Carpal Tunnel Syndrome and Chiropractic: Hand in Hand

(Originally posted on bcotoronto.com on Nov 3rd, 2011)

In today’s computer-centric culture the prevalence of a condition called Carpal Tunnel Syndrome has drastically increased but the common understanding of it has not. This, of course, leads to a lack of knowledge of the options available to us as patients with this condition. My goal today is to try and broaden these horizons as it were.

The Carpal Tunnel is a structure created by the bones and ligaments of the wrist. Our forearms have two bones which run parallel and form a cup at our wrist. Inside this cup sit the eight small bones, called “Carpal” bones, that make up our wrist arranged in two rows of four. These are the floor of the Carpal Tunnel. On the palm side of this arrangement arches a broad, thick ligament that forms the roof of the Tunnel. Through this tube run 9 tendons going to the fingers and one nerve. The trouble starts when, for one reason or another, the Carpal Tunnel gets smaller or something in it starts to swell.

The main symptom of Carpal Tunnel Syndrome is numbness or tingling over the palm side of the thumb and index and middle fingers. If left alone long enough a severe case can lead to weakness and eventually atrophy (wasting) of groups of muscles in the hand. This is all due to that one little nerve picking its way through the Carpal Tunnel. The space within the Tunnel can be decreased in several ways but the most common is non-ergonomic use of the wrist. The wrist is optimally used in a neutral position where the forearm and the hand form a straight line. If your wrist is bent back (in extension) for long periods of time like it is using a keyboard this will put strain on the joints of the wrist and forearm. This can lead to shortening of the ligament forming the roof of the Tunnel and/or tightening of the ligament between the radius and ulna (bones of the forearm) which compresses the cup holding the carpal bones forcing them forward or backward. When the carpal bones are pushed out in this way they like to spread out which pulls the roof of the Tunnel taught and presses down on the Carpal Tunnel.

The usual medical approach is either pain killers or surgery. Occasionally injections are suggested but those just reduce the inflammation which does nothing for the pressure on the nerve. The surgical option, which is the most commonly known solution to this problem, consists of slicing through the tight ligament. Think about it from a biomechanical point of view. The mechanical issue that caused the ligament to tighten in the first place has not been addressed and the loss of a stabilizing structure will not help the joints of the wrist return to their regular patterns. Carpal Tunnel Syndrome is purely (except for rare special circumstances) a biomechanical condition, so why not avoid drugs and scalpels and see a biomechanical specialist?

Chiropractors deal with joints and shortened ligaments daily and have many different techniques to use on these problems. Carpal Tunnel Syndrome responds very well to many other alternative medicines as well. It is a doctor’s responsibility and your right to know all of the options available to you but only you can ensure that this happens. Do research and ask questions. It’s the only way to learn.

Thanks for reading,

Dr. Ben

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