Carpal tunnel syndrome (CTS) is a condition characterized by numbness, tingling, pain, and weakness in the thumb, index finger, middle finger, and the radial half of the ring finger, as well as the portion of the hand between these digits and the wrist. The condition results from compression of the median nerve as it passes through the wrist; however, if care is only directed toward alleviating pressure on the nerve within the carpal tunnel, lasting relief may not occur. This is because of the course of the median nerve itself.

Five nerves exit the cervical spine and join to form the brachial plexus at the base of the neck. Segments of the lateral and medial cords then combine to form the median nerve. From there, the nerve travels through the shoulder, down the upper arm, past the elbow, along the forearm, and finally through the carpal tunnel to terminate in the hand. The median nerve functions much like a two-lane road, carrying commands for movement and other body functions to muscles and tissues while relaying sensory information back to the brain. When this process is impeded by narrowing in the carpal tunnel, sensory nerves may misfire and motor nerves may be slow to activate—leading to the symptoms of CTS.

Compression, however, can occur at any point along the nerve’s path and may create the same symptoms as CTS. In some cases, compression exists in multiple locations simultaneously. For this reason, chiropractors examine the entire length of the median nerve to identify all potential points of entrapment. By applying pressure with the thumb over the most common compression sites and noting how quickly symptoms are reproduced, chiropractors can identify inflamed areas requiring treatment.

Once the points of compression are identified, chiropractors typically employ a combination of methods such as manual and soft tissue therapies, exercise training, splinting (particularly at night to maintain a neutral wrist position), and anti-inflammatory physiologic or nutritional approaches. They will also inquire about work and recreational activities, since highly repetitive hand movements—especially those involving forceful gripping or pinching—can worsen symptoms and may impede recovery.

Perhaps even more important than how chiropractors treat CTS is when they treat it. Because the condition typically develops from repetitive microtrauma, symptoms often begin subtly and intermittently then gradually increase in frequency and severity. Many individuals ignore or self-manage until the condition interferes too much with their daily life and work tasks. Unfortunately, delaying care can allow permanent nerve damage to occur, making complete resolution unlikely. The key takeaway is to seek chiropractic care for carpal tunnel symptoms sooner rather than later.