Is it difficult to grasp a jar, bottle, or cup? Have you lost the strength to twist open a large jar? Do you have tingling or numbness in your hand, wrist, or fingers? Or, does your wrist just hurt? If you have some or all of these symptoms, you may have Carpal Tunnel Syndrome (CTS).

Carpal tunnel syndrome is numbness, tingling and pain in the thumb and fingers of one or both hands. It is caused by pressure on the nerve that passes into the hand. CTS typically occurs in adults, with women 3 times more likely to develop it than men. One survey found that it affects 7% of women, compared with 1% of men. The condition can occur at any age, but tends to affect those in their 40s and 50s.

It is common to hear this term used frequently when patients have wrist or hand pain. The human body has two long bones that start at the elbow and extend to our wrists. These bones are called the ulna and the radius. Connective tissue attaches the bones near the wrist from one side to the other. Picture in your mind, a piece of silk attached to both bones and pulled tightly.  The pressure on the nerves below is the most common cause of true carpal tunnel syndrome and may result in pain, weakness, and/or numbness in the hand and wrist, which radiates up into the forearm.  Fortunately, not all wrist pain should be called CTS. It is important to determine, if in fact, the symptoms are being caused by the pressure on the nerves of the wrist, or if there is a different cause of the problem.

Symptoms can include burning, tingling, itching, and/or numbness in the palm of the hand and thumb, index, and middle fingers are most common. Some people with CTS say that their fingers feel useless and swollen, even though little or no swelling is apparent. Since many people sleep with flexed wrists, the symptoms often first appear while sleeping. As symptoms worsen, they may feel tingling during the day.  In addition, weakened grip strength may make it difficult to form a fist or grasp small objects. Some people develop wasting of the muscles at the base of the thumb. Others are unable to distinguish hot from cold by touch.

Why does CTS develop?  Some people have smaller carpal tunnels than others, which makes the median nerve compression more likely. In others, CTS can develop because of an injury to the wrist that causes swelling, over activity of the pituitary gland, hypothyroidism, diabetes, inflammatory arthritis, mechanical problems in the wrist joint, poor work ergonomics, repeated use of vibrating hand tools, and fluid retention during pregnancy or menopause.  CTS should be diagnosed and treated early, so it is important to visit your GP. A standard physical examination of the hands, arms, shoulders, and neck can help determine if your symptoms are related to daily activities or to an underlying disorder.  Treatment can include immobilising the wrist in splints, ice packs, anti-nflammatory drugs, wrist and finger exercises and manipulation and also surgery in more serious cases. The surgeon releases the ligament covering the carpal tunnel. The majority of patients recover completely after treatment, and the recurrence rate is not too high.

CTS is also commonly treated by chiropracticaly trained practitoners through the manipulation of the wrist, elbow, and upper spine. Two studies support the use of chiropractic adjustments for CTS.

In the first study, 25 individuals diagnosed with CTS reported significant improvements in several measures of strength, range of motion, and pain after receiving a course of chiropractic adjustments.  Most of these improvements were maintained for at least 6 months.  A second study compared the effects of chiropractic adjustments with conservative medical care (wrist supports and ibuprofen) among 91 people with CTS.

Both groups experienced significant improvement in nerve function, finger sensation, and comfort.

The researchers concluded that chiropractic adjustments and conservative medical care are equally effective for people with CTS.  (“It is worth noting however that there are no complications associated with a chiropractic adjustments to the wrist etc other than improved health.  Surgery on the other hand can have multiple complications, mainly based around post surgical scar tissue formation!”)

Davis PT, Hulbert JR, Kassak KM, Meyer JJ. Comparative efficacy of conservative medical and chiropractic treatments for carpal tunnel syndrome: a randomized clinical trial. J Manipulative Physiol Ther. 1998;21(5):317-326.

You can help prevent CTS or alleviate symptoms by making some simple changes in your work and leisure habits.

• Stretch or flex your arms and fingers before beginning work and at frequent intervals.
• Alternate tasks to reduce the amount of repetitive movements.
• Modify or change daily activities that put pressure on your wrists
•  Modify your work environment. If you use a computer, have an adjustable keyboard table and chair, and a wrist rest.  Our Corporate care programme provides not only in office staff    assessments but also ergonomic assessments if you are unsure.