Non-Invasive Treatments for Carpal Tunnel Syndrome

Hello, everyone! This is Dr. Bob Salamon with Lowcountry Chiropractic. I hope you are doing well and staying healthy! Winter is well and truly among us here in the Lowcountry, as evidenced by frosty windshields in the morning and nearly freezing temperatures at night. While these lower temperatures mean we might have to bundle up to stay warm, they mean something different for those who suffer with carpal tunnel. Carpal tunnel syndrome is a form of entrapment neuropathy, which is a “condition in which a nerve becomes compressed, or entrapped, between two other structures in the body… Repetitive motion can cause the ligament and bone to press or rub against the nerve.” 
 
The median nerve, which passes through the wrist into the palm-side of our hands, is what is being compressed. (And the passage this nerve takes is, somewhat obviously, known as the carpal tunnel.) This nerve is responsible for almost all sensation in our hands and fingers, as well as our dexterity. When our wrists swell, due to overuse or a host of other factors, this nerve is compressed. Those with carpal tunnel syndrome experience weakness, numbness, tingling, and pain in their wrist and hand. It is possible to have carpal tunnel syndrome in one hand, but not the other. About 2.7% to 5.8% (or between 4 and 10 million) adult Americans deal with carpal tunnel syndrome. Usually, this syndrome is diagnosed in those between the ages of 30 and 60. If you have diabetes, high blood pressure, or arthritis, you are predisposed to developing carpal tunnel as well. Likewise, if you have a job which requires repetitive movements (such as assembly lines, keyboarding, construction, etc.), you are predisposed to developing carpal tunnel. 
 
Winter can be a tough time for those who suffer with carpal tunnel syndrome, as winter conditions are known to exacerbate CTS. A study investigating the seasonal prevalence of carpal tunnel syndrome revealed higher rates of CTS diagnosis during winter months (50.8%), the lowest rate during summer months (38.9%), and equal rates during both spring and autumn (43.5% and 42.8%, respectively). These figures suggest temperature does play a significant role in the flare up of carpal tunnel symptoms. If you have carpal tunnel syndrome, you might notice an uncomfortable stiffness when your hands are exposed to the cold, increased numbness, or difficulty performing tasks. Sometimes, the median nerve can send pain signals up through the arm, neck, and even back. Similar to those with joint pain, those with carpal tunnel syndrome must take great care to stay warm during winter. Similarly, because colder temperatures can slow our blood flow, staying active is important. 
 
For those suffering with carpal tunnel this winter, it’s recommended you wear the proper external gear, including gloves or mittens. If you are going to spend prolonged periods outdoors, you should keep hand warmers in your pockets. To combat stiffness, try stretching your hands regularly. Nothing fancy. Simply bending your fingers back towards your wrist as far as is comfortable and holding for ten seconds is enough. It’s important to take regular breaks when performing tasks with your hands, including cooking and typing. When you experience pain, twinges of numbness, or tingling, you should always stop whatever you’re doing. Continuing to work through the pain is counterproductive and could worsen your condition. If your carpal tunnel is triggered by an underlying medical condition, focus the bulk of your energy on addressing the root issue. If you’ve just come inside from a day spent in the cold, you might soak your hands in warm water or take a warm bath to stimulate blood flow. 
 
Carpal tunnel syndrome is a progressive condition, which means—If you do not isolate the cause, your condition will steadily decline. A full deterioration of carpal tunnel syndrome could mean limited use of one’s hands, nerve damage, and pain. That’s why it’s crucial to seek medical care as soon as you suspect you might have carpal tunnel syndrome. The most common treatments for carpal tunnel syndrome include lifestyle modifications, oral corticosteroids, and wrist splints. The lifestyle modifications seek to cut out whichever repetitive task has triggered the inflammation putting pressure on your median nerve to begin with. Identifying this action shouldn’t be too difficult, as your pain will flare up most notably whenever you try to do this task. The oral corticosteroids are another means of targeting and suppressing your body’s inflammatory response. Finally, a wrist splint is intended to keep your wrist in a neutral position, which—in addition to helping heal inflammation—limits the amount of pressure placed on the median nerve. You might try intermittent icing and heating, as well, to bring down any swelling. 
 
Now this first-line of treatment can be met with positive or not-so-positive results. If the initial condition does not improve, the next line of therapies may include local corticosteroid injections into the affected wrist. Non-steroidal anti-inflammatories, diuretics, and vitamin B6 might also be used to address inflammation. Ultimately, if nothing else works, open or endoscopic surgery might be recommended. Now, very few people are eager to undergo surgery and the vast majority of us would like to avoid going under the knife at any cost. That’s why I’m here to discuss alternative, noninvasive treatment methods for carpal tunnel. While surgery is sometimes the only path towards healing, it should remain a last resort. There are a few options you might also try before undergoing a surgical evaluation for your carpal tunnel syndrome. 
 
Now, if you haven’t already been diagnosed with carpal tunnel, one of the first things you’re going to want to do is take part in a nerve conduction study. A nerve conduction study is a test which isolates the exact point at which the nerve is being impinged. Why is this important? Because carpal tunnel syndrome is caused by the compression of the median nerve at the carpal tunnel. If, indeed, your condition is being caused by the compression of a nerve elsewhere (say, the elbow or the cervical spine), then you’ll need different treatment. I’ve had patients come into my office who underwent surgery for their carpal tunnel and saw no difference afterwards because they were misdiagnosed. They never had carpal tunnel at all!
 
After your nerve conduction study, if your condition is being caused by a nerve compression somewhere other than the carpal tunnel, then you may respond excellently to chiropractic care. The main purpose of chiropractic care is to resolve subluxations. Subluxations are instances where a bone misalignment has caused a nerve to become compressed and, thus, irritated. A chiropractor can adjust the elbow, can adjust the neck, can even adjust the wrist (although if you’re experiencing swelling there, this might not be advised). A chiropractor can adjust any part of the body with joints (including, but not limited to: hands, feet, fingers, toes, legs, arms, backs, and necks). An adjustment of the wrist may be necessary, in the event your nerve conduction study reveals you are suffering from carpal tunnel syndrome, since carpal bones can potentially be pressing on your median nerve and contributing to your condition. 
 
Therefore, your best bet when initially treating your carpal tunnel is to see a chiropractor. Chiropractic care is safe, noninvasive, and requires next to no downtime. If your first stop for treating your carpal tunnel is a doctor, you’ll probably follow a treatment route similar to what’s outlined above. There’s nothing wrong with such a treatment plan, but to give yourself the best chance at a pain-free life, definitely add a chiropractic appointment to the mix. If you reach out to us at Lowcountry Chiropractic, we’d be more than happy to formulate a plan for your treatment. You can schedule an appointment on our website, email, or call. I would love to perform an initial exam, speak to you about your condition, and begin working towards your pain-free future together. 

Before I leave you, I would like to make note of one more thing. Lowcountry Chiropractic is hosting a food drive this December! That’s right! All food will be donated to the Lowcountry Foodbank. If you bring in five non-perishable food items, we will provide you with an exam, consultation, and x-ray for free. This package is valued at $191, but they are free to new patients! If you’re an existing patient and you refer a new patient to Lowcountry Chiropractic, you’ll receive five raffle tickets. Likewise, if you donate five nonperishable items, you’ll receive one raffle ticket. (Only five tickets per person.) The prizes available in this year’s raffle include a 50” flat screen TV; two $50 Walmart gift cards; and two one-hour massages. Make sure to bring in any items before December 22nd. We hope you’ll participate in this year’s food drive! If so, we’ll see you soon! Thank you for reading!