July 21, 2017


Carpal Tunnel: Is There Light at the End of the (Carpal) Tunnel?

by Dr. Shaila Goldsman

Have you been dropping your coffee mug in the morning? Trouble holding your pen? You may be experiencing more than just clumsiness! Carpal tunnel syndrome seems to be a term many are familiar with, but don’t know much about! The carpal tunnel is a narrow passageway in the wrist formed by bones and ligaments. Nine tendons and one nerve, known as the median nerve, pass through this space. When the median nerve becomes pressed or squeezed in this tunnel, it can lead to painful sensations, and carpal tunnel syndrome (CTS) occurs.

Am I at Risk?

Anyone can be afflicted with CTS, but there are a number of risk factors that may cause some to develop it more than others.

Age: As we increase in age, the chance of developing CTS increases.

Gender: Women have a significantly higher risk for developing CTS as compared to men – 3 times more likely, in fact (sorry, ladies…!). This may be due to the fact that women have smaller wrists than men, and hormonal changes also appear to be related. CTS is also common during pregnancy, but is usually less severe and will usually go away within 6 months of delivery. CTS has also been associated with menopause.

Obesity: Being overweight is a major risk factor for CTS. Why? I’m glad you asked! A greater body mass slows down the speed of nerve signals to the hand! It is also associated with decreased overall physical fitness, which can also increase the risk of CTS and decreased nerve signaling speed.

Anatomical Changes: Have you fractured or dislocated your wrist? This can alter the space within the carpal tunnel and increase pressure on your median nerve!

Nerve-damaging Conditions: Certain chronic illnesses, such as diabetes and alcoholism (among others) can increase the risk of nerve damage, including that to the median nerve.

Inflammatory Disorders: Illnesses characterized by inflammation, such as rheumatoid arthritis, infections, and certain cancers, can affect the fluid levels in your body and can cause fluid retention (swelling). If you are retaining fluid, the pressure within your carpal tunnel may increase and irritate the median nerve.

Cigarette Smoking and Alcohol Abuse: Smoking cigarettes will slow down your blood flow, which will worsen CTS symptoms and lead to a slower recovery from CTS, as compared to non-smokers. Increased alcohol intake has also been associated with CTS for a myriad of reasons – some have already been mentioned above.

Not Just at Work!

Those who love to cook, sew, knit, do needlepoint, play computer and video games, text on their phones, do carpentry or use power tools are at increased risk for CTS too! Long-distance cycling may also make the symptoms of CTS worsen.

How do I know if I may have CTS?

Symptoms can vary in frequency and intensity. Here is a list of the more common symptoms to look out for:

pain, tingling, or numbness in the thumb or fingers
pain from your hands, up the arm, which may extend to your shoulders or neck
a swollen or ‘tight’ feeling in your hands or wrists
hands or lower arms may feel weak, especially in the morning
you may drop things more than usual
difficulty pinching or grasping objects
difficulty with detail tasks (ie. writing or tying your shoes)
difficulty with strength tasks (ie. opening sealed jars or using a screwdriver)

CTS and Your Chiropractor:

CTS is very commonly treated by chiropractors! Your median nerve originates in your spine and travels down your arm to your fingertips. Your chiropractor will examine you for proper mobility and positioning in all areas that the nerve passes though (neck, shoulder, elbow, wrist, fingers). After you have been examined, your chiropractor will utilize specific methods to reduce the irritation to the nerve along its length. The most common treatments include manipulation to the upper spine, shoulder, elbow and wrist. Your doctor will almost always prescribe a special brace for your wrist to wear while you are sleeping. Your posture is also often assessed as incorrect posture and wrist positioning during repetitive tasks (typing, for example) can aggravate your CTS symptoms. Chiropractic care offers drug-free, non-surgical treatment for CTS patients, and has been proven to yield excellent, long-term results.

Ask Dr. Shaila Goldsman a question - email here

Dr. Shaila Goldsman

Toronto Health and Physical Rehabilitation Clinic

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