Description:
Carpal tunnel syndrome (CTS) is a hand and arm condition that causes pain, numbness, tingling and other symptoms. It is caused by a compressed or irritated nerve in your wrist. A number of factors can contribute to carpal tunnel syndrome including overuse, repetitive patterns of hand use, chronic tension in the neck, arm, or hand, the anatomy of your wrist, age, obesity, gender, and certain underlying health problems.
Bound by bones and ligaments, the carpal tunnel is a narrow passageway located on the palm side of your wrist. This tunnel protects a main nerve to your hand – the median nerve – and the nine tendons that bend your fingers. Compression or irritation of the nerve produces the pain, numbness, tingling and, eventually, hand weakness that typically characterize CTS.
Carpal tunnel symptoms are caused by swelling – the body's natural response to tissue damage. Swelling is the body's attempt to heal itself after injury or overuse, by bathing the area with more blood, oxygen, and nutrients, and by immobilizing the injured area to prevent further damage. Because the carpal tunnel is small – about the size of the tip of your little finger – and it houses nine flexor tendons, a major nerve, and numerous smaller nerves and blood vessels, it is a traffic jam, with very little room to spare. Add in a little inflammation and swelling and the pressure within the tunnel rapidly increases to the point where it restricts free movement and puts pressure on the median nerve. It is a vulnerable area that can quickly become symptomatic if injured or overused.
In the body, pain is always information. It is nature's way of telling us something is wrong, and needs our attention. We are well-served by heeding the call, listening to what our body is telling us, and taking steps to address the issue.
Carpal tunnel syndrome (CTS) is a hand and arm condition that causes pain, numbness, tingling and other symptoms. It is caused by a compressed or irritated nerve in your wrist. A number of factors can contribute to carpal tunnel syndrome including overuse, repetitive patterns of hand use, chronic tension in the neck, arm, or hand, the anatomy of your wrist, age, obesity, gender, and certain underlying health problems.
Bound by bones and ligaments, the carpal tunnel is a narrow passageway located on the palm side of your wrist. This tunnel protects a main nerve to your hand – the median nerve – and the nine tendons that bend your fingers. Compression or irritation of the nerve produces the pain, numbness, tingling and, eventually, hand weakness that typically characterize CTS.
Carpal tunnel symptoms are caused by swelling – the body's natural response to tissue damage. Swelling is the body's attempt to heal itself after injury or overuse, by bathing the area with more blood, oxygen, and nutrients, and by immobilizing the injured area to prevent further damage. Because the carpal tunnel is small – about the size of the tip of your little finger – and it houses nine flexor tendons, a major nerve, and numerous smaller nerves and blood vessels, it is a traffic jam, with very little room to spare. Add in a little inflammation and swelling and the pressure within the tunnel rapidly increases to the point where it restricts free movement and puts pressure on the median nerve. It is a vulnerable area that can quickly become symptomatic if injured or overused.
In the body, pain is always information. It is nature's way of telling us something is wrong, and needs our attention. We are well-served by heeding the call, listening to what our body is telling us, and taking steps to address the issue.
Medical Options:
The standard medical treatment for carpal tunnel syndrome typically consists of a multi-tiered approach, as follows:
Step 1: Pain, anti-inflammatory, and muscle relaxant medications
These drugs are prescribed to reduce the pain, swelling and inflammation associated with carpal tunnel syndrome. Unfortunately they also shut down the body's natural healing response, and artificially mask the body's natural sensations and pain signals, often resulting in more overuse and more damage. Eventually the body habituates to the presence of the drugs, and they lose effectiveness, often requiring increased dosages to control the symptoms. In addition, all these drugs can have significant side effects including ulcers, liver and kidney damage, accidents, and even death.
Step 2: Splints
A common response of doctors is to immobilize the wrist with a splint, thinking that if they take the strain off the area it could heal. In extreme cases, this approach can sometimes be warranted for a short time. But generally this approach has one major flaw: it restricts or eliminates almost all motion, thereby further reducing blood and oxygen flow to the already swollen and constricted area and making it more difficult for the body to heal itself. What is needed is more movement, not less.
