Carpal Tunnel Syndrome:
Difficultly in Carpal Tunnel Syndrome Management
Carpal tunnel syndrome (CTS) can be a complex condition that can be a challenge to manage for several reasons.
- There can be multiple contributing causes. Seldom is CTS the result of one traumatic event, like a broken wrist that produces instant symptoms that requires emergency surgical treatment. Rather, the condition tends to develop over time as the result of an accumulation of microtraumas that affect the tissues in the carpal tunnel and place pressure on the median nerve and hamper its mobility. To complicate matters even more, conditions like hypothyroidism, pregnancy, obesity, and the use of birth control pills can also affect the function of the median nerve, either directly or indirectly through swelling/inflammation.
- Median nerve entrapment elsewhere. The median nerve originates in the cervical spine and travels from the neck to the shoulder and down the arm. Compression anywhere along the path of the nerve can stimulate CTS-like symptoms. Additionally, entrapment of the median nerve elsewhere on its course can often co-occur with entrapment at the wrist.
- It might not be carpal tunnel syndrome. While we commonly associate symptoms in the hand and fingers with CTS, there are two additional nerves—the radial and ulnar—that innervate other parts of the hand and fingers. Radial and ulnar nerve entrapment can also co-occur with CTS.
- Work can be the cause. Occupational exposure to vibration, repetitive movements, infrequent breaks, and awkward wrist postures can each increase the risk for CTS. It may not be possible for the patient to change how they perform their work, which can make recovery difficult.
- Some factors can’t be controlled. Women are three times more likely to develop CTS than men, which is believed to be due to females having a narrower carpal tunnel and possibly hormonal differences compared with males. The risk for CTS also increases with age.
- Patients often wait too long. Because CTS symptoms come on gradually, it’s easy to ignore them, and a patient may not seek care until their symptoms become so bothersome or severe that they simply can’t maintain their usual activities. Unfortunately, the longer a patient waits, the longer it may take to achieve a satisfactory resolution. In some cases, a full resolution may not be possible or surgery may be the only viable option.
The good news is that chiropractic care can be an effective intervention for managing CTS, especially if you seek care sooner rather than later. If necessary, your doctor of chiropractic will co-manage the case with an allied healthcare provider to give you the best possible chance at recovery.