Carpal Tunnel Syndrome – What Is It?  How Do I Know If I Have It?

According to The Merck Manual, Carpal Tunnel Syndrome (CTS) is defined by compression of the median nerve as it passes through the carpal tunnel in the wrist.  Signs and symptoms include pain in the hand and wrist associated with tingling and numbness, distributed along the median nerve (palm side of thumb, index and middle fingers and possibly ½ of the ring finger).  Awaking at night with burning, numbness, and/or tingling and having to shake the hands for relief is a common finding.  Muscle weakness and atrophy of the thumb pad must also be present for an accurate diagnosis of CTS.

After reading the above it is obvious that in order to diagnose CTS a person must have very specific symptoms.  Pain and numbness cannot be in the entire hand because the median nerve does not supply the entire hand.  You must also have weakness and atrophy (muscle wasting) of the thenar pad.  Specific orthopedic tests will usually be positive if you have CTS.  Try this.  Place your hands together as if you were going to pray.  Slowly lower your arms so that your elbows are perpendicular with the floor without letting your palms break contact.  If this recreates the exact symptoms then you may have CTS.  However, further testing is required to make an accurate diagnosis.  According to Gray’s Anatomy, the sensory branch of the median nerve branches prior to and crosses over the carpal tunnel!  The significance of this is that if the tunnel were compressed it still would not affect the sensory branch.  The sensory branch is responsible for the pain and numbness you may be feeling.  What this may mean is that you certainly have symptoms related to the hand and wrist but compression of the median nerve in the carpal tunnel is not the culprit!  You are then not a surgical candidate for carpal release.  Another point to make here is that if you are experiencing forearm complaints you probably do not have CTS.  Nerves are the energy wires in your body and they behave the same way.  If you were to cut an electrical wire, electricity would flow up to the cut but not beyond.  A nerve, if compressed works the same way.  You will experience symptoms beyond the compression but not before it.  How then, if you have compression in the carpal tunnel could you have pain in the forearm, shoulder, and neck? 

If you are experiencing any of these symptoms you are probably not a surgical candidate.  Our multidimensional approach to dealing with these types of problems may work for you.  Rather than treating the site of pain we will evaluate why the pain is there.  There are many approaches to solving a problem.  We combine specific chiropractic adjustments to the wrist and hand; nutritional/herbal therapy to help decrease inflammation of involved nerves; Motion Release Therapy to areas which may entrap the nerves, such as the pronator teres muscle; correction of improper ergonomics; and exercise therapy to help achieve your goal.  Before surgery try conservative care.  If you want a second opinion, or wish to try an alternative approach, feel free to contact us.

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