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Carpal Tunnel Syndrome
Carpel tunnel syndrome (CTS) is an irritation of the nerve that enters your wrist and goes to your hand and fingers. Symptoms may include any or all of the following: pain, numbness, tingling, weakness in the thumb, second and third fingers; loss of grip strength; shooting pain toward the elbow, shoulder and neck; neck pain and stiffness. The word carpal refers to the 8 bones in the wrist (two rows of four across). The "tunnel" is formed on the top by a ligament which runs across the carpal bones and on the bottom by the carpal bones themselves. A nerve called the median nerve runs through this tunnel to the first three fingers of the hand. This nerve controls the feeling and muscle strength of these fingers.
CTS has many causes. Anything which irritates the median nerve can cause CTS. You may have heard the terms repetitive motion injury or cumulative trauma disorder; these apply to CTS. Overuse. improper use, or both of the hand and wrist may irritate and inflame the median nerve. People who type (computer or typewriter), grasp (store check out counter, painters, plumbers, electricians, carpenters, dentists, dental hygienists, etc...), lift, or do anything with their hands are susceptible to this problem.
CTS may start with just a slight, occasional tingling in the fingers. The tingling may progress to numbness and pain of your wist and hand. Ultimately, loss of gripping and grasping ability with severe pain radiating to the neck may occur. Elbow and shoulder pain may also occur.
A proper history and examination must be performed to properly diagnose CTS. The doctor should ask about your work habits and what causes the pain. The examination should include the taking of vital signs, reflexes, muscle strength, range of motion of your neck, shoulder, elbow, hand, wrist, and fingers, and orthopedic tests. Other tests may include X-rays, blood flow (vascular) tests, and nerve tests. The doctor must differentiate CTS from disorders like sprains and strains of the wrist, fractures, pinched nerve in the neck, ganglion cysts, and ulnar neuropathy ( another nerve going through the wrist to the fourth and fifth fingers).
Treatment for CTS may include chiropractic care, medical care or both. Chiropractic care address the crux of the problem- the nerve irritation. By properly aligning and restoring the function of the joints of the wrist, elbow, shoulder, and neck, chiropractic care treats the cause of the nerve irritation. Quite often treatment of the neck, shoulder, and elbow are forgotten. Treatment of these other areas as well as the wrist are critical to proper care. All of the nerves that go into the shoulder, arm, forearm, hand, and fingers come from the neck. improper function and misalignment of the joints in the neck will cause irritation, "pinching" to these nerves.
Chiropractors use what is called an "adjustment" or manipulation to the joints to properly realign them. You may hear a pop sound when you receive an adjustment. This is just the release of gas (carbon dioxide, nitrogen) from the joint as if you popped the cork off a champagne bottle. This is what takes the pressure off of the nerves and allows them to work correctly.
Treatment may also include physical therapy, electrical muscle stimulation, ultrasound, and traction. Proper rehabilitative exercise, nutritional consultation as well as instructions on how to use your arm and wrist properly at work, are part of complete care. Taking medication to cover up the pain may be fine for the short term, but this does not fix the problem. Surgery should only be considered as a last resort if all else fails. |
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