CARPAL TUNNEL SYNDROME

By: Dr. Terry Weyman

“When I ride my wrist hurts and sometimes my hands go numb. Do I have carpal tunnel syndrome?” “This is one of the leading questions I am asked in my practice. In the past 15-20 years, carpal tunnel syndrome has become one of the most significant medical problems affecting the U.S. population. The U.S. Department of Labor reports that carpal tunnel syndrome and other repetitive motion disorders account for over 60 percent of all workplace injuries. Computer operators have joined assembly line workers, meatpackers, building tradesmen, hairstylists, dental assistants, cashiers and others as victims of repetitive strain injuries causing these disorders to be dubbed “the number one occupational hazard of the twentieth century.” For MX Athletes, the problem is also growing, but what makes it this condition hazardous is when you have a hard time holding onto the bars at top speed.

So now what? Unfortunately carpal tunnel syndrome is also one of the most over and misdiagnosed conditions along with sciatica. Carpal tunnel is defined as “a compression of the median nerve at the wrist. This compression is caused by one of two things:

ONE, swelling of the tissue (blood vessels, nerves, fat and tendons) surrounding the nerve in a tunnel-like passage (canal) in the wrist. This swelling can be as simple as fluid retention associated with mensration, arm pump or several other minor issues.

The SECOND possible cause is a collapse of one or more of the carpal bones compressing the median nerve. This collapse can be the result of an injury (landing on your outstretched hand and bending your wrist backwards or any forced hyperextension wrist injury) or from sustained pressure from activities like typing/keypunching (computer work), sustained riding, over doing your workout or activities involving pushing. The symptoms include pain, weakness and numbness in the thumb and first finger (pointer finger), and could involve the second finger (middle finger). These are the only locations of symptoms if the diagnosis is carpal tunnel syndrome. If the pain, numbness and/or weakness are in the entire hand, outside of the hand, in the forearