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CARPAL TUNNEL

Carpal tunnel syndrome (CTS) is a condition caused by swelling and pressure inside a tunnel-like structure of the wrist called the carpal tunnel. The carpal tunnel is made up of the 8 small bones (carpal bones) at the base of the hand, and a ligament, or fibrous tissue, joining those bones together. Passing through the carpal tunnel are the flexor tendons–connective tissue that allows the fingers to move–and the median nerve, which runs from the forearm into the hand. Any repetitive motion that causes the wrist to flex and extend–such as typing, knitting, assembly work, or playing the piano–may result in swelling and thickening of the protective sheaths surrounding each of the tendons. This swelling, in turn, causes pressure on the median nerve, which serves as a pathway for sensory cells in the hand. When this nerve is compressed, symptoms of CTS–which may include tingling, numbness, pain, or weakness in the fingers, wrist, or arm–may appear. In addition to repetitive motion, injury or diseases such as arthritis, diabetes, or thyroid disorders may lead to CTS. Women are 3 times more likely to develop the disease than men because, some think, the carpal tunnel is often smaller in women than in men.

How NUCCA treatment can help

The standard medical approach to treating CTS may include a splint to immobilize the wrist, diuretics (water pills), anti-inflammatory drugs, or corticosteroid shots to reduce swelling. As a last resort, surgery may be performed, but recovery may take months or years, and even if the pain is eliminated, symptoms may return over time.

In the NUCCA approach, it is important not only to treat symptoms but also to determine the cause of the problem. The NUCCA practitioner usually examines the neck and spine before the wrist. There are a group of nerves that come out of the mid- to lower-neck region and branch out to the arms, hands, and fingers. Pressure on any of these nerves, especially the median nerve, may result in CTS.

Specific imaging studies of the cervical (upper neck) region are taken to locate a misalignment of the vertebrae. Insight Millenium technology is used to scan and measure the nervous system for possible irritation. If a misalignment has been found to affect nerve function in the wrist, then very specific gentle adjustments are made, by hand, to correct the misaligned vertebrae in the neck. After the adjustments have been made, follow-up imaging studies and nervous system scans are taken to confirm a successful spinal correction. Once the spinal correction is accomplished successfully, normal nerve function is restored to the wrist, and many patients with CTS find relief.

Sources

National Institute of Arthritis and Musculo-skeletal and Skin Diseases Web site. Available at: http://www.niams.nih.gov. Accessed March 6 , 2005

National Institute of Neurological Disorders and Stroke Web site. Available at: http://www.ninds.nih.gov/disorders/carpal/carpal.htm. Accessed: March 7, 2005.

Peddie S, Rosenberg CH. The Repetitive Strain Injury Sourcebook. Lincolnwood , Ill : Lowell House, 1998.

Useful Links

  • Carpal Tunnel Syndrome Home Page 
    Useful starting point for information about CTS as well as ergonomic equipment and resources.
    http://www.ctsplace.com
  • National Institute for Occupational Safety and Health 
    Branch of the Centers for Disease Control and Development; good source of information on cumulative stress disorders, including CTS, and healthy workplace environment.
    http://www.cdc.gov/niosh
  • National Institute of Arthritis and Musculoskeletal and Skin Diseases 
    Part of the National Institutes of Health; offers useful information on CTS for patients.
    http://www.niams.nih.gov/an/index.htm