Affecting up to 10 million Americans, carpal tunnel syndrome (CTS) is considered to be one of the most common neurological disorders in the US. This condition causes debilitating pain and can impact all aspects of your life, including your ability to work, engage in social activities, and enjoy your favorite hobbies.
To make things worse, for many individuals battling chronic wrist pain, undergoing carpal tunnel release may seem like the inevitable choice to regain their hand and wrist function.
Nonetheless, advances in regenerative medicine are now providing an alternative to taking medications every day or living in fear of needing invasive surgeries. With Neuragenex’s Neurofunctional Pain Management approach, you can regain control over your health without surgeries or medications. Let’s explore how below.
Carpal tunnel syndrome is a nerve condition that develops when the median nerve in the wrist is compressed, irritated, or damaged.
The median nerve is a nerve located outside of the brain and spinal cord. It is responsible for controlling wrist movements and transmitting signals to the brain regarding muscle movements, sensations, temperature, touch, pain, and vibration.
The median nerve can become compressed when the carpal tunnel, which is a passageway composed of ligaments and tendons located in the wrist, becomes swollen, inflamed, or restricted. Given the fact that this passageway is no more than 20 millimeters wide, even the slightest changes in anatomy can compress the median nerve that runs within it.
When the median nerve is compressed, it may become irritated or inflamed, which leads to pain, discomfort, swelling, and reduced range of motion. Pressure on this important nerve can also prevent nerve signals from reaching the brain, which results in loss of feeling, numbness, and tingling in the hand.
Depending on the severity of this condition, carpal tunnel syndrome may cause disability, chronic pain, and even irreversible nerve damage.
To better understand carpal tunnel syndrome, let’s look at the anatomy and physiology of the wrist.
The hand and wrist are at the core of most movements we perform every day; from driving, lifting a glass of water, and tying our shoes to working and enjoying our favorite hobbies. And, what makes all of these movements possible is the bundle of nerves, ligaments, tendons, and muscles in the wrist joint. Here’s what you need to know:
The wrist – also known as the radiocarpal joint – is a complex structure that links the forearm to the arm, stabilizes the hand, and allows the movement of our upper extremities.
The wrist is a collection of several joints that connect the forearm bones (radius and ulna, also known as distal joints) to the carpal and metacarpal bones, which are the bones at the base of the hand and palm. These joints are made stable and mobile by several nerves and ligaments that connect the bones to one another, as well as to the hand and wrist muscles.
The carpal tunnel is located in the volar aspect of the wrist or the side of the palm. Small bones called carpal bones function as the floor and sides of the carpal tunnel, while the roof of the tunnel is made of a strong band of connective tissue. This band is known as the transverse carpal ligament.
As a single joint, the wrist covers the function of providing stability and range of motion to the hand and fingers. However, each component in the wrist and carpal tunnel has its own function. In particular, the median nerve, which is housed in the carpal tunnel, is responsible for controlling the movement and sensory capability of the base of the thumb, middle finger, index finger, and part of the ring finger.
The nerves in the brachial plexus, including the median nerve, are responsible for connecting the brain to various extremities and transmitting signals relating to movement, touch, pain, temperature, and vibration. After the wrist portion, the nerve endings stemming from the median nerve branch out onto the hand and fingers.
Carpal tunnel syndrome affects each person uniquely, and manifests itself with a wide range of symptoms. What’s more, for patients such as pregnant women, CTS is a minor and temporary condition; while for others it can become a source of chronic pain and severe disability.
Although varied, most of the symptoms of CTS are caused by the fact that a compressed median nerve prevents pain, motor, and sensory signals from traveling between the brain and the wrist. These symptoms include the following:
At first, you may experience pain only on certain occasions but, as the condition becomes more severe, the painful sensations can become acute and constant. In people with CTS, the pain is often described as aching, with occasional burning and shock-like sensations.
Over time, the pain may start to radiate from the wrist to the hand and fingers and intensify at night.
When these motor signals are prevented from reaching the brain, you may experience weakness in the hand, loss of pinching strength, and clumsiness (i.e., dropping objects).
These sensations are particularly noticeable in the part of the hand directly controlled by the median nerve, which includes the thumb and the index, middle, and ring fingers.
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In most cases, carpal tunnel syndrome is caused by a combination of factors. However, some causes and risk factors – such as repetitive stress to the hand and wrist, injury, underlying health conditions, and genetic factors – make it more likely.
