Carpal tunnel syndrome is a condition where the median nerve becomes pinched and inflamed at the wrist. People with carpal tunnel can experience numbness, tingling, have difficulty buttoning shirts or opening jars due to weakness in grip and pinch strength.
According to the American Academy of Neurology they would like to see non-surgiccal approaches to the treatment utilized before surgery is considered. One of the reasons why 40% of neurologist polled recommended non-surgical care is due to the potential side effects of surgery, some of which being severe, resulting in lengthy work loss post-surgically. Here is their list of non-surgical care options:
Rest – Giving the inflamed CTS time to heal is therapeutic but not always an option.
Activity/job modifications – Avoiding certain activities or modifying them by taking breaks during the work day, slowing down the pace of the job, altering the position of the job task, such as propping up a part so that the wrists do not have to bend to the extremes, or when necessary, complete avoidance of the job task.
Wrist Splint – This is a brace that maintains the wrist in a neutral position so it cannot easily bend. When the wrist flexes or extends, the pressure inside the carpal tunnel (on the palm side of the wrist) increases significantly, placing additional pressure on the already pinched median nerve. Wrist splints are especially useful at night.
Nerve Gliding Exercises – These are exercises that stretch the wrist joint and muscle tendons (as well as the median nerve inside the carpal tunnel), with the objective of breaking adhesions that limit the normal glide or movement of the nerve in the forearm and wrist.
Manual therapy techniques – These include manipulation of the arm including the forearm, wrist, and hand and sometimes the neck and shoulder, when needed. The objective is to improve the range of motion of the joints and soft tissues that may be participating in the process of median nerve pinching which is where Chiropractic can help. We have several treatments that take care of the joint involvement, the inflammation, the wrist splint, job modification, and the exercises that help.
Anti-inflammatory medication / nutrients – Medications include aspirin, ibuprofen, naproxen and similar prescription drugs. Nutritional options including herbs (such as ginger, turmeric, boswellia), digestive enzymes, and Vitamin B6 may also help. Ice is also anti-inflammatory and direct, on-the-skin ice massage is quite effective.