Most patients with carpal tunnel syndrome will put up with their symptoms for days and weeks until they’re troubling enough to bring to a doctor’s attention. Their doctor should rule out certain causes for the hand pain (such as diabetes) and focus the examination on the wrist and other anatomic sites where nerve compression may occur. For example, the nerves to the hand begin in the neck area, cross the shoulder and elbow, and enter the wrist tunnel before finally exiting into the hand. The median nerve can be injured anywhere along these areas and produce symptoms that mimic carpal tunnel syndrome.
When the joints in the neck sprain, the nerves that run between them can be compressed or irritated. There may not be much neck pain involved, but it reduces the function of the nerve. When the nerve gets to the carpal tunnel, it is already in a weakened state. Just a slight irritation at the wrist carpal tunnel can be enough to give the tingling pains into the hand.
Treatments that address misalignment of the vertebrae in the neck, like spinal manipulative therapy performed by chiropractors, may then help to normalize nerve function into the arm and hand. Sometimes, patients will have both wrist injury and neck problems. In these complex cases it is important that treatment is individualized to the patient’s needs.
If there is inflammation, applying cool packs can help reduce swelling. This may be preferable to the use of nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers as such medications do not address the cause of the pain symptoms but rather mask pain. These pain signals are important as they tell you which movements to avoid so that tissues are not stretched and healing can occur.
Stretching and strengthening exercises of the arm can be helpful in people whose symptoms have abated. These exercises may be supervised by a chiropractor who is trained to use exercises to treat physical impairments. Sometimes contractures develop around the wrist and arm and these can be released with stretches or deep massage.
Conservative approaches should always be tried first before invasive surgery. Although thousands of surgeries are performed every year, most patients can resolve their pain with conservative measures.