joints can become stuck like a couple of suction cups when they are injured. This is usually due to repetitive stress which occurs during such activities as typing and using a computer mouse for prolonged periods. When the joints get stuck, it causes irritation to the joint surfaces (a.k.a. arthritis) and the surrounding soft tissues become inflammed and swollen. Its this swelling that infiltrates the tight space of the carpal tunnel and causes compression and irritation of the median nerve. So, it makes logical sense that if we restore normal motion to the joints of the wrist, then the swelling will decrease in the carpal tunnel, the pressure on the medial nerve will be relieved, and the symptoms will be resolved.
Chiropractic research is proving this to be the case. One study published in the journal Manual Therapy (by Tal-Akabi A, Rushton A., 2000 Nov; 5(4):214-22, Bern Switzerland) shows that, on average, chronic carpal tunnel syndrome patients get 70% improvement in their symptoms following three weeks of specific wrist manipulation. It also demonstrated that 86% of the control group (the group that did not receive any manipulative treatment) went on to have their scheduled surgery, whereas only 14% of the group who received manipulative therapy, went on to have their scheduled surgery. Therefore, while a small percent of patients may still need surgery, it makes sense to try an effective, less painful, and much safer conservative treatment, like specific wrist manipulation, before making the trip to the surgeon.
But there is more to this story. The nerves that exit between the bones of the lower region of the neck and upper back control all of the functions of the shoulders, arms, wrists, and fingers. The first place that there can be interference between the brain's communications with the arms is where these nerves exit between these bones (vertebrae). These spinal nerves extend from the spine and through the arms to the wrist and hand. Like vines that form smaller branches, one of these branches ultimately becomes the median nerve. It is vitally important that we trace any nerve interference back to its source, usually originating at the spine. Otherwise, results from any form of treatment will merely be temporary. Like the wrist bones, the spinal joints also need to move individually; otherwise, inflammation and swelling of the soft tissues around the joint can cause pinching, choking, or irritation of the spinal nerves. This can cause pain, numbness, tingling, or weakness anywhere along the branches of the shoulder, arm, wrist, or hand. That is why examination and treatment of the neck is also essential for complete and lasting healing to occur.
Chiropractors are doctors who specialize in the restoration of normal joint motion, most commonly in the spine. Some chiropractors also perform specific manipulation of the extremities, such as the shoulders, elbows, and wrists. To treat carpal tunnel syndrome most effectively, it is important to find a chiropractor who manipulates extremities as well as the spine. Also, ask your potential chiropractor if they prescribe nutritional supplements, perform exercise therapy, and utilize therapeutic modalities such as electric muscle stimulation and cervical traction to help treat your condition. In my experience, a well-rounded approach will give you the best chance of fast and long-lasting relief.
The most common injury suffered by workers in an office environment is carpal tunnel syndrome (CTS). According to the Bureau of Labor Statistics, "disorders associated with repeated trauma account for about 60 percent of all occupational illnesses." Carpal tunnel syndrome is the condition most frequently reported out of all these disorders. So, what is carpal tunnel syndrome? What are the causes? Besides surgery, what are some effective treatment options?
The word "carpus" is derived from the Greek word "carpos", which means "wrist". Eight individually moving bones, called the carpals, are what make up the wrist. These carpal bones are surrounded by a fibrous band of tissue, called the transverse carpal ligament, which binds them together and supports them. A tunnel is formed by these structures, which the median nerve passes through. When the median nerve gets irritated, it can cause pain, tingling, numbness and weakness of the wrist, index and middle fingers, and the thumb. Some of you may already know how debilitating this condition can be. I have heard some of my patients mention how their productivity at work is reduced, how the pain keeps them awake at night, and how the weakness in their hands will even cause them to drop things like their coffee cup (heaven forbid!). So, if the carpal tunnel is supposed to protect the median nerve, then how does it get irritated? We will explore two of the most common reasons.
The eight carpal bones of the wrist are designed to move individually. One or more of these joints can become stuck like a couple of suction cups when they are injured. This is usually due to repetitive stress which occurs during such activities as typing and using a computer mouse for prolonged periods. When the joints get stuck, it causes irritation to the joint surfaces (a.k.a. arthritis) and the surrounding soft tissues become inflammed and swollen. Its this swelling that infiltrates the tight space of the carpal tunnel and causes compression and irritation of the median nerve. So, it makes logical sense that if we restore normal motion to the joints of the wrist, then the swelling will decrease in the carpal tunnel, the pressure on the medial nerve will be relieved, and the symptoms will be resolved.
Chiropractic research is proving this to be the case. One study published in the journal Manual Therapy (by Tal-Akabi A, Rushton A., 2000 Nov; 5(4):214-22, Bern Switzerland) shows that, on average, chronic carpal tunnel syndrome patients get 70% improvement in their symptoms following three weeks of specific wrist manipulation. It also demonstrated that 86% of the control group (the group that did not receive any manipulative treatment) went on to have their scheduled surgery, whereas only 14% of the group who received manipulative therapy, went on to have their scheduled surgery. Therefore, while a small percent of patients may still need surgery, it makes sense to try an effective, less painful, and much safer conservative treatment, like specific wrist manipulation, before making the trip to the surgeon.
But there is more to this story. The nerves that exit between the bones of the lower region of the neck and upper back control all of the functions of the shoulders, arms, wrists, and fingers. The first place that there can be interference between the brain's communications with the arms is where these nerves exit between these bones (vertebrae). These spinal nerves extend from the spine and through the arms to the wrist and hand. Like vines that form smaller branches, one of these branches ultimately becomes the median nerve. It is vitally important that we trace any nerve interference back to its source, usually originating at the spine. Otherwise, results from any form of treatment will merely be temporary. Like the wrist bones, the spinal joints also need to move individually; otherwise, inflammation and swelling of the soft tissues around the joint can cause pinching, choking, or irritation of the spinal nerves. This can cause pain, numbness, tingling, or weakness anywhere along the branches of the shoulder, arm, wrist, or hand. That is why examination and treatment of the neck is also essential for complete and lasting healing to occur.
Chiropractors are doctors who specialize in the restoration of normal joint motion, most commonly in the spine. Some chiropractors also perform specific manipulation of the extremities, such as the shoulders, elbows, and wrists. To treat carpal tunnel syndrome most effectively, it is important to find a chiropractor who manipulates extremities as well as the spine. Also, ask your potential chiropractor if they prescribe nutritional supplements, perform exercise therapy, and utilize therapeutic modalities such as electric muscle stimulation and cervical traction to help treat your condition. In my experience, a well-rounded approach will give you the best chance of fast and long-lasting relief.
About the Author:
Dr. Dana Williamson is a specialist in the treatment of carpal tunnel syndrome by natural methods. He has been practicing at his Chiropractic Centers of Virginia | Richmond and Mechanicsville offices since 2001. He is a graduate of Palmer College of Chiropractic and is a long standing member of the Virginia Chiropractic Association.
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