Carpal Tunnel Syndrome is a condition that affects the hand and is very common for the American population. It is estimated around ~5% of people in the U.S. either have been or will be diagnosed with CTS (and I would argue much more), so this is obviously a significant issue for many folks.

The carpal tunnel is actually a normal part of our anatomy where the 8 little bones that make up our wrist create a bony-arch that aids in mobility. It becomes a syndrome when the median nerve that travels through this arch gets compressed. This compression typically comes from a collapse of the arch of the wrist bones or swelling of the tendons that pass through the tunnel from over-use (but usually a combination of the two).

This dysfunction of the wrist is the general reason most people with CTS experience pain, numbness, or grip weakness. For some it can be more of an annoyance, yet for many others it can be debilitating – to the point of losing grip strength entirely. However because these symptoms can be caused by other mechanical issues further up the arm and near the spine, it is important to have it properly addressed through an expert in extremity diagnosis.

Treatment for true carpal tunnel syndrome is typically recommended in the form of corticosteroids, bracing, and surgery – all of which I think are poor in regards to addressing the cause of the issue. Corticosteroids are hit or miss in general with potential risk factors, bracing masks the problem, and surgery for CTS generally involves cutting the little ligament that maintains the tendons going into the wrist. 

The TRUE underlying cause of CTS is due to instability of the wrist. Neither chemical interventions, bracing, nor surgery will address this underlying cause. They may help to temporarily get rid of symptoms, however because it doesn’t address the original cause of the carpal tunnel syndrome, it leaves a high chance for reoccurrence of symptoms. I typically don’t recommend surgery in general, unless a trial of conservative care has failed first.

The best route for addressing true carpal tunnel syndrome is having the bones manipulated to reform the arch of the wrist, than reinforce proper movement patterns and tendon strength through specific exercises and ergonomic adjustments.

Food for thought  – Today’s world is full of fun technological advances that put added repetitive strain on our wrists and hands (smartphones, keyboards, etc.) that leave us vulnerable to these type of injuries. It is best to be aware of this potential problem and prevent any type of repetitive use and poor ergonomic set-ups when possible to avoid these types of injuries as best you can!

Your’s in health,

Dr. Kyle

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