Carpal Tunnel Syndrome

The U.S. Department of Labor called Carpal Tunnel Syndrome (CTS) the chief occupational hazard of the 1990’s, disabling workers in epidemic proportions. Little has changed; carpal Tunnel Syndrome still affects countless millions of people. It is a major medical problem, which accounts for a high percentage of all work related injuries. Hundreds of thousands of surgeries are performed ever year, the percentage of patients who are able to return to their previous jobs following surgery is poor.

Could it be that carpal tunnel surgery is something to be questioned more carefully? Carpal tunnel syndrome isn't like a broken bone or a cut; it develops slowly and barely noticeable. One might not even take it seriously at first, but the symptoms slowly build and build. It could start with some numbness and tingling, but then become more difficult to type at the computer. So you give your family doctor a visit. If you're like many people, here's what you've been told: "You’ve got carpal tunnel syndrome… take this medicine and wear these wrist braces... come back if it doesn't work." The problem here is that the symptoms associated with carpal tunnel syndrome can have several different causes... many of which are NOT even near your wrist!    
 

FACT: If your doctor doesn't examine or consider those other areas...you have NOT been given a thorough examination for your condition.  

Any doctor that assumes you have true carpal tunnel syndrome, simply because you have wrist or hand pain, tingling, numbness or weakness is missing the boat! If a doctor assumes that your wrist is the ONLY cause of the symptoms, and focuses treatment only on that, the same criticism applies.    
 

Myth: carpal tunnel syndrome is caused by computer mouse usage.   

Reality: A 2005 Harvard medical study reported that carpal tunnel syndrome is simply NOT caused by computer usage! A 2001 Mayo Clinic neurology study reported the same. This one of the reasons that treatment for carpal tunnel syndrome may fail. 

The good news is that even if treatments have failed to help you, there’s still hope. It may simply be that nobody was looking in the right places for the cause (or causes) of your symptoms. If the diagnosis is wrong; the treatment is likely to be wrong. Focusing exclusively on the wrist is a huge mistake when considering the symptoms of pain, tingling, numbness and weakness in the wrist and hand. 

Here's why: Wrist pain, tingling, numbness, and weakness are symptoms of NERVE entrapment. In other words, the nerves that travel from your brain to your fingers must be interfered with somewhere along that pathway. The amazing thing about your nervous system is that interference in one place can give you symptoms in other places that are a long distance far away from the interference point itself. Because of the complexity of the nerve pathways from your brain, down and out through your neck... through your shoulder area... down your arm... and finally... through your wrist... it is possible that...

You May NOT Even Have Carpal Tunnel Syndrome!  

If you think that all cases of wrist or hand pain, tingling, numbness or weakness are caused by carpal tunnel syndrome... think again! Solid scientific evidence reveals that many cases of so-called carpal tunnel syndrome have little or nothing to do with the wrist at all!  

The term carpal simply means wrist. The carpal tunnel is a small canal inside the wrist. It is formed by the bones of the wrist, which are of course called carpals! The other part that makes up the carpal tunnel is a ligament, which is a tough band of connective tissue between the bones.   

There Are 3 Structures Inside the Carpal Tunnel:   

1. The Median Nerve which controls some hand movement and sensation  2. Nine Flexor Tendons that enable you to curl your wrist and fingers  

3. Blood vessels 

Authentic carpal tunnel syndrome is when the MEDIAN NERVE is compressed or entrapped within the CARPAL TUNNEL.  

However, what is often neglected is the fact that the median nerve originates in the NECK. Then it travels under your collarbone, down the center of your forearm and finally through the carpal tunnel to the hand muscles.

Why is this so important? It is critical because there are 8 possible anatomical regions where the nerve can be compressed! Consider some of the symptoms of median nerve compression (not necessarily carpal tunnel syndrome):

Pain in the Wrist… Numbness in the fingers… Tingling or other abnormal hand sensations… Weakness of hands… Neck Pain… Swelling. These symptoms can be from median nerve compression at the carpal tunnel syndrome.

But they can also be from median nerve compression in ANY or ALL of the 8 areas! 

The median nerve comes out between the bones of your NECK. Therefore, when doctors do not properly examine the neck, as well as all possible interference points; they are extremely neglectful, and in my opinion, should not be seeing patients for "carpal tunnel syndrome!  just look at the diagram and see how the nerves travel down the arm to the hand. It is not difficult to see that a problem anywhere from the neck to the wrist can cause nerve compression symptoms. Signals transmitted from the brain through the median can be distorted by interference from many causes and in many places. Some examples are misaligned bones in the neck, bulging discs, tight neck muscles, an extra rib (some people are born with one), shoulder or elbow injuries, inflamed tendons, and misaligned wrist bones.

If your doctor is treating “carpal tunnel syndrome” by giving you a wrist brace, anti-inflammatory drugs, or perhaps physical therapy for your wrist… it may be absolutely the wrong treatment. If the problem is coming from ABOVE your wrist… you can see why your treatment might fail. Yes, you might get some temporary relief from the drugs reducing inflammation… but the cause or causes of the problem will be completely ignored. 

The proper treatment is determined through proper diagnosis. For example, if the cause of symptoms of hand tingling, numbness, weakness and/or pain is coming from poor movement of the joints of the neck, the primary treatment would be chiropractic, cold laser therapy, and/or home cervical traction devices. 

If the wrist is indeed the culprit, cold laser therapy with manual joint mobilization techniques for the wrist joints would be my first choice. These have all been outstanding treatments for median nerve compression syndromes, even for some folks who have had failed wrist surgery. The cold laser can also be used as a diagnostic screening tool to locate areas of nerve entrapment. It is now easy to understand that if you have pain, numbness, tingling, or weakness in either of your hands… you should be evaluated and treated appropriately anywhere from your neck to your wrist.