Carpal tunnel syndrome (CTS) is a condition the occurs when mobility of the median nerve is restricted as it passes through the wrist, resulting in symptoms that extend into parts of the hand including pain, numbness, tingling, and weakness. Generally, symptoms come on gradually but worsen and become more frequent over time. While most often associated with computer work, CTS can affect anyone whose work involves repetitive hand movements—especially when combined with non-neutral wrist postures or vibration exposure—or who is affected by conditions that create swelling or inflammation in the wrist tissues, such as pregnancy, obesity, diabetes, rheumatoid arthritis, and more. There are many treatment options available to the CTS patient, of which chiropractic care is highly favored both by patients and the clinical treatment guidelines.
When the CTS patient first presents for chiropractic treatment, they will complete a patient history that describes both their current symptoms as well as any other health conditions they’ve had in the past or are currently experiencing. In addition to letting the doctor of chiropractic know if there are health conditions that may contribute to CTS and may require co-treatment to achieve a successful resolution, the history will also indicate the potential for conditions that can co-occur with CTS or be mistaken for it, such as median nerve compression elsewhere along the course of the median nerve or compression of another nerve that innervates other parts of the hand, such as the ulnar nerve. With this information, the chiropractor will conduct an examination to better understand the patient’s unique situation, which may include diagnostic imaging, such as X-ray. At this point, they can confirm a diagnosis and decide upon a treatment approach.
Treatment will typically include a combination of in-office therapies and at-home instruction. In-office treatment will primarily involve manual therapies, such as manipulation, mobilization, and soft tissue work, to increase mobility of the median nerve as it passes through the wrist as well as elsewhere along the course of the nerve’s course if multiple entrapments are present. In-office treatment may also include modalities such as cold laser, e-stim, pulsed electromagnetic field, and more.
Between visits, patients may be advised to wear a wrist splint at night or during some activities, though not all the time, to help keep the wrist in a neutral position that takes pressure off the median nerve. They may also be instructed on exercises or stretches they can perform several times a day and/or receive instruction to take supplements or modify their diet to reduce inflammation.
While several studies support these conservative treatment approaches for managing CTS, it’s important to note they work best early in the course of the disease. The longer a patient waits to seek care, the more time it may take to achieve a satisfactory outcome. In severe cases, the only option may be surgical intervention. If you’re currently dealing with bothersome symptoms in the hand and wrist, don’t just shake your hand and carry on. Contact your doctor of chiropractic and schedule an evaluation.