By Dr. Vic Weatherall
Carpal tunnel syndrome (CTS) arises primarily from compression of the median nerve as it passes through the ligamentous and bony tunnel formed by the wrist due to ligamentous laxity or tendonitis. It is the most common compression nerve compression injury in the body and it is the most common and costly repetitive strain injury. Carpal tunnel syndrome is two to five times more common in females and is most prevalent in persons aged 40-60.
Common causes of CTS include
Other causes include
Typical symptoms of CTS include
The formal diagnosis of CTS is made by
It is important to note that additional compression of the median nerve anywhere along its path, from the nerve roots in the neck to the forearm, can predispose, initiate, or exacerbate CTS; therefore, it is important to examine and treat the nerve along its course.
Note that symptoms similar to those of CTS can be caused by compression of the median nerve anywhere along its path from the nerve root to the hand; therefore, it is important to seek a proper diagnosis.
To help prevent CTS
There are many ways to treat CTS. Conservative treatment by chiropractors and therapists involves joint manipulation or mobilization, massage, stretching, splinting, rehabilitative exercises, and ice and heat. Vitamin B6 has also been promoted.
Medical treatment includes diuretics, sedatives, and nonsteroidal anti-inflammatories (NSAIDs) to provide temporary relief. When these fail, a physician may resort to corticosteriods or surgery to decompress the median nerve. However, steroid therapy may cause chemical nerve irriation and degeneration of the local tendons and bony structures. Surgery has its own complications including possible recurrence or worsening of the condition due to scaring; therefore, surgery should be used as a tool when all other treatment has been unsuccessful.