Methods For Treating Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) is a nerve compression disorder which causes pain and numbness of the hands in 2.7 percentof the adult population. It is the most common nerve compression disorder affecting the upper extremities. The median nerve passes through the carpal tunnel, which is a narrow, rigid passageway in the wrist. When the tendons and other tissues surrounding the carpal tunnel become swollen and inflamed the median nerve becomes compressed. This results in pain and numbness, tingling, and loss of strength and sensation.
People who's work or lifestyle requires prolonged repetitive movements of the wrist, hand and fingers are at increased risk for developing this disorder. People with diabetes or other disorders that affect the nerves are more susceptible as well. Womenhave a three times greater risk of developing CTS than men, possibly because they have a smaller carpal tunnel.
It is important to determine whether symptoms are the result of another underlying condition, such as thoracic outlet syndrome, or cervical spine diseases so the treatment will be appropriate to the condition.
Wrist splints, or braces, help CTS sufferers by holding the wrist in a neutral position to avoid compression of the median nerve that results from improper hand positioning. A study by William C. Walker, MD, from the Medical College of Virginia found, “Wearing the splints either at night onlyor all the time brought significant improvement after the six-weeks, with full-time splint wearers faring slightly better. Symptoms improved, functions were gained, and nerves began to work a bit faster.”
If your CTS has been caused by work or other repetitive movement it is important to modify or eliminate these activities. If some physical activities cannot be avoided altogether, the best option may be periodic breaks from tasks that stress the hand, accompanied by stretching exercises.
A physical or occupational therapist can provide information on proper wrist positions, and correct posture for the neck and upper back. They can recommend exercises that may be helpful in increasing the strength and flexibility of the forearm, wrist, hand and fingers. These exercises can also help in relieving symptoms and avoiding further damage. Physical therapy can also help patients regain strength following a surgical release procedure.
Massage treats CTS by relaxing and lengthening the muscles and fascia in the forearm, from the elbow down into the hand. This allows the inflammation to recede and brings relief from the associated pain and numbness.
Treatments chiropractors often use in treating CTS include manual therapies such as Active Release technique, Graston technique and manipulation of the wrist, elbow and upper spine, as well as ultrasound therapy and wrist supports. Two studies of treatment by these methods have shown that patients, “experienced significant improvement in nerve function, finger sensation, and comfort.”
Non-prescription anti-inflammatory pain relievers, such as NSAIDs, may help relieve pain and inflammation caused by short-term strenuous activities. Other medications may be prescribed by a doctor to treat or ease the symptoms of CTS, although most of these are for temporary relief of symptoms and do not generally resolve the underlying condition.
The American Society of Surgery of the Hand (ASSH) gives this information, “When symptoms are severe or do not improve, surgery may be needed to make more room for the nerve.”
Patients whose symptoms do not respond to other methods of treatment may require surgery. The ligament that forms the roof of the carpal tunnel on the palm side of the wrist is severed, enlarging the tunnel and relieving compression of the medial nerve. Recovery of strength and normal functioning may take several months, and the time it takes for numbness and tingling to go away completely will depend on the severity of the condition.
Coastal Integrative Health is dedicated to helping people overcome physical obstacles and achieve their health and fitness goals. Contact us if you would like to know more about treatments for carpal tunnel syndrome.