What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition of the wrist that is generally caused by overuse and repetitive strain injuries. This causes the narrowing and inflammation in the carpal tunnel — a narrow tunnel of bone and cartilage in the wrist that houses nerves, tendons and blood vessels leading to and from the forearm and hand — causing nerve pain and pressure up the arm. Tingling the fingertips and poor circulation are very typical symptoms of carpal tunnel syndrome.

Effective Treatments for Carpal Tunnel Syndrome

At Shepherd Health, we use a number of different treatment modalities to effectively treat this uncomfortable, and often debilitating condition. Active release and massage therapy is used to treat the tissues and tendons that cause CTS. Cold laser therapy treats wrist pain on a cellular level by promoting cells to produce more energy, in turn promoting healing. As light energy is transformed into biochemical energy in the body, the blood supply to damaged cells is increased and the healing process is stimulated. Shockwave therapy and nerve flossing are some of the other treatments we use here at Shephard Health.

Understanding CTS

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What are the causes of carpal tunnel syndrome?

There are eight bones found in your wrist that form a U-shaped channel that houses several tendons and your median nerve. This channel is known as the carpal tunnel. Your median nerve is responsible for your feeling and your sensation on the palm side of your first 3 ½ fingers.

Compression or irritation of this nerve as it travels through the carpal tunnel is responsible for the creation of a condition known as Carpal Tunnel Syndrome (CTS). CTS is currently the most common nerve entrapment, affecting 3-5% of the general population. Females are affected roughly two or three times more often than males. Carpal tunnel syndrome most often is found in adults age 45-60. 

Risk Factors Of CTS

CTS can be caused by prolonged wrist flexion and/or repetitive wrist motions like supermarket scanning, keyboard use, carpentry or assembly line work. Exposure to vibration or cold is also known to aggravate the condition or worsen it.

Carpal Tunnel Syndrome is more common in your dominant hand but can also frequently affect both hands. Some risk factors for developing CTS include diabetes, thyroid disease, rheumatoid arthritis, alcoholism, kidney disease, being short or overweight. Fluid retention during pregnancy is also common cause of carpal tunnel symptoms. 

What are the symptoms of CTS?

Symptoms of CTS include numbness, tingling or discomfort on the palm side of your thumb, index, middle finger and half of your ring finger. The pain and discomfort you feel can also sometimes extend towards your elbow. The symptoms you experience usually start as nighttime discomfort or waking up with numb hands, but can rapidly progress to a constant annoyance.

Your symptoms are likely aggravated by gripping activities such as holding a book while reading, driving or painting. Early on, your symptoms may be reduced by simply "shaking your hands out". You may sometimes feel as though your hands are tight or swollen. In more severe cases, hand weakness can form.

How to treat CTS

Compression of the median nerve that is found in the carpal tunnel is often accompanied by compression at a second or third site as well. Researchers call this "double crush syndrome." Common "double crush" partners for CTS also involve the spine or muscles in and around your neck, shoulder and forearm.  

To help resolve your condition, you should do your best to avoid activities that involve repetitive wrist flexion, i.e. pushups. Grasping the handlebars on your bicycle will likely increase irritation of your condition. We may prescribe a special splint that keeps your wrist in a neutral or slightly extended position that will help with your nighttime symptoms. 

Recovering From CTS

If left untreated, carpal tunnel syndrome can cause your forearm to sustain permanent nerve damage. The American Academy of Neurology recommends conservative treatment, like the type provided in our office, before going down the surgical route.

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