Let’s look at these factors in more detail below.
Repetitive motions, especially when performed over long periods, may put the hand and wrist under excessive or constant pressure. High levels of stress can cause the ligaments and tendons in the carpal tunnel to become irritated, swollen, or inflamed, thus narrowing the passageway that houses the median nerve.
Individuals who are at greater risk of developing CTS include professionals that regularly use vibrating tools, work on an assembly line, or type on a keyboard. Athletes participating in sports that require prolonged hand movements, such as racket sports, archery, rock climbing, and handball, may also be prone to carpal tunnel syndrome.
Some traumatic injuries that result in a dislocation or fracture of the wrist can lead to changes in the anatomy of the carpal tunnel and misalignments of the wrist joint. These changes can obstruct the carpal tunnel and irritate the median nerve.
Some health conditions can lead to further inflammation and swelling of the carpal tunnel, thus constricting and damaging the median nerve. You may be at greater risk of developing CTS if you have one or more of the following diagnoses:
In turn, excessive inflammation causes the breakdown and damage of the joint’s components. Inflammation also restricts the carpal tunnel because of the build-up of fluids and swelling that it causes.
Although carpal tunnel syndrome is not an inherited condition, the risk of developing this disorder is greater among those with a close relative diagnosed with CTS.
Additionally, congenital conditions and malformations of the wrist that run in families – such as having a smaller carpal tunnel – can make carpal tunnel syndrome more likely.
Some risk factors can increase your risk of developing carpal tunnel syndrome, including the following:
Anatomical factors – such as having a slight or small frame – can also increase the risk of carpal tunnel syndrome.
If you are experiencing pain, numbness, hand weakness, or tingling sensations in the wrist area, you may have carpal tunnel syndrome. A provider will perform one or more tests to offer an accurate diagnosis. These tests include the following:
For example, if the tingling sensations and numbness occur in your little finger, which is unaffected by the median nerve, you may have a problem other than CTS.
During a physical examination, a doctor will also press on the hand and wrist to determine the source of pain, assess your hand muscles’ strength, and test your ability to feel pressure in the fingers.
As the mild shock navigates from the electrodes to the brain, your doctor will assess whether there are obstructions that cause it to slow down when passing through the median nerve.
Carpal tunnel syndrome is a condition that develops over time, and finding treatment as soon as possible can slow down the progression of pain and discomfort.
If your discomfort is still mild, you can manage it by taking frequent breaks, avoiding activities that involve hand and wrist movements, and applying cold packs.
If carpal tunnel syndrome is related to the hormonal changes that occur during pregnancy, these conservative treatment options can help you manage your condition until it improves, which usually happens after delivery.
However, if the pain is becoming regular and more intense, you can discuss other conservative treatment options, such as the ones below:
An occupational therapist can help you modify your work and sporting activities to reduce the pressure on the wrist.
It is important to notice that, if you have chronic pain, taking these medications daily can expose you to severe side effects, including an increased risk of stroke, heart attack, peptic ulcers, and dependency.
If carpal tunnel syndrome is caused by another underlying condition, such as diabetes or arthritis, treating these conditions may relieve the symptoms of CTS.
It is important to notice that conservative treatments are most effective when carpal tunnel syndrome is still mild or moderate. If you have constant pain, have been suffering from CTS for more than ten months, or experience numbness, you should look for more efficient treatment options.
Leaving carpal tunnel syndrome unaddressed or not taking measures to manage aggravating factors can lead to severe complications.
Firstly, constant pressure and constriction of the median nerve can cause irreversible nerve damage, which can lead to inhibited wrist function and disability.
Additionally, the pain and weakness you experience may make hand movement undesirable. And, if not exercised, the muscles of the hand, wrist, and fingers can shrink and lose mass. This condition, which is called muscle atrophy, may require surgery to prevent irreversible damage.
Other complications of carpal tunnel syndrome include sleep disturbances. 8 in 10 people with CTS experience sleep problems due to the fact that wrist pain intensifies at night.
What’s more, over time, wrist pain and discomfort due to carpal tunnel syndrome can continue to worsen, which causes patients to lose an average of 27 days of work a year. 18% of people who develop CTS are also forced to leave their jobs within 18 months of the start of symptoms.
If CTS does not improve with medications or is causing irreversible damage, surgery may start to appear as the inevitable option. Let’s look at the surgical treatment options for carpal tunnel syndrome below.
