Aka: Median nerve dysfunction; Median nerve entrapment Carpal tunnel syndrome is a condition where pressure on the median nerve -- the nerve located in the wrist that supplies feeling, sensations and movement to parts of the hand. Pressure on this nerve at the carpal tunnel can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers due atrophy of the nerve and muscles. Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist due to numbness and/or tingling. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell the difference between hot and cold by touch because of lack of sensation in the hands. Carpal tunnel syndrome (CTS) is among the most expensive of all work-related injuries. Over his or her lifetime, a carpal tunnel patient loses about $30,000 in medical bill expense and time absent from work. CTS typically occurs in adults, with women 3 times more likely to develop it than men. The dominant hand is usually affected first, and the pain is typically severe. CTS is especially common in assembly-line workers in manufacturing, sewing, hairdressers, finishing, cleaning, meatpacking, and similar industries that require constant repetitive motions of the hand. Symptoms Associated with CTS Ø Pain extending to the elbow Ø Weaknessin one or both hands Ø Pain in wrist or hand in one or both hands Ø Numbness or tingling of the palm or fingers of the hand Ø Weak grip or difficulty carrying bags (a common complaint) Ø Problems with fine finger movements (coordination) in one or both hands Ø Wasting away of the muscle under the thumb (in advanced or long-term cases) Ø Numbnessortinglingin the thumb and next two or three fingers of one or both hands Signs and tests Possible findings during a physical examination: Ø Numbness in the palm, thumb, index finger, middle finger, and thumb side of the ring finger Ø Weak hand grip strength Ø Tapping over the median nerve at the wrist (the carpal tunnel area) may cause pain to shoot from the wrist to the hand (this is called Tinel's sign) Ø Bending the wrist forward all the way for 60 seconds will usually result in numbness, tingling, or weakness (this is called Phalen's test) Tests may include: Ø Electromyography Ø Nerve conduction velocity Ø Wrist x-raysshould be done to rule out other problems (such as rheumatoid arthritis or gout) Chiropractic Treatment: Chiropracticadjustmentsto the extremity (wrist, elbow and shoulder) to relieve pressure exerted on the nerves have shown to provide lasting relief of carpal tunnel. The cervical spine should also be evaluated to rule out involvement and treated by a chiropractor if involvement is discovered. Realigning the bones of the hand, elbow, shoulder, and cervical spine removes the pressure on the nerves and allows the nervous system to heal. With regular chiropractic care to maintain alignment of the nervous system, the inflammation and the pain symptoms associated with the disorder begin to clear up and go away. Chiropractic care is a conservative management approach to treatment of carpal tunnel syndrome and is a non-invasive procedure. Proper posture and exercises as instructed by your doctor of chiropractic can help prevent CTS recurrences. Prevention and Treatment: Avoid or reduce the number of repetitive wrist movements whenever possible. Use tools and equipment that are properly designed to reduce the risk of wrist injury. Wrist exercises designed to stretch the ligaments of the wrist and hand help to reduce pressure on the median nerve can provide temporary relief. There are changes you can make in the workplace to reduce the stress on your wrist: Special devices include keyboards, different types of mouses, cushioned mouse pads, and keyboard drawers. Someone should review the position you are in when performing your work activities. For example, make sure the keyboard is low enough so that your wrists aren't bent upward while typing. You may also need to make changes in your work duties or recreational activities. Some of the jobs associated with carpal tunnel syndrome include those that involve typing and vibrating tools. Carpal tunnel syndrome has also been linked to professional musicians. Chiropractic Care Conservative treatment options such as chiropractic should be considered first due to risks associated with invasive procedures.
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