Carpal Tunnel Syndrome is also know as a type of repetitive stress injury.  Repetitive Stress Injuries (RSI) are common injuries affecting more and more individuals, especially in the computer age that we live in.

Like the name suggests, “repititive stress (or strain)” occurs by doing an activity over and over until eventually an “injury” occurs.

Now I know that the image of an injury usually conjuers up the idea of an acute type mechanism, meaning there is a close relationship between what you just did, and the resultant pain. For example, lifting a television, moving furniture, twisting an ankle, or even a motor vehicle accident, can all be linked to the specific “event” that resulted in the injury.

What causes Carpal Tunnel Syndrome?

With carpal tunnel syndrome, it doesn’t quite work that way. “Repetitive” implies that the injury occurs over time. Being in front of a computer, using a keyboard, and holding your body and posture in a certain position over an 8 hour day, will ultimatley cause a carpal tunnel syndrome.

Repitively using your upper body, shoulders, and arms will result in a RSI as well .Think of an athlete like a tennis player or golfer, they repititively use the upper body and arm to swing the raquect of club. “Golfers Elbow” or Tennis Elbow” are two types of RSI that is characterized by inflammation of specific tendons and ligaments, resulting in bursitis and tendonitis.

Carpal Tunnel Syndrome (CTS) is a very common problem affecting many workers and is one of the costliest condition afflicting today’s workforce. It too, is another type of RSI.

Again, the repititive nature of using rapid movements in the arms and hands can lead to an injury over time, and can also lead to work loss and disability when not properly managed.

Carpal Tunnel Syndrome (CTS) is characterized by numbness and tingling and/or pain of the index, middle and forth fingers.

 

Why do you get carpal tunnel syndrome?

The reason that we get the carpal tunnel syndrome is because when the median nerve that travels through the carpal tunnel (CT) it becomes pinched by the swelling of the 9 tendons that also travel through the carpal tunnel. The carpal tunnel is located on the palm side of the wrist, and the median nerve when “pinched”, will come in contact with the transverse carpal ligament that holds on the tendons in secure.

Sleep interuption where shaking and flinging the fingers to help “wake them up” is also reported with Carpal tunnel syndrome. This is caused by sleeping with the wrist in a flexed or bent position, which ultimately increases the pressure inside the already swollen carpal tunnel.

The way I explain this phenomena to my patients is to have them invision a piano player. We all can see that pianist flexing her wrist downwards, which bares down on the carpal tunnel. As a solution, I further explain have them imagine spiderman when he spins a web, spidey extends his wrist backwards to open up the carpal tunnel.

This is why a “cock-up” wrist splint usually helps as it does not allow the wrist from bending to the extremes and the nerve is not pressured or pinched as much.

Carpal Tunnel Syndrome Symptoms:

Other symptoms associated with Carpal tunnel syndrome are weakness in grip or grip strength, making it difficult turning a door handle, or opening a lid to a tightly squeezed jar. Driving can also by affected as the hands may fall asleep while holding the steering wheel.

Many times with Carpal tunnel syndrome, pain in the neck and rest of the arm may be reported. “Double Crush” injuries is when the median nerve that is pinched in the carpal tunnel, is also pinched in another place, thus the name “double crush”.

It may be squeezed in the forearm, the shoulder, or even where it exits out of the neck. Thus it is necessary to not only evaluate these other areas, but to treat them as well.

Women are at greater risk for Carpal tunnel syndrome then men, workers handling small tools, computer workers, waitresses/waiters, factory line workers, and people older then 40 years of age are more at risk. Conditions like Rheumatoid arthritis, diabetes, Lymes disease, pregnancy, birth control and menopause all increase the risk of getting Carpal tunnel syndrome.

So what should you do once you have Carpal tunnel syndrome???

Well, even though treatment is very important, and the sooner the better, PREVENTION is the KEY.

What’s great about that is the fact that simple changes can make a huge difference. Modifying the position of a computer chair, keyboard, monitor, or mouse so that your wrist is in a slightly extended position (think about spider man again, never flexed).

Alternating tasks, so that you are not doing the same thing over and over again, to reduce the “repitition”.Sretching your forearms and fingers before, during, and after work goes a long way too.

I always suggest that every hour on the hour while at work, or in front of a computer, stretch each arm 3-5 x for 30 seconds each arm, counting one one thousand, two one thousand, etc. This works fantastically, and basically can be done anywhere.

When Carpal tunnel syndrome symptoms first appear, these recommendations, as well as wearing a night wrist cokc-up splint will often reverse the conditions without difficulty. Chiropractic care is an awesome solution as well, especially because the neck bones and the postural changes that result from the RSI.

If you wait too long, and nerve damage occurs, it becomes more challenging to manage, with surgery not being very helpful as well.

Some of the treatment approaches by the chiropractic physician include joint mobilization or manipulation applied to the neck, shoulder, elbow, wrist. As well, ultrasound, electrical stimulation, or even low level laser therapy (LLLT).

In regards to the stretches illustrated above, as mentioned early these can be fantastic at reducing the symptoms associated with carpal tunnel syndrome. However, focusing on posture, which involves the entire spine, is essential. Thus exercises that work on posture, namely increasing the curve in the lower spine, and reducing forward head carriage.

Hope this advice helps with your own carpal tunnel syndrome.

Until then, watching your back, and neck.

 

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