Holistic News & Events
May 6, 2011
Carpal Tunnel Syndrome
“Chronic medication usage and surgery are not the only options and actually should be the last options in the management of CTS.”
By Dr. Sal Masi
Most of us rarely think about the intricate function of our wrist and the complex movements that it can create, unless of course it becomes painful and movement is uncomfortable. One of the common ailments of wrist pain is Carpal Tunnel Syndrome.
In order to understand Carpal Tunnel Syndrome (also known as CTS) let me explain the anatomy and mechanics of the wrist. The word Carpal refers to the eight small bones found in the wrist, each has a name: Hamate, Capitate, Trapezoid, Trapezium, Pisiform, Triquetrum, Scaphoid and Lunate. They are arranged in two rows of four bones and it is these bones that allow the tremendous movement at the wrist. These carpal bones are considered the floor of the carpal tunnel.
Overlying these bones are nine tendons that attach to the fingers an are responsible for movement of the fingers, specifically flexion of the fingers. Each of these tendons are wrapped in a sheath (like a glove) that protects and lubricates these tendons. In between these tendons is a nerve, a very important nerve known as the Median Nerve.
The Median Nerve is responsible for sensation (or feeling) in the first three finger and one half of the fourth finger and movement of the thumb. Lying over all these tendons and the Median Nerve is a strong tissue known as the Flexor Retinaculum. It is like a strong Band-Aid covering from one side to the other and holds everything in place.
Carpal Tunnel Syndrome (CTS) is a condition in which there is irritation of the Median Nerve by the structures in the "tunnel" leading to nerve pain in the wrist, first three fingers and possibly up the arm to the elbow. Trauma, swelling, chronic inflammation, arthritis and excessive flexion of the wrist can cause irritation. Many times there is pain at night that can wake the person from their sleep. Sometimes intense pain can lead to disuse of the hand and wrist.
Irritation of the motor component of the nerve can cause loss of muscle function in the hand, specifically the thumb. CTS becomes a nuisance and can be a chronic condition unless the patient does two things. First they must seek treatment. Second they must modify the use of their hand to prevent future re-injury.
There are many ways to treat CTS. The treatments that we utilize are all manual medicine techniques. We treat the dysfunction tissue by hand utilizing massage, stretching, adjustments, ultrasound and supports to correct the tissue and allow it to return to normal function. Finally, we educate the patient on how to avoid re-injury in the future through the use of sound ergonomic instruction.
Carpal Tunnel Syndrome is treatable and the results can be excellent. Chronic medication usage and surgery are not the only options and actually should be the last options in the management of CTS. If you need further assistance or information about CTS please let me know. When you are ready I am here to help you.
Dr. Sal Masi