Carpal Tunnel

Carpal tunnel is a common injury which presents to the practitioners at Elite Health and Performance. It is often over diagnosed by the health industry and true carpal tunnel is much less common. So how do you know if you actually have carpal tunnel and what are the options if this is you?

Firstly to understand if you are suffering from this injury it is key to have an understanding of what the injury is and how it may have been caused. Carpal tunnel is a nerve entrapment of the median nerve within the wrist. The median nerve is one of three major nerves which supply movement and sensation to the hand. The nerve becomes entrapped within a sheath and between tendons in the front (palm side) of the wrist.

This entrapment may be caused by many different factors. Most commonly it is from repeated loading of the flexor tendons which move the hand and fingers during gripping. Repeated loading of these tendons cause a tendinosis which begins the inflammatory cycle and in turns decreases the room for the nerve to move through. This mechanism is not the only way this injury may result. It may also be caused from a traumatic strain in the flexors which again put excessive pressure to the wrist and minimise room for the nerve or also prolonged pressure irritating the area form computer work.

Once the nerve becomes entrapped symptoms may include pain in the wrist and hand especially at night, numbness in the palm or middle three fingers (other fingers indicate other nerves), weakness with gripping or poor hand coordination and in long term cases muscle wasting in the palm. Sometimes it may be difficult to differentiate between carpal tunnel and other median nerve entrapments. Other injuries that can mimic carpal tunnel are pronator teres syndrome, cervical disc injury, thoracic outlet syndrome and radial or ulnar nerve entrapments.

So how do you cure carpal tunnel? Once the injury has been identified there are several things you can do at home to manage this if it is the early stages of injury. Firstly stretching the muscles of the forearm are key to reducing pressure on the wrist tendons and reopening the space that the nerve passes through.

Next step is to mobilise the median nerve to help free it from any entrapment points along its pathway from the neck down to the hand.

Finally non steroidal anti inflammatories are another solution to break the inflammatory cycle at the wrist and allow the area to heal.

If this does not change your symptoms within a couple of days then further treatment by a qualified practitioner is highly recommended. Who do you see for this; chiropractor vs physio? In today’s practice of conservative treatment these two professions are becoming more and more similar. The number one thing you should be aware of are they practicing evidence based care and are they providing both active and passive treatment. At Elite Health and Performance we have successfully treated many cases of this injury generally within 3-6 visits. Treatment will consist of a multi modality approach as well as looking at your overall health and any factors preventing your body from recovering.

What you will expect from a treatment is a full assessment of the upper limb and neck to correctly diagnose the injury and confirm carpal tunnel syndrome. This is done by a series of orthopaedic tests to assess the correct tissue in lesion and discover the cause. Once identified a treatment plan can begin. This may include active release technique, dry needling, fascial release, PNF stretching, neural flossing and muscle rehabilitation. Do you need a referral to see a chiropractor or other allied health practitioner? In short no. Our practitioners have great diagnostic ability and imaging or doctor referral won’t be required.