Carpal Tunnel Syndrome

Treatment options and Massage

What is Carpal Tunnel syndrome?

There is a group of small bones that make up your wrist and the base of your hand called "carpals." To allow nerves and tendons to pass through to your fingers, there is a tunnel through these bones called the "carpal tunnel." Through this tunnel pass nine tendons and a bundle of nerve fibers called the "median nerve." There is limited room in this tunnel, and if anything happens to cause swelling of any of the tissues, the median nerve will be compressed, at first causing irritation, then over time causing actual nerve damage. Since the median nerve includes both sensory fibers (carrying information about touch to the brain) and motor fibers (carrying impulses from the brain to move the fingers), this irritation or damage results in numbness, pain, and possibly even partial paralysis. The muscles most likely to be affected are the muscles forming the ball of your thumb. It is important to remember, though, that pain and even movement problems in your wrist and hand can be caused by things other than carpal tunnel syndrome.

The progress of carpal tunnel syndrome is usually predictable. First, the small nerve fibers that are not insulated are affected, then the larger insulated sensory fibers, then the larger insulated motor, or movement, fibers. These changes can be the result both of direct irritation to the nerve and of loss of blood to the nerve.

By the time a person goes to the doctor complaining of numbness, pain or movement problems, the last condition -- damage to the motor fibers -- has usually come about. At that point, a neurologist or a professional specializing in electrical measurements of nerve performance can perform tests that will determine whether the condition is early, moderate or severe.

The median nerve is all by itself in the tunnel among these tendons. Anything that causes tissues to swell can cause this problem, and anything that reduces the swelling and increases the flow of blood to the nerve can help it.

Some women get temporary carpal tunnel syndrome when they are pregnant, because fluid tends to collect in their hands causing swelling of the tissues.

Carpal Tunnel Treatments

Chiropractic Treatments

A word about chiropractic and wrist pain:

Many things can cause symptoms that resemble carpal tunnel syndrome, one of which is a problem with the root of the nerve at the seventh neck vertebra. If that's the problem, then a spinal adjustment might be helpful, along with other treatments near the source. But if that treatment gets rid of the problem, then it wasn't really carpal tunnel syndrome.

Sometimes carpal tunnel syndrome is treated with acupuncture. That could be a problem, because the purpose of pain is to tell us there's a problem, and if acupuncture just gets rid of the pain without solving the problem, then the nerve damage could just keep getting worse, perhaps beyond hope of recovery.

Anti-inflammatory drugs, such as aspirin and ibuprofin, and corticosteroid injections, will help carpal tunnel syndrome temporarily. Things like wrist braces, and wrist-rests on keyboards, help carpal tunnel syndrome by relieving stress on the tendons. Anything that reduces swelling and irritation and promotes blood flow to nourish the tissues and remove the waste products will help carpal tunnel syndrome, and massage therapy can help by reducing the tightness in the muscles that control these tendons and by increasing blood flow to the area. But it's also important to use anything that will help retrain the person in the positioning and use of the wrists and hands.

The cure for carpal tunnel syndrome is to do whatever is necessary to relieve pressure on the median nerve in the wrist. Surgery does that very well by opening the tunnel and making it bigger, and the relief is almost immediate. But if the same result can be accomplished without surgery, that would certainly be preferable, even if it might take a little longer.

Any therapy offered to treat carpal tunnel syndrome must focus on the wrist, the hand and the forearm flexor muscles, and has to relieve pressure on the median nerve while increasing circulation. Also, the patient must be retrained in good positioning and use of the hand to keep the problem from returning. Massage therapy can offer this sort of help without the side effect of drugs or the invasiveness of surgery.

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