Carpal Tunnel Syndrome

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ctsCarpal Tunnel Syndrome (CTS) is the entrapment of  the median nerve at the wrist and causes numbness, tingling, and pain in the hand. More specially the pain, numbness, and tingling occurs on the palm side in the thumb, index, middle, and occasionally the ring finger. These symptoms on the back side or in any other part of the hand is not true carpal tunnel syndrome. Pain, numbness, and tingling starting in the elbow area and includes the thumb and fingers mimics carpal tunnel but could be pronator teres syndrome.

The carpal tunnel is a narrow canal or passageway  located on the palm side of the wrist. A ligament, the transverse carpal ligament, covers the tunnel and the 9 tendons of the forearm/wrist muscles along with the median nerve pass through the tunnel. When the ligament shortens due to adhesion/scar tissue development median nerve compression occurs. This compression causes numbness, tingling and/or pain to occur in the hand and fingers. Overuse of the forearm muscle and tendons can cause crowding and adhesion development in the tunnel and also lead to nerve compression.

Standard medical treatment for carpal tunnel is wrist brace for 6 months
, NSAIDs,  and surgery if symptoms precede.  According to Mayo Clinic, “Fortunately, for most people who develop carpal tunnel syndrome, proper treatment usually can relieve the tingling and numbness and restore wrist and hand function.” Conservative treatment consist of nerve mobilization to free the nerve of compression, Graston to mobilze the soft tissue (ligaments/tendons, and rehab to decrease the factors that lead to CTS. According to research Graston has a 88% success rate for the treatment of CTS. Click here to see CTS exercises.

 

Yours in Health,

 

Dr. Justin Hildebrand

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