Carpal Tunnel Syndrome

The Anatomy

The carpal tunnel is a narrow tunnel that is formed by the carpal bones on the bottom and sides, and the transverse carpal ligament, which is a thick fibrous band of tissue, on the top of the canal. The carpal tunnel provides a route for and protects the median nerve and tendons of the flexors of the forearm. Around the flexor tendons is synovium, which is a tissue that assists with lubricating the tendons and allowing all the structures of the carpal tunnel to glide smoothly with wrist motions. The flexor tendons insert into different locations of the palmar side of the fingers to cause bending of the fingers and thumb. The median nerve controls contraction of the muscles at the base of the thumb and sensory control to the palmar side of the thumb, index finger, and portions of the long fingers. Understanding this anatomy is vital to understanding the symptoms of this condition.

What Will You Experience?

The most common symptom of carpal tunnel syndrome is numbness, tingling, and even pain into the palmar side of the hand along the distribution of the median nerve. As the condition progresses, you could also experience weakness in movements of the thumb, such as abduction, flexion, and possibly adduction. You could also experience abnormal sensations and pain traveling back up the arm towards the elbow and possibly higher towards the shoulder. If the condition continues for a long time without being treated, then you may even experience atrophy, or decreased muscular tone, in the thenar pad of the affected hand. Symptoms usually progress gradually and can occur during any time of the day, although symptoms are most common at night because people usually sleep with their wrists curled, which causes even more narrowing of the canal.

What Causes Carpal Tunnel Syndrome?

This condition occurs when the synovium around the tendons becomes swollen and irritated. When this synovium swells, it takes up more space in the tunnel and thus decreases the space that is available for the median nerve to travel smoothly through the tunnel. This condition can also arise if you have developed excessive scar tissue in the ligaments or tendons of the wrist. Excessive scar tissue can develop from repetitive wrist motions or even repetitive sprains to the wrist. In addition, you could also get narrowing of the tunnel if the carpal bones are out of alignment. Whatever the cause of the narrowing, the symptoms arise when the median nerve is being impinged upon or doesn’t have the proper space to move between structures in the canal.

Predisposing Factors

Heredity is an important factor to keep in mind, since the carpal tunnel can be anatomically smaller is certain people and this can actually run in families. Hormones can also play a factor, and thus this condition can commonly occur in pregnant women. Also, older people are more predisposed to this condition. In addition, individuals with diabetes, rheumatoid arthritis, and thyroid gland imbalances can also be predisposed to narrowing of the carpal tunnel.

What Can Lake Marion Chriopractic Do for You?

At Lake Marion Chiropractic, we would start by performing a full exam of the area which will include neurological and orthopedic exams that will determine your exact diagnosis and determine the tissues that are involved in your specific case. Your treatment plan will consist of a combination of advanced soft tissue techniques, strengthening exercises, stretching exercises, nutritional counseling, and chiropractic treatments. In most cases, results come from the advanced soft tissue techniques, which are aimed at decreasing scar tissue within the affected tissues, and lengthening the muscle bodies of the flexor tendons, which will allow the tissues within the canal to slide freely and cause less irritation. In addition, if you have a condition such as thyroid problems, that could be leading to your condition, then nutritional deficiencies will be addressed. Also, the doctors at Lake Marion are trained in extremity adjustments, which will be used if the need is indicated.


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