Carpal Tunnel Treatment

Carpal Tunnel Surgery is the second most common surgery performed in the US according to Bureau of Labor and the National Institute of Occupational Safety and Health (OSHA).  Carpal Tunnel Syndrome (CTS) effects roughly 8 million people each year and is more common in women than men.

Certain occupations can have a higher incidence of Carpal Tunnel Syndrome.  It is mostly found in people that work extensively with their hands, for example in manufacturing, mechanical, or office work.  Any trade that requires excessive flexing or extending of the wrist can make a person more prone towards Carpal Tunnel Syndrome.

So what exactly is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is a condition where the nerve that goes through the wrist becomes compressed by muscles and/or ligaments.  Specifically, the Median nerve is affected.  This nerve gives feeling to the thumb and first two fingers on the palm side of the hand.  When the Median nerve becomes compressed, it can start to cause numbness, tingling, and pain in that area, and even weakness.

When a person works a lot with their hands, the tendons and ligaments around the Median nerve can become enlarged from over use and put pressure on the Median nerve.  Typical treatment with Carpal Tunnel Syndrome is to either decrease inflammation around the nerve or the remove the compression entirely.

Surgery for Carpal Tunnel Syndrome

As mentioned earlier, carpal tunnel is the second most common surgery performed in the US. There are two different procedures that surgeons will often do: endoscopic surgery and open surgery.

Endoscopic Surgery

This is a less invasive surgical approach where the surgeon uses a scope to go in and make a couple of small incisions to cut the transverse carpal ligament.  This is a long ligament that goes horizontally across the palm side of the wrist.

Open Surgery

This option involves making an incision on the palm of the hand and cutting the ligament to release pressure from the nerve.

Endoscopic surgery usually involves less pain post-surgery, however, both have the same end goal of cutting the ligament that goes across the wrist to free up pressure. Endoscopic surgery also has a higher incidence of Carpal Tunnel Syndrome recurrence.  The goals is for the ligament to heal in a way that gives more room for the Median nerve.  This generally takes several months.  There are some complications that can happen with surgery, including:  incomplete release of the ligament, wound infections, scar formation, and nerve or vascular injuries.   While many get relief from this procedure, there are risks involved like any surgical procedure, and the recovery is very long.

Non-Surgical Treatment Options

There are some conservative options that are often recommended by medical doctors before going the surgical route.

NSAIDS

This could include the use of NSAIDS, which essentially masks the symptoms by attempting to bring down inflammation to the area.  Like all medication, there is a risk of side effects.

Wrist Splints

There is also the use of wrist splints/braces during sleep to try to keep the wrist in a neutral position to reduce flexion at night

Therapy Options

Other treatment options include things like physical therapy, massage, or yoga.  The goal with these is to stretch the tissues in the wrist to help relieve some of the pressure on the Median nerve.  Some of these options can be effective, however, prevention is always the best strategy.

Prevention is the Best Option

First, make sure you are not over-using your hands and doing excessive flexion or extension with your wrist. Proper ergonomics at your workplace is very important to keep your wrist in as much of a neutral position as possible. Many workplaces can offer ergonomic specialists to evaluate the space to help prevent chronic injury.

Some other simple actions include alternating hands, not gripping too tightly, and even taking breaks to make sure you are allowing your hands to rest.  Another way to prevent the progression of this painful condition is to take a closer look at another possible cause: Obstruction at the root of the Median nerve.

Can Chiropractic Care Help with Carpal Tunnel Syndrome?

The Median Nerve originates from a nerve root that comes out of the base of the neck.  In some people, pressure will originate on the nerve where it exits the spine, irritating it enough that any further pressure at the wrist will elicit symptoms.

This phenomenon is called Double Crush Syndrome.  This means that there are two sites where the median nerve is being irritated.  Many of the patients that we see in our office with carpal tunnel syndrome typically have a history of some sort of past trauma. In addition to Carpal Tunnel Syndrome they may also have neck pain, shoulder pain, back pain, and/or headaches.

The Role Neck Trauma Plays

Any sort of trauma, even if it happened years ago, can damage the muscles and ligaments of the spine. If tissues do not heal in proper alignment the person may experience symptoms later in life, sometimes years later. Therefore, a spinal injury can result in the symptoms of Carpal Tunnel Syndrome.  The symptoms may be aggravated by issues in the wrist, but the problem may actually originate at the spine.  A more conservative and effective type of care that gets to the cause is Upper Cervical Chiropractic Care.

Upper Cervical Chiropractic Treatment

Upper Cervical Chiropractic focuses on the proper alignment of the top two bones in the neck, the Atlas and the Axis.  This is the least stable area of the spine.  There are only small muscles and ligaments holding these bones together. Plus, add the skull on top, which weighs about as much as a bowling ball, and you have an area that can easily get injured during a trauma.

When the Atlas becomes misaligned, it puts an increased stress on the area of the brainstem that passes through this bone.  This can have an effect on all parts of the body as this is Grand Central Station for all the messages that go from the brain to the body and vice versa.

Additionally, the body will follow where your head goes.  So if the head becomes misaligned, the body will compensate.  The shoulders and pelvis become uneven, putting stress unevenly on the spine.  This is called a righting reflex.  This could increase stress at multiple points of the spine and joints since the entire body is not in balance.

Therefore, when a person goes about their daily activities, while out of alignment, pain can result in multiple areas of the spine;  especially at the base of the neck where the nerve root for the Median Nerve exits.  If the upper cervical spine is left out of alignment, the cause will never be fixed.

The goal of an upper cervical chiropractor is to determine how the upper neck is misaligned and how to precisely correct it.  Once the alignment is corrected, it needs to hold.  Holding is healing.

Holding allows the body to stop compensating and put pressure on the rest of the spine and joints. Therefore, with Carpal Tunnel Syndrome, upper cervical chiropractors address the cause by taking pressure off the nerve where it exits the spine, so it does not get symptomatic at the wrist.

Upper cervical care is a safe and noninvasive form of healthcare that gets to the cause of the problem.  If you have been told you need the second most commonly performed surgery in the US, but want to know if you have another option, please contact the nearest upper cervical chiropractor for a consultation. 

Call our office today for a free consultation. Dr. Thad Vuagniaux at Upper Cervical Glen Carbon committed to helping those in pain.