Carpal tunnel syndrome (CTS) is a condition that occurs when pressure is applied to the median nerve as it passes through the wrist resulting in symptoms such as tingling, numbness, and weakness. Outside of an emergency leading to a sudden onset of such symptoms—like a broken wrist—surgery is rarely advised as a first-line treatment. In general, treatment guidelines recommend exhausting all non-surgical options before consulting a surgeon. So, what happens when a patient consults a doctor of chiropractic for CTS?
First, the patient completes paperwork regarding their current symptoms and their health history. The information provided will inform the doctor about the chronicity, frequency, and intensity of the patient’s symptoms. The history may also reveal conditions that are known to contribute to an elevated risk for CTS such as diabetes, birth control pill usage, pregnancy, hypothyroid, etc.
Next, the doctor of chiropractic will conduct a thorough examination, with added focus on the course of the median nerve. The median nerve arises from the spinal cord in the neck as nerve roots travel down through the shoulder, past the elbow, and through the wrist. If the nerve is compressed anywhere along this route, a patient may experience CTS-like symptoms, so it’s important to locate where the nerve is “pinched” in order to ensure the best chance for a positive outcome. To complicate matters, the median nerve may be compressed at several points, a condition referred to as double crush or multiple crush syndrome. Not only that, but the median nerve isn’t the only nerve that supplies sensation to the hand. When entrapped, the ulnar and radial nerves can also produce symptoms in the hand and these symptoms can be mistaken for CTS by the layperson because it’s the most commonly known peripheral neuropathy.
Once all the potential contributing factors to the patient’s hand and wrist symptoms are identified, the doctor of chiropractic will recommend a course of treatment that may involve manipulation, mobilization, therapeutic exercises, modalities, wrist splinting, and even dietary recommendations, depending on the patient’s unique situation. The goal is to reduce pressure on the median nerve by restoring normal motion in the affected joints, as well as in reducing inflammation that may be present from a variety of causes.
While patients with more severe cases of CTS can benefit from non-surgical approaches, like chiropractic care, it’s important to note that it may take longer for such patients to experience improvements in pain and disability, and it may not be possible to totally reverse the course of the disease if it has progressed too far. As with many conditions, the sooner a patient seeks care, the greater their chance for achieving a successful outcome.
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