Step 3: Steroid injections
Corticosteroids are powerful drugs used to override the body's immune response and reduce swelling. Injections in the area of the carpal tunnel can reduce symptoms for a few weeks, although they often returning after the effects of the drug wear off. Also, the side effects of steroid injections can be significant. Repeated cortisone shots can result in the surrounding tissue becoming permanently weakened, necrotic, and mushy. Steroids are serious drugs and should only be used as a last resort, and most experts recommend using only once or twice at most.
Step 4: Surgery
Carpal tunnel surgery consists of cutting the transverse carpal ligament that makes up one side of the carpal tunnel, thereby opening up space in the tunnel and reducing pressure on the median nerve. This procedure often does the trick of alleviating the symptoms, at least in the short term. In some patients however, especially when body use patterns remain unchanged, the symptoms return once the area becomes scarred over. Surgery patients also commonly report some degree of weakness or instability in their hands – the direct result of cutting a major structural ligament. This weakness can last for several months, and in some cases is permanent. The scar tissue that naturally forms after this surgery can also result in restricted movement and range of motion in the wrist and fingers.
The standard medical treatment for carpal tunnel syndrome typically consists of a multi-tiered approach, as follows:
Step 1: Pain, anti-inflammatory, and muscle relaxant medications
These drugs are prescribed to reduce the pain, swelling and inflammation associated with carpal tunnel syndrome. Unfortunately they also shut down the body's natural healing response, and artificially mask the body's natural sensations and pain signals, often resulting in more overuse and more damage. Eventually the body habituates to the presence of the drugs, and they lose effectiveness, often requiring increased dosages to control the symptoms. In addition, all these drugs can have significant side effects including ulcers, liver and kidney damage, accidents, and even death.
Step 2: Splints
A common response of doctors is to immobilize the wrist with a splint, thinking that if they take the strain off the area it could heal. In extreme cases, this approach can sometimes be warranted for a short time. But generally this approach has one major flaw: it restricts or eliminates almost all motion, thereby further reducing blood and oxygen flow to the already swollen and constricted area and making it more difficult for the body to heal itself. What is needed is more movement, not less.
Step 3: Steroid injections
Corticosteroids are powerful drugs used to override the body's immune response and reduce swelling. Injections in the area of the carpal tunnel can reduce symptoms for a few weeks, although they often returning after the effects of the drug wear off. Also, the side effects of steroid injections can be significant. Repeated cortisone shots can result in the surrounding tissue becoming permanently weakened, necrotic, and mushy. Steroids are serious drugs and should only be used as a last resort, and most experts recommend using only once or twice at most.
Step 4: Surgery
Carpal tunnel surgery consists of cutting the transverse carpal ligament that makes up one side of the carpal tunnel, thereby opening up space in the tunnel and reducing pressure on the median nerve. This procedure often does the trick of alleviating the symptoms, at least in the short term. In some patients however, especially when body use patterns remain unchanged, the symptoms return once the area becomes scarred over. Surgery patients also commonly report some degree of weakness or instability in their hands – the direct result of cutting a major structural ligament. This weakness can last for several months, and in some cases is permanent. The scar tissue that naturally forms after this surgery can also result in restricted movement and range of motion in the wrist and fingers.
The Holistic Approach
The holistic approach to carpal tunnel syndrome, developed after more than 16 years of working with many CTS clients, consists of one main goal: Restoring normal motion in the hand, wrist, and arm. As normal, pain-free motion is restored, the health of distressed tissues is simultaneously restored, as well. In our experience, pills, injections, or surgery are seldom required.
In a carpal tunnel bodywork session, you will be carefully evaluated both structurally and functionally. Structurally, we will look primarily at your hand, arm, shoulder, and neck/upper back. We will look for restrictions, imbalances, shortness, congestion, inflammation, and reductions in available range of motion. Structural bodywork techniques will then be applied to affected areas to loosen, lengthen, and release the restrictions, and restore normal motion. This consists of the therapist using his hands and sometimes his forearms or elbows to gently work the affected tissues. Common problems often addressed in this process include a narrow, restricted carpal tunnel, tight and short forearm flexors, tight anterior shoulder muscles, and tight anterior neck muscles. Sometimes all of these are present. When the restricted structures are gradually released, balance is restored, normal motion returns, blood flow improves, swelling subsides, and symptoms are often reduced or eliminated.
In some cases, functional considerations are important. One common functional problem we often see is an unsupported sitting position – slumping and slouching at a desk all day, for example. With little support or stability in the core, a person has to compensate for this by increasing the tension in their arms to create the stability required to type and perform other desk work. When a person learns how to sit in a supported fashion – with a level pelvis, active legs, and a stable core – tension in the arms is reduced, resulting in diminished symptoms. Another common problem we see is an unconscious, chronic pattern of holding tension in the arms and hands. Many people hold stress and tension in their arms in an unconscious effort to protect themselves or control their surroundings. Bringing any unconscious holding or tension patterns into the light of awareness often results in the resolution of persistent symptoms.
Most cases of carpal tunnel syndrome respond well to this holistic bodywork approach. Specific stretches and strengthening exercises are often recommended to further your recovery. Sometimes changes to your workplace ergonomics are recommended. Body use patterns including work habits, extreme workouts, and athletic endeavors may also need to be considered. Commonly, three to five sessions are required to address the symptoms. Sessions are normally scheduled once every 2 – 3 weeks, depending on your unique goals and circumstances. Success depends to a large degree on your willingness to work directly with your symptoms, increase your self-awareness, do your stretches and exercises, and change any habits that may be contributing to your symptoms. Within a week or two, you should notice the difference.
The holistic approach to carpal tunnel syndrome, developed after more than 16 years of working with many CTS clients, consists of one main goal: Restoring normal motion in the hand, wrist, and arm. As normal, pain-free motion is restored, the health of distressed tissues is simultaneously restored, as well. In our experience, pills, injections, or surgery are seldom required.
In a carpal tunnel bodywork session, you will be carefully evaluated both structurally and functionally. Structurally, we will look primarily at your hand, arm, shoulder, and neck/upper back. We will look for restrictions, imbalances, shortness, congestion, inflammation, and reductions in available range of motion. Structural bodywork techniques will then be applied to affected areas to loosen, lengthen, and release the restrictions, and restore normal motion. This consists of the therapist using his hands and sometimes his forearms or elbows to gently work the affected tissues. Common problems often addressed in this process include a narrow, restricted carpal tunnel, tight and short forearm flexors, tight anterior shoulder muscles, and tight anterior neck muscles. Sometimes all of these are present. When the restricted structures are gradually released, balance is restored, normal motion returns, blood flow improves, swelling subsides, and symptoms are often reduced or eliminated.
In some cases, functional considerations are important. One common functional problem we often see is an unsupported sitting position – slumping and slouching at a desk all day, for example. With little support or stability in the core, a person has to compensate for this by increasing the tension in their arms to create the stability required to type and perform other desk work. When a person learns how to sit in a supported fashion – with a level pelvis, active legs, and a stable core – tension in the arms is reduced, resulting in diminished symptoms. Another common problem we see is an unconscious, chronic pattern of holding tension in the arms and hands. Many people hold stress and tension in their arms in an unconscious effort to protect themselves or control their surroundings. Bringing any unconscious holding or tension patterns into the light of awareness often results in the resolution of persistent symptoms.
Most cases of carpal tunnel syndrome respond well to this holistic bodywork approach. Specific stretches and strengthening exercises are often recommended to further your recovery. Sometimes changes to your workplace ergonomics are recommended. Body use patterns including work habits, extreme workouts, and athletic endeavors may also need to be considered. Commonly, three to five sessions are required to address the symptoms. Sessions are normally scheduled once every 2 – 3 weeks, depending on your unique goals and circumstances. Success depends to a large degree on your willingness to work directly with your symptoms, increase your self-awareness, do your stretches and exercises, and change any habits that may be contributing to your symptoms. Within a week or two, you should notice the difference.
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Disclaimer:
The information contained on this page is the opinion of the author and does not connote medical advice. Consult your medical doctor to rule out a serious medical condition.
The information contained on this page is the opinion of the author and does not connote medical advice. Consult your medical doctor to rule out a serious medical condition.
