Carpal Tunnel is the most common repetitive use injury. It affects as many as 10% of adults at some point. Recent studies have reported a resolution of 89% of cases with massage, compared to less than 10% with surgery.
What is Carpal Tunnel Syndrome?
Technically, CTS is the irritation of the median nerve as it passes under the transverse carpal ligament into the wrist.
In simpler terms, overuse of the hands and fingers leads to pain and loss of grip strength. This can happen while performing tasks such as, typing and computer mouse use, sewing and crochet, or other repetitive actions.
Women suffer CTS three times as often as men, perhaps because the structures in the hand and wrist are smaller.
Signs and Symptoms
- Pain in the wrist, thumb, and first three fingers can be caused by some combination of nerve irritation and a decrease in blood flow.
- Tingling, “pins and needles,” or numbness in the hand.
- Occasional grip strength weakness.
- Edema (swelling) in the wrist can be the cause of CTS, especially in patients who are overweight, pregnant, or suffering from a condition that causes fluid retention.
- Subluxation, or the misalignment of one or more bones in the wrist, can put physical pressure on the nerve. Chiropractic care to realign the bones can provide relief.
- Thickening of the tendons and/or ligaments in the wrist. This is the most common cause of carpal tunnel syndrome. Overuse of the hand causes these tissues to build additional fibers putting pressure on the surrounding nerves.
Diagnosis
It’s important to get a proper diagnosis of carpal tunnel syndrome by a physician. There are other conditions that can cause similar symptoms, including neck injury, thoracic outlet syndrome, upper crossed syndrome, other wrist or elbow injuries, etc.
There are two simple tests that are often used to diagnose CTS: Tinel’s Test, which involves tapping on the wrist while the hand is extended, and Phalen’s Maneuver, which involves flexing the wrist for 1 minute or longer to see if symptoms appear.
Treatment of Carpal Tunnel Syndrome
Often, treatment for carpal tunnel syndrome depends on the severity and the clinical path you choose to follow.
The first line of defense is the use of a splint or brace that immobilizes the wrist. Resting the affected hand and supporting tissues for extended periods can sometimes resolve symptoms without further treatment.
Physician's Treatment of Carpal Tunnel Syndrome
Your doctor may prescribe anti-inflammatory and steroidal medications. They may also refer you to a physical therapist for stretch and exercise. This path of treatment usually ends with a “carpal tunnel release” surgery in which the transverse ligament is cut and excess tissues are scraped away. It should be noted that CTS often returns following a release surgery.
Massage Therapist's Treatment of Carpal Tunnel Syndrome
As noted previously, recent studies have shown that massage therapy provides excellent results in treating carpal tunnel. Additionally, a research study has found that massage therapy can improve grip strength.
Deep tissue work to the forearms, elbow, and shoulder should be performed to realign fibers and release tension from the carpal flexors and extensors.
Lymphatic drainage of swelling in the hands and wrists will relieve pressure on the irritated nerves.
PNF stretching and range of motion exercises have proven to be quite effective. These stretches improve flexibility and help strengthen other supportive tissues that can reduce the work of the transverse ligament.
Continued maintenance massage sessions have proven to be far more effective at preventing a recurrence of carpal tunnel syndrome than surgery.
Some studies have put a long-term resolution rate of carpal tunnel release surgery of only 8%. The same studies have shown that massage resolves CTS 89% of the time.
If you book a massage session with me as soon as you experience any symptoms of carpal tunnel, the better your chances of preventing long term damage. Early intervention is the best method of resolving symptoms.
Aaron Harris, BCTMB
One Response