What is Carpal Tunnel Syndrom?
Median nerve Compression, also known as Carpal Tunnel Syndrome.
It was first described in the mid-1800s. It has been recognized by orthopaedic surgoens for more than 40 years. The first Carpal tunnel surgery was done in the 1930s. To explain further median nerve, which is one of the main nerves that supply our hands. The median nerve originates from the neck, combined with other nerve roots in the neck form a single nerve in the arm. In hand, it passes through the carpal tunnel at the wrist and supplies our hand. It mainly provides feeling in the thumb and index and part of the middle finger. The median nerve also controls the muscles around the base of the thumb. In the Carpal tunnel, alongside the nerve, nine tendons that bend the fingers and thumb are also are located.
What are the common causes of CTS?
Major cases of carpal tunnel syndrome are caused by a combination of factors such as gender and age; Studies indicate that women and older people are more likely to develop Carpal Tunnel syndrome.
Like many other diseases, there are some risk factors, including
Genetic. The carpal tunnel anatomy may be smaller in some people, and this can affect the outcome.
Repetitive use. Repeating the same motions or activities for a long period can irritate the tendons in the wrist, causing swelling that puts pressure on the nerve.
Certain occupation. Certain activities that involve extreme flexion or extension of the wrist for a long time can increase pressure on the nerve.
Pregnancy. Commonly, hormonal changes during pregnancy cause swelling in the Carpal Tunnel.
Metabolic conditions such as Diabetes, Thyroid condition, and rheumatoid arthritis are conditions that pose the body into inflammation and have been associated with carpal tunnel syndrome.
Tests
After a complete history and general health examination, certain standard tests to evaluate carpal tunnel are:
Tappin along the median nerve in order to aggravate the symptoms such as numbness or tingling in the fingers ( it is called The Tinel sign)
They were bending and holding the wrists in a flexed position again to see if the symptoms appear or get aggravated.
The patient rests their elbows on a table and allows the wrist to fall forward freely. Patients with carpal tunnel syndrome may experience numbness and tingling in the fingers in 60 seconds or less. The more quickly symptoms appear, the more severe the carpal tunnel syndrome is.
Light touch Test to check the sensitivity of the fingertips and hands with an instrument.
Check for strength and weakness in the muscles around the base of the thumb.
Often atrophy in the muscles around the base of your thumb. In severe cases, these muscles are visibly smaller.
X-ray to check for any blockage in the cervical spine or the rib
MRI to evaluate the soft tissue.
Nerve Conduction Studies to evaluate the extent of damage of the nerve.
Certain populations are more at risk for Carpal Tunnel Syndrome, such as:
people with jobs that involve repetitive use of their fingers.Certain motions place people at risk of developing carpal tunnel syndrome They include:
High-force (hammering).
Extreme wrist motions
Vibration
Many factors can also contribute to the development of carpal tunnel syndrome, such as:
Heredity
Pregnancy is one of the common causes
Previous Wrist fracture and dislocation
Deformity of Hand or wrist
Arthritic conditions such as rheumatoid arthritis, gout
Thyroid gland hormone problems(hypothyroidism).
Diabetes
Alcoholism
Tumor or any mass that occupies in the Carpal tunnel area
Aging
Inflammation
Carpal tunnel syndrome is to be more common in women than in men.
What are the symptoms of CPT?
Symptoms usually begin slowly and may occur at any stage of life and build gradually.
Early-onset of symptoms could be:
Night numbness
Tingling, or pain in the fingers (especially the thumb, index, and middle fingers).
The first symptom that is usually reported is numbness or tingling at night. When people sleep with their wrists curled; nighttime symptoms are more common and can wake people from sleep. Usually, in the early stages shaking hands helps relieve symptoms.
Daytime symptoms can include:
Tingling in the fingers specially thumb
loss of feeling in the tip of the finger
Difficulty using the hand for smaller tasks, such as:
Grasping a steering wheel to drive
Holding a small obejcts
Writing.
Using a computer keyboard.
The symptoms become more constant as the carpal tunnel worsens. These symptoms can include:
Weakness in the hand
Inability to perform delicate tasks (example: buttoning a shirt)
Often patients complaints of dropping small to medium size objects.
In some severe condition, the muscles at the base of the thumb will atrophy.
Carpal tunnel syndrome is difficult to prevent. The condition can be caused by so different activities in a person’s life that is hard to change. Workstation ergonomic changes such as : proper seating, hand, and wrist position may help decrease some of the factors that result in carpal tunnel syndrome.
Other preventative methods include:
Sleeping with your wrists held straight.
Keeping wrists straight while using tools.
Avoiding flexing and extending wrists.
Decreasing repetitive motion/avoid strong grasping with the wrist in a flexed position.
Frequent rest between repetitive activities.
Practice conditioning and stretching exercises before and after activities.
Properly treating medical conditions that are linked to carpal tunnel syndrome.
How our Chiropractor in Newport Beach, Dr.Gilak will treat CTS?
Non-surgical treatment of carpal tunnel usually is consist of:
Use of Nonsteroidal anti-inflammatory drugs (NSAIDs).
Activity Modifications. Certain position aggravates the symptoms avoiding them, or modifying these activities are the key in slowing down the inflammation. Changing work ergonomics could be the key. Bracing also could help with management of CTS.
Exercises. Most patients may benefit from stretch and strengthing the proper muscles to remove the pressure off the median nerve.
Chanign ergonomics could also be beneficial for patients, changes such as:
Raising or lowering the chair you sit on
Moving the computer keyboard
Changing hand/wrist position while doing certain activities.
Our Chiropractor in Newport Beach uses affordable, less aggressive methods to treat CPT, it a great way to treat Carpal Tunnel Syndrome conservatively.
Dr.Gilak, a chiropractor and physiotherapist based in Newport Beach, CA, has been certified in the Active Release Technique and other soft tissue modalites and have been using these technique along the side of biomechanical and spinal corrective exercises, changing ergonomic to treat Carpal Tunnel Syndrome. Following a personal consultation, our chiropractor will analyze the condition of your Carpal Tunnel Syndrome and provide a custom and individualized plan to help you to resume your daily activities pain-free. If you are interested in a successful comprehensive plan for our Newport Beach Chiropractic Clinic, feel free to make an appointment with us.