Introduction

The carpal tunnel is a narrow passageway of ligament and bones at the base of the hand that houses and protects tendons and the median nerve. Carpal tunnel syndrome is an overuse condition in which pressure is put on that nerve, which controls movement and feeling in the thumb and the fingers. The trauma can also cause the tendons to become inflamed. The condition affects hundreds of thousands of individuals, including many athletes.

How it Happens

Although the exact cause varies from person to person, a combination of factors can increase pressure on the median nerve and tendons.

A naturally small carpal tunnel

In some people, the carpal tunnel is smaller than in others, which makes the nerve inside more susceptible to pressure caused by repetitive movements or swelling brought on by a fracture or sprain.

Repetition of hand movement

In others, the size of the tunnel is normal, but the same kinds of outside forces, primarily swelling, can put pressure on the nerve, causing a variety of painful and debilitating symptoms. Spending long days at the office typing away at your computer is a common cause. In sports, gripping a tennis racquet, golf club, or baseball bat repeatedly can all result in pain.

Related Conditions:

Pronator Teres Syndrome

Pronator teres syndrome is a compression of the median nerve at the elbow. This is the same nerve invovled with Carpal Tunnel Syndrome, but the compression occurs in the elbow rather than the wrist.  This compression of the median nerve in the region of the elbow or proximal part of the forearm can cause pain and/or numbness in the distribution of the distal median nerve.  There is often a weakness of abduction of the thumb in the plane at a right angle to the palm, reflecting the involvement of the unbranched portion of the median nerve.  The long flexor muscles of the thumb, index and finger are often weak as well, leading to impairment of a pincer movement of the fingers. The most common cause is entrapment of the median nerve between the two heads of the pronator teres muscle.

Treatment

Initial Treatment

• Take aspirin, ibuprofen, acetaminophen, or naproxen for pain.
• Use an over-the-counter splint or brace at night to immobilize the wrist.
• Use ice applications on the wrist for 15-20 minutes, 3-4 times a day.
• Rest the hand and wrist for 1-2 weeks.
• See a doctor if symptoms persist longer than 1-2 weeks; perhaps early if symptoms are severe.

Long Term Treatment

• Mild carpal tunnel syndrome often requires change of hand use, patterns of hand use, and posture at work.
• Adjusting repetitive movements, the frequency with which movements are preformed, and the amount rest between periods of performing movements can sometimes help.
• Prioritizing their activities and possibly avoiding certain hand activities so that they can minimize pain and perform the essential tasks.
• Go to a chiropractor to receive instruction on exercises that can help you recover from Carpal Tunnel  or Pronator Teres Syndrome.
  

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Call us at (858) 452-3734 and our helpful front office staff will be happy to assist you in making an appointment with Doctor Todd Plutchok, D.C.

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