With nearly half a million carpal tunnel release surgeries performed each year in the US, CTS is considered to be one of the most common hand conditions requiring surgery.
However, surgical interventions for carpal tunnel release are only recommended for advanced cases of CTS or when conservative therapies have not delivered results.
If you are considering this treatment option, make sure to discuss the risks of carpal tunnel release surgeries, which include infections and irreversible damage to the median nerve.
Additionally, be sure to be aware of post-surgery recovery and rehabilitation times, which can stretch to 1 year or more. If you require surgery on your dominant hand, an invasive intervention can significantly delay your return to work.
Some of the most common surgical interventions for carpal tunnel syndrome include the following ones:
The endoscope is used to carry out a thorough examination of the carpal tunnel and cut a portion of the carpal ligament. This will create more space for the median nerve.
However, this surgery is highly invasive and requires the surgeon to perform an incision that runs from the palm of the hand to past the wrist. The incision is used to cut through the ligament and free the median nerve. This remains the most used surgery for carpal tunnel.
If you have moderate or severe carpal tunnel syndrome, you may be struggling with debilitating pain and disability. And, in this case, surgery may seem like the only option.
Fortunately, thanks to advances in medical therapy, you can manage your pain and regain control of your wrist’s function without medications, invasive procedures, or chiropractic treatments.
Neurofunctional Pain Management aims to address all aspects and risk factors that may be contributing to your pain and offer a treatment protocol that is non-invasive, non-surgical, non-chiropractic, and drug-free.
Some of the therapies used as part of a Neurofunctional Pain Management program include the following:
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Carpal tunnel syndrome may affect anyone, at any age. Some risk factors, such as genetics, a small frame, or menopause, cannot be modified. However, others can be addressed and corrected to reduce your risk of developing carpal tunnel syndrome. Here are some of the key guidelines to follow:
Carpal tunnel syndrome can affect every aspect of your life. Chronic wrist pain can prevent you from being productive at work, enjoy the activities you love, inhibit your athletic performance, and make it harder to complete daily tasks such as tying your shoes, driving, or cooking.
But, today, undergoing surgeries or taking pain medications daily are no longer the only options. A custom Neurofunctional Pain Management program can help you regain the health and function of your wrist without drugs or invasive procedures.
We take great pride in the wealth of talent and expertise that our providers have as they improve the health outcomes of our patients, each and every day.
Dr. Victor Osisanya is Board Certified in Physical Medicine and Rehabilitation. He earned his undergraduate degree from the University of Michigan in Ann Arbor and his medical degree from Chicago Medical School. Upon completion of...
Ashley Locus is a Board-Certified Nurse Practitioner who began her career in healthcare as a registered nurse in 2013, working in a diverse array of healthcare settings including the emergency department, critical care, case management,...
Dipa is a double board-certified Nurse Practitioner in Family as well as Adult-Gerontology Acute Care. She graduated with her Bachelor’s in Nursing from Mercer University in Macon, GA and her Master’s in Nursing from Columbia...
Emma Henigman is a Board-Certified Family Nurse Practitioner. She received her Bachelor of Science in Nursing from Lakeview College of Nursing and then her Master of Science in Nursing at Olivet Nazarene University. Emma started...
Dr. Joanne Wu is an accomplished physician leader specializing in integrative and functional rehabilitation. In addition, as a certified holistic health coach, as well as an experienced registered yoga and fitness teacher, she is dedicated...
Over the last 18 years he has worked in family practice and as a civilian contractor for the Department of State spending almost 5 years split between Iraq and Afghanistan. During his medical missions overseas,...
Dr. Johnny Ross was born and raised in Waco, Texas. He graduated from Waco High school, McLennan Community College and Baylor University. He attended The University of Texas Health Science Center at Houston, and completed...
Originally from Jacksonville, FL, Dr. Williams enlisted in the United States Air Force after graduating from high school. After serving honorably in the military, he enrolled in college at the University of North Florida where...
John Ham is a board certified physician assistant with extensive experience working in rehabilitation services, musculoskeletal medicine, and pain management since 2004. He received his PA degree with a masters in medical science from Midwestern...
Dr. Mikuzis is also a certified life care planner (CLCP, LCP-C). He has studied extensively and trained with physicians including programs sponsored by The American Association of Orthopedic Medicine, The American Academy of Osteopathic Medicine,...
Don't let carpal tunnel syndrome control your life. Find relief today with Neuragenex.