Carpal Tunnel Syndrome (CTS) is a condition that causes numbness, tingling and pain in the hand and wrist. It happens when the median nerve becomes entrapped or compressed at the carpal tunnel, a bony tunnel in the wrist.

Symptoms:

Sufferers of CTS will often have numbness and tingling on the palmar side of the thumb, index, middle and outer edge of the ring finger. There is often pain and inflammation in this area as well as on the front of the wrist and sometimes even up the arm. Weakness often results, and CTS suffers will find themselves dropping things from their affected hand. Sufferers will often find themselves shaking out their hands in and attempt to regain normal sensation. As the condition progresses, this may not offer any relief.

Causes:

There are many causes of CTS, and often it comes down to a combination of causes. The carpal tunnel is formed by the wrist bones on the bottom and sides and a ligament (transverse carpal ligament) on top. Inside the carpal tunnel are 9 tendons, a vein, an artery and the median nerve. Anything that reduces the space available to the median nerve can create symptoms. This could be inflammation of one or more of those structures due to causes such as repetitive stress or arthritis, thickening of the tissues, injury to or misalignment of the carpal bones and more.

Risk factors:

Certain people are more prone to CTS than others. Women get CTS more frequently than men. Those who have nerve damaging conditions such as diabetes or who have sustained damage are more at risk. Various medical conditions such as thyroid disfunction and obesity increase risk at well. The most well-known risk factor for CTS is RSI or Repetitive Stress Injuries, just as injuries from typing and mousing.

Treatment:

Classically, the treatment for CTS includes anti-inflammatories, splinting and potentially surgery. At The Body Mechanic, a more holistic approach is taken. We must recognize that CTS is NOT just a problem of the wrist. Compression/entrapment of the median nerve elsewhere, or even of it’s contributing nerve structures further up in the arm or neck can contribute. The Double-Crush phenomenon dictates that entrapment or compromise to one part of a nerve, makes other parts of the nerve more vulnerable to inflammation and entrapment. So, in order to fully resolve CTS and to ensure it doesn’t return, treatment must extend beyond the wrist. Components of CTS resolution include address nerve entrapments and adhesions, addressing dysfunctions and adhesions involving the muscles and tendons of the carpal tunnel, addressing misalignments of the wrist bones, and potentially addressing compression or misalignment of the neck. Additionally, breath mechanics must be addressed and contributing factors such as ergonomics must be addressed as well. Ergonomics alone won’t resolve the issue though. For some times on proper ergonomics, refer to the blow infographic.

Carpal Tunnel Syndrome is a highly treatment problem and often does NOT require surgery. In fact, the surgery itself doesn’t have a particularly great success rate as is. I encourage clients to try Active Release Techniques and other non-invasive methods first before trying more drastic methods. The results speak for themselves.