Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs when a nerve in the wrist (the median nerve) gets compressed between some bones and soft tissues. The symptoms usually consist of pain, numbness, tingling, weakness and deficits in sensation. Typically, carpal tunnel syndrome is more common in women and often occurs in both hands.

Carpal Tunnel Syndrome Treatment

There are many different treatment approaches for carpal tunnel syndrome. For those individuals with significant changes in the hand musculature, an unrelenting symptom pattern and objective confirmation of carpal tunnel syndrome surgery is often indicated. For most people carpal tunnel syndrome can be easily controlled with conservative treatment.  At our chiropractic and physiotherapy clinic in Burlington we recommend a combination of soft tissue therapy (active release techniques and graston technique) with night splinting. The purpose of the soft tissue therapy is to break-down scar tissue that is impeding the proper function of the median nerve. The night splinting is used to “unload” the nerve and allow it to heal.

Wrist Brace for Carpal Tunnel Syndrome?

Although there is significant evidence supporting night splints for carpal tunnel syndrome, the results of a 2007 paper published in the Archives Physical Medicine Rehabilitation suggest that there may be a right and a wrong way to do this. In this study the authors compared two different approaches for splinting the wrist in patients with carpal tunnel syndrome. Their findings indicated that a splint which keeps a specific segment of the finger extended is more effective, as several studies have shown that this position keeps certain muscles out of the carpal tunnel. Shortening these muscles at night therefore allows the median nerve to have more room in the carpal tunnel without being compressed.

Brace for Carpal Tunnel Syndrome

Carpal Tunnel Brace

Physiotherapy for Carpal Tunnel Syndrome

The combination of active release technique, graston technique and night splinting is an effective and evidence based way to conservatively control carpal tunnel syndrome.  Our clinic has also found laser therapy to be effective for this condition.  What is right for you?  It depends on a variety of factors; how long you’ve had carpal tunnel syndrome and what else you’ve tried are two of the more important factors.  Keep in mind that there are numerous causes of numbness, tingling, pain and weakness in the wrist and hand. There are other potential entrapment sites of the median nerve and there are other nerves that can create similar symptoms to carpal tunnel syndrome. Ensure that your condition is properly diagnosed by a qualified practitioner; feel free to contact our clinic and schedule an appointment with one of our doctors to see if you truly have carpal tunnel syndrome.

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References

Brininger TL, Rogers JC, Holm MB et al. Efficacy of a fabricated customized splint and tendon nerve gliding exercises for the treatment of carpal tunnel syndrome: a randomized controlled trial. Arch Phys Med Rehabil 2007; 88: 1429-1435.

Goodyear-Smith F, Arroll B. What can family physicians offer patients with carpal tunnel syndrome other than surgery? A systematic review of nonsurgical management. Ann Fam Med 2004; 2: 267-273.

Miedany YE, Ashour S, Youssef S, Mehanna A, Meky FA. Clinical diagnosis of carpal tunnel syndrome: old tests – new concepts. Joint Bone Spine 2008; 75: 451-457.

Ugbolue UC, Hsu WH et al. Tendon and nerve displacement at the wrist during finger movements. Clinical Biomechanics 2005; 20: 50-56.

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