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CARPAL TUNNEL SYNDROME

The function of the wrist is to position the hand in space and allow movement from the forearm to the hand and vice-versa. To accomplish this the wrist must have a large range of movement in all directions. All the muscles that initiate this movement do not directly insert or originate in the wrist. The wrist’s stability depends on the integrity of its ligamentous support.

The wrist is made up of 8 tiny bones known as carpals. They are arranged in 2 rows

and are held together in a specific alignment by numbers of strong ligaments. These

ligaments are located between the bones and attach the carpals to the bones of the

forearm. Between the wrist bones a tunnel is formed allowing the median nerve to pass

through and innervate certain muscles of the hand.

When the ligaments of the wrist become lax, the carpal bones shift, decrease the size of the tunnel and “trap” the median nerve inside. This accounts for the specific type of pain that accompanies carpal tunnel syndrome.

SYMPTOMS

Pain upon moving the wrist, especially when flexing the back of the hand towards the shoulder.
Night time pain that interferes with sleep.
Hand weakness; difficulty grasping objects.
Possible atrophy of the thumb muscles

CAUSES

Trauma
Overuse: Repetitive motion-keyboard use; use of hammers and screwdrivers
Constant wrist extension-waitress carrying trays

People scrubbing floors

Chiropractors adjusting people

Other: conditions causing edema

We treat this condition utilizing the following protocols:

EXAM

Orthopedic testing
Applied Kinesiology muscle testing
If needed, x-rays to rule out bone damage and pathology

THERAPIES

Extremity adjustments: wrist, forearm, elbow, fingers; neck and shoulder if necessary
Muscle work: Trigger point therapy, myofascial release, muscle re-balancing
Supplementation: natural anti-inflammatories and tissue support for the ligaments
Home care exercise regimen
Supportive taping procedures (can be taught to the patient to do on their own)
Ergonomic re-education if warranted