Carpal Tunnel Syndrome or CTS is a very common problem affecting many workers and is one of the most costly conditions afflicting today’s workforce. It is most often caused by repetitive activity involving rapid movements of the arms and hands and can lead to work loss and disability when not properly managed. CTS occurs when the median nerve that travels through the carpal tunnel (CT) located on the palm side of the wrist becomes pinched by the swelling of the 9 tendons that also travel through the CT. This results in numbness, tingling and/or pain of the index, middle, and forth fingers.
Other symptoms include sleep interruptions where shaking and flicking of the fingers is required to allow for a return to sleep. This is frequently caused by sleeping with the wrist in a cocked position, which increases the pressure inside the already swollen carpal tunnel. This is why a cock-up wrist splint usually helps as it keeps the wrist from bending to the extremes so the nerve is not pressured or pinched as much. Other symptoms include weakness of the grip, making it a challenge to unscrew a jar, open a door, and even sometimes turn the key when starting a car. Driving can also be affected as the hands often fall asleep while holding onto a steering wheel.
Pain can also affect the rest of the arm and sometimes the neck area. The median nerve can also be pinched in more than one place and may include the neck, shoulder, elbow, as well as the wrist making it necessary to have all the areas treated for a satisfying result.
People at greatest risk are women > men, workers who handle small tools, computer workers, fast repetitive line workers, and people older than 40 years of age. People with other health conditions including rheumatoid arthritis, Lyme disease, rubella, pregnancy, birth control pill use, diabetes mellitus, and menopause are at an increased risk of developing CTS. Certain foods such as caffeine, tobacco, and/or alcohol may also contribute to CTS.
Though treatment is very important –the sooner the better- prevention is perhaps most important. In fact, some simple approaches can make a big difference! Some of these include modifying the position of a computer chair, keyboard, monitor, or mouse (work station modifications), alternate between different tasks to reduce the repetition of work, stretch your forearms and fingers before, during and after work, and treat any underlying conditions. When symptoms first occur, these recommendations, as well as wearing a night wrist cock-up splint and seeing your chiropractor, will often reverse the condition without difficulty. If you wait too long and nerve damage occurs, it becomes a more challenging process to manage CTS and at times, even surgery will not be very helpful.
Some of the non-surgical treatment approaches you might expect from your chiropractor include joint manipulation and/or mobilization applied to the neck, wrist, elbow and/or shoulder, the application of physical therapy modalities such as ultrasound, electrical stim, and/or low level laser therapy ("light" therapy), as well as the use of wrist splints.
The University of Maryland Medical Center cites two research articles on chiropractic treatment for CTS. They report good results are usually obtained and that these good results continued for at least 6 months after treatment ended. The same reference also recommends nutrition and supplements in the management of CTS. Some of these include: eliminate food allergens (often milk, cheese, eggs, ice cream, glutens/wheat-grains, soy, corn, and preservatives) and eating foods high in B-vitamins (dark leafy greens like spinach, kale, and sea vegetables), anti-oxidants (fruits – blueberries, cherries, tomatoes; vegetables – squash, bell peppers), avoiding refined foods, using olive oil, and adding omega 3 fatty acids to the diet (fish oil). Other vitamins including a multivitamin, B complex, Vit. C, alpha-lipoic acid, MSM, resveratrol, Vit. D, Co-Q10, magnesium can also really help.
