I was talking to a newer patient this week who had been struggling with wrist, arm and hand pain/tingling for quite some time. As we were speaking, he said “I wish someone had told me this before. I thought I ‘just’ had carpal tunnel syndrome”. And this is not the first time I’ve heard something like this.
When a nerve outside of your spinal cord gets pinched, this is referred to as a peripheral nerve entrapment (PNE). If the nerve is pinched at your wrist, it is called carpal tunnel syndrome.
The carpal tunnel is a crowded tunnel in your wrist that has a total of 10 structures in it, including a nerve called the median nerve. The median nerve provides sensation, to your thumb, first 2, and ½ of your third finger on the palm of your hand. Pinching, twisting, irritation or pressure on this nerve causes numbness, tingling, and pain most commonly in your thumb and first two fingers.
However, the carpal tunnel is not the only place the median nerve can be pinched. Maybe not even the most commonplace for it to be pinched. The median nerve can be pinched, twisted, tugged and irritated at several different places in the forearm alone. So, even though carpal tunnel syndrome is the most well know PNE, it is not the only median nerve entrapment site.
Often PNE are caused by overuse. Common sources of overuse that we see in our office are things like:
• Computer work
• Video games
• Bike riding
• Lots of carrying
• Lots of gripping
Taking the patient that I mentioned above as a perfect example, they overuse their forearms lots by carrying heavy plates at work. Being an avid cyclist compounds the problem by also placing stress on several of the median nerve compression sites including the carpal tunnel.
In short, excessive pressure anywhere along the path of the nerve can eventually lead to it becoming compressed, twisted, pinched or irritated.
for the median nerve to get entrapped. As you can see below the median nerve follows a complicated path in your forearm to your wrist. There are many points where it passes; under, around, over or even through structures. At several of these points the nerve is vulnerable to getting pinched, twisted, stretched, tugged or otherwise irritated. This is why a detailed exam by an experienced professional is essential in identifying the right kind of treatment.
Because there are so many places for the median nerve to be compromised a thorough history, examination is essential in determining which sites (there are often more than one). Once the probable sites of irritation are identified specific, well-directed treatments to those areas are very often successful and reducing or eliminating the pain and tingling caused by the nerve irritation. Techniques like Active Release Techniques(ART) can be beneficial in identifying and treating all kinds of peripheral nerve entrapments.
In more stubborn or complicated cases, we use a treatment called shockwave to help break up scar tissue, speed the healing of the nerve. Shockwave is a safe and effective treatment for even chronic and post-surgical cases of carpal tunnel syndrome.
Finally, like with many repetitive strain type injuries a well-designed home program is an essential component to speeding and maximizing your recovery. Click here for a sample exercise program.
So, if you have pain and tingling in your hands, make sure not to ignore it and hope it will go away, instead find a chiropractor with experience treating carpal tunnel syndrome and other peripheral neuropathies. In Winnipeg, the chiropractors at Sun Chiropractic have extensive training and experience treating peripheral neuropathies and would be happy to help you recover as quickly as possible.