Carpal Tunnel Syndrome
James Revell, chiropractor at Lushington Chiropractic in Eastbourne explains what Carpal Tunnel Syndrome is and how it can affect people.
Chiropractic is a healthcare profession regulated by the General Chiropractic Council. Chiropractors focus on the diagnosis, treatment and where possible on the prevention of mechanical disorders of the musculoskeletal system (muscles and joints), with particular emphasis on the spine.
In carrying out my work as a chiropractor I emphasise hands-on therapy, for example spinal manipulation (we tend to use the term adjustment), as well as a range of other joint or soft-tissue treatment techniques as well as exercises and health or lifestyle counselling.
As part of this patients sometimes ask about other health conditions they have that I’m not treating.
This blog focuses on Carpal Tunnel Syndrome which I’ve been asked about a number of times. Let me be clear from the outset that Carpal Tunnel Syndrome can be a complex clinical condition, and although there are a range of treatment approaches which can be helpful, some people will ultimately require surgery. Although I hope you find this blog helpful, I am not suggesting that I’m the person to see to treat Carpal Tunnel Syndrome.
I think one of the reason’s people ask me about Carpal Tunnel Syndrome is because it’s the commonest form of peripheral nerve entrapment. The prevalence of Carpal Tunnel Syndrome is estimated to be in the region of 7-16% by the Royal College of Surgeons Commissioning Guide 2017 . Given Eastbourne’s population that would equate to approximately 7-16,000 people in and around Eastbourne suffering with Capral Tunnel Syndrome.
Carpal Tunnel Syndrome occurs when the median nerve, which runs down your arm into your hand, gets compressed at the wrist. The median nerve controls sensation in your palm, thumb and fingers, but not the little finger. It also controls some movement in your wrist. It’s made up of branches from the nerves that come out of your neck from C5, C6, C7 and C8.
Picture of the nerves from the neck, including the median nerve, which is involved in carpal tunnel syndrome.
Median Nerve And The Carpal Tunnel At The Wrist.
The carpal tunnel itself is made by the bones of your wrist and the tough ligaments that hold them together. Running through the tunnel are various tendons, nerves and blood vessels. Sometimes thickening of the ligaments or tendons, or stiffness of the joints, or swelling in general (e.g. during pregnancy) can compress nerves. When this occurs in the median nerve there are a number of distinct symptoms that indicate carpal tunnel syndrome – such as weakness, numbness and pain radiating up the arm.
Carpal Tunnel Syndrome is the most common of the entrapment neuropathies, accounting for 90% of all peripheral nerve compression syndromes. Some studies suggest that 5% of people suffer with carpal tunnel-type symptoms. The most common age is 45-60 year olds.
Although carpal tunnel syndrome is the most common and most well-known peripheral trapped nerve problem, it’s possible to get a trapped nerve at many points throughout the body.
Trapped nerves are more correctly referred to as compression neuropathies. There are numerous ways your nerves can be damaged, but in this blog we are focusing on the compression type of injuries, which are responsible for carpal tunnel syndrome.
Your peripheral nerves can also be pinched, irritated or compressed as they leave the spine for example by a slipped disc, or arthritis in the spine (aka spondylitis). Symptoms will affect just one part of the body, depending on where the nerve is trapped (compress or irritated). However, to clarify I’ve had a number of patients with carpal tunnel who’ve suffered with the symptoms in their hand but also an ache radiating up their forearm.
Carpal Tunnel Syndrome is a Type of Compressional Neuropathy
There can be a range of factors that cause Carpal Tunnel Syndrome. Overuse and in particular using vibrating machinery, such as a pneumatic drill, is often to blame for these this type of trapped nerves. However, there may also be something that’s causes swelling in the patient, for example Rheumatoid Arthritis or with pregnancy etc.
Some people have a congenital predisposition (having a smaller tunnel than others). When I was studying the Anglo-European College of Chiropractic (http://www.aecc.ac.uk/) I remember reading a statistic suggesting that Caucasians were most likely to suffer with Carpal Tunnel Syndrome but I can’t find that reference and it’ll be over a decade out of date by now. If you have a genetic predisposition then other people in your family will have suffered with Carpal Tunnel too. But remember, think about what jobs they have or do they have rheumatoid arthritis etc.
Women are three times more likely to get Carpal Tunnel Syndrome than men. Experts believe this is because the carpal tunnel itself is smaller in women. Women are also 3 to 5 times more likely to suffer with Rheumatoid Arthritis than men, while the fact that women go through pregnancy also skews the statistics somewhat.
Carpal tunnel symptoms usually start as a burning or tingling / pins and needles sensation in your hand and wrist, which easily settles when you shake your hand out. In my experience people first notice these symptoms when sleeping at night. Typically swelling will build up as we lie still sleeping, plus if you lie on your wrist you’ll compress the carpal tunnel even more.
Early diagnosis and treatment is important
If you have any questions about Carpal Tunnel Syndrome or other trapped nerves, why not leave your comment below or ask a member of the team at Lushington Chiropractic. The intention of this blog post is to share information about carpal tunnel syndrome with my patients, so they can better understand what’s going on if they have this condition.
This blog is about Carpal Tunnel Syndrome and I hope you’ve found that information useful. If you also have questions about chiropractic, then please check out some of our other blogs such as:
Or contact me at the clinic.
Chiropractors treat a range of conditions listed below, some of which you may more or less have expected to see included under the chiropractic umbrella.
Ankle sprain (short term management); Cramp; Elbow pain and tennis elbow (lateral epicondylitis) arising from associated musculoskeletal conditions of the back and neck, but not isolated occurrences; Headache arising from the neck (cervicogenic); Joint pains; General, acute & chronic backache, back pain (not arising from injury or accident); Generalised aches and pains; Minor sports injuries; Muscle spasms; Short term management of plantar fasciitis; Rotator cuff injuries, disease or disorders; Sciatica; Shoulder complaints (dysfunction, disorders and pain) and soft tissue disorders of the shoulder.
By James Revell
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