When you think of carpal tunnel syndrome, chances are you think of a chronic wrist injury caused by typing on a computer keyboard. But did you know that carpal tunnel syndrome is not a new type of injury? For decades, carpenters, factory workers, and people employed in the garment industry have occasionally suffered carpal tunnel.
Carpal tunnel is not new. Still, healthcare providers are seeing more of this injury since the 1990s, when personal computers became mainstay office technology. This isn’t surprising when you think about it. People who use computers on the job may type 10,000 keystrokes a day. And typically, the keystroke movements are repeated continually, without breaks. By way of comparison, when typists used manual typewriters, they paused periodically-to make corrections, perhaps, to replace the paper. With computers, breaks are often few and far between.
This repetitive motion sets the stage for mechanical stress to the wrists and other skeletal structures. The mechanical stress can be further exacerbated by other factors, including emotional stress and even ambient temperatures. Offices which are air-conditioned, for example, might set the stage for carpal tunnel by causing tissues in the wrist to contract. In fact, having cold hands at work may be a signal that you’re at risk for carpal tunnel.
So what exactly, is carpal tunnel syndrome?
True carpal tunnel syndrome is an entrapment—a pinching—of the median nerve, which is one of the three main nerves that run from the spine to the fingers. The median nerve passes through a cluster of pebble-like bones, the carpals, that nestle snugly together between the bones of the fingers.
The wrist is one place where the median nerve can cause trouble. If stress causes the space between carpals to become constricted, the median nerve may be irritated. The result is often a combination of pain, tingling, and numbness: carpal tunnel syndrome.
Interestingly, the wrist is not the only place where the median nerve can become entrapped. Poor posture or poorly designed furniture can also result in the median nerve becoming irritated in the shoulder, for example. When this happens, the symptoms can be very similar to those caused by pinching in the wrist.
The median nerve is not the only nerve that can be affected by posture or repetitive hand motions. There are other nerves that follow a similar course down the arm, which can also become pinched. For this reason, carpal tunnel syndrome is often misdiagnosed. For example, if the radial nerve is affected, the patient will experience pain radiating up the backside of the hand. This is not carpal tunnel. A tell-tale sign that it’s the median nerve that is having trouble, is pain radiating up the arm.
Treating carpal tunnel
Many people suffering from carpal tunnel syndrome end up in surgery, during which a tendon-like structure called the flexor retinaculum is cut. The flexor retinaculum encircles the wrist like a thick rubber band. When its cut, more spaces open up between the carpals, which can help alleviate the pinching of the median nerve. Chiropractors, however typically seek less drastic ways to alleviate the pinching. In most cases, all that’s needed to cure carpal tunnel is an adjustment that gives the median nerve a hairs breath of space—and this can often be achieved through simpler measures. In addition, sometimes people with carpal tunnel also have other conditions that need to be addressed, such as a misalignment of the two bones of the forearm, the ulna and the radius. Surgery on the retinaculum does not correct this misalignment.
The chiropractic approach
When a chiropractor sees a patient with the symptoms of carpal tunnel, the first step is a complete orthopedic evaluation to see where the nerve entrapment has occurred. The alignment of the neck and upper extremities is checked. X-rays may be requested to help identify the source of the problem. In this way, the chiropractor verifies that it is the median nerve, not the radial nerve that is causing the symptoms.
The chiropractor then may perform an adjustment of the wrist to open up additional space between the carpals. If spinal alignment is also a factor, adjustments to the neck vertebrae may also be needed.
A chiropractor may also stimulate selected acupuncture points. This therapy is based on an ancient Chinese school of medicine that seeks to alleviate pain and other symptoms by manipulating the flow of energy, or ch’i, within the body. Ch’i pathways often correspond to the body’s physical and nervous system; improving the flow of ch’i, therefore, can help with nervous system disorders.
Nutritional therapy can also help with carpal tunnel. Vitamin B6 is a mild diuretic, which can help alleviate the swelling of tissues that can contribute to nerve pinching. At the same time, B6 helps the body’s tendons recover from stress or damage, which can also help in some carpal tunnel cases.
Carpal tunnel syndrome can be a frustrating injury. Yet many patients can experience complete relief from carpal tunnel symptoms in as few as 4-5 chiropractic treatments. Of course, to remain pain-free, patients must also address the injuries or underlying causes—the things that caused the spine or wrist to become misaligned in the first place. For this reason, people with carpal tunnel must pay special attention to their posture. Whenever you work at a computer or any other task that requires repetitive motions of the fingers and wrist, make sure each hand, wrist, and forearm form a straight line. Select a chair that enables you to hold your back straight, rather than hunched over.
In fact, carpal tunnel syndrome doesn’t have to be a long-term, debilitating injury. With good ergonomics, proper posture, and proper care of the spine and wrist, it can be alleviated quickly—and for good.
If you are suffering from carpal tunnel syndrome call us today at 585.586.7630 or complete our New Patient Survey for a free chiropractic consultation with one of our doctors and put yourself back on the road to health.
Dr. Sadlon has over 30 years of experience as a chiropractor, acupuncturist, and integrative medicine practitioner and provides treatment to patients in Brighton, Fairport, Greece, Henrietta, Irondequoit, Penfield, Perinton, Pittsford, Rochester, Victor Walworth, and Webster, NY.