Carpal tunnel syndrome (CTS) occurs when pressure is placed on the median nerve as it passes through bones and ligaments of the wrist in order to innervate a portion of the hand. This pressure can be cause by compression of the carpal tunnel due to mechanical injury or when other tissues near the median nerve become inflamed, either from disease or overuse.
When it comes to treating a patient with carpal tunnel syndrome (CTS), what separates chiropractic care from standard medical care? Both options recommend night wrist splints, anti-inflammatory measures, rest, and the “tincture of time.” Doctors of chiropractic are trained to provide manual therapies like manipulation and mobilization. Two studies show that these therapies can relieve pressure on the median nerve by improving the shape of the carpal tunnel itself.
In a study published in December 2018 in The Journal of Hand Surgery, researchers used dynamic ultrasound to capture images of longitudinal median nerve motion inside the tunnel as compressive forces were applied to the two sides of the wrist and distal forearm in both healthy and CTS patients. The researchers observed that the median nerve moved more within the carpal tunnel in patients with CTS compared to those without the condition.
In an anatomical study published in the journal Clinical Biomechanics (November 2018), lead author Dr. Elena Bueno-Gracia and colleagues measured the cross-sectional area of the carpal tunnel before and after manual manipulation and mobilization of the carpal bones. They observed both an increase in the front-to-back diameter of the tunnel AND a reduction in pressure on the median nerve. Additionally, the researchers noted that the shape of the carpal tunnel itself becomes more round following manipulative therapy. The research team reported that their findings are consistent with prior studies.
These studies demonstrate that the carpal tunnel is indeed dynamic/flexible and that manual techniques can alter its shape, providing more “breathing room” and allowing the contents within (i.e., the tendons and the median nerve) increased mobility with less friction.
Doctors of chiropractic are trained to provide manual therapies, which include mobilization and manipulation, of the spine and extremities of individuals with musculoskeletal conditions, including carpal tunnel syndrome. Together with the “standard” therapies previously mentioned, proper exercises, and patient education, chiropractic is the perfect choice for non-surgical CTS care!
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