Carpal Tunnel Syndrome (CTS) is when a nerve in the wrist (the median nerve) becomes compressed, usually due to repetitive motions over time, acute trauma (rare), or as part of other upper extremity musculoskeletal disease complexes.
Either the diameter of the carpal tunnel narrows or the contents of the carpal tunnel expand putting pressure on the median nerve (which originates in the neck). The carpal tunnel is a small opening, about the size of the tip of your pinkey, that is created by the 8 carpal bones and the transverse ligament that holds them together. There is no extra space in the carpal tunnel.
Inside the carpal tunnel is the median nerve and some some blood vessels. The median nerve has protective sheaths around it that also secrete fluids which allow for the nerve to glide within the tunnel.
With overuse syndromes such as repetitive stress injuries (RSI) the fluid dries up and the nerve sheath and median nerve swell causing pain and dysfunction. RSI can also cause the carpal bones to misalign which can irritate the median nerve as well. Trauma to the hand can also cause CTS. The signs and symptoms of carpal tunnel syndrome are as follows:
- Hand Pain
- Numbness and Tingling
- Weak Grip
- Night Pain
- Neck, shoulder, elbow pain
So, true carpal tunnel syndrome is when there is compression of the median nerve in the carpal tunnel…either from the tunnel narrowing or the contents expanding. True CTS is rare. The majority of the time CTS symptoms are NOT the result of true CTS…they are the result of problems (nerve pressure) in the neck.
The median nerve originates in the neck. It is actually created by branches of nerve roots that exit the lower part of the neck (C5-8). Each of these nerves passes through bones. If there is any kind of nerve pressure on these nerve roots it can cause the same exact symptoms in the hand that you would get if you had true CTS.
This is why it’s so important to visit a doctor that routinely treats patients with carpal tunnel SYMPTOMS. Carpal Tunnel Syndrome is one of the most misdiagnosed conditions there is. It is not uncommon for an emergency room doctor or primary physician or nurse to make a CTS diagnosis for hand pain. The typical course of treatment is a wrist splint and Motrin. Meanwhile, the true cause in the neck is left untreated.
Some of the conditions in the neck that can cause carpal tunnel SYMPTOMS in the upper extremity are as follows:
- Bulging or Herniated Cervical Disc
- Vertebral Subluxation
- Thoracic Outlet Syndrome
- Facet Syndrome
- Degenerative Disc Disease
- Spinal Stenosis
There are other upper extremity disorders that can mimic CTS. The point here is you need to know what they are and how to check for them. And even more importantly…how to treat them before they get worse.
A chiropractor that specializes in carpal tunnel syndrome and related disorders is your best bet. We may take x-rays or order a nerve conduction test or MRI. The treatments we use to treat these types of problems are spinal and extremity adjustments (gentle), massage, laser, exercise, ice/heat, physical therapy, ART, Graston, traction.
All cases present differently and are treated as such. Often times a patient that presents with carpal tunnel SYMPTOMS can be fixed in a fe days. Other times, with more chronic cases it takes months. And everything in between.
Whatever you do make sure you see an expert. My advice is to see a chiropractor. Call around. Search the internet and find out if the doctor is experienced in carpal tunnel treatment and call and speak to them.
And even if you do have true carpal tunnel syndrome, a trained chiropractor is your best treatment choice. You can save yourself a lot of time and grief by doing some homework.
If you live or work in San Francisco you can see us. We also have medical doctors and physical therapists in the event you need them.
To make an appointment with a carpal tunnel doctor in San Francisco please call 415-392-2225. We validate parking at the Embarcadero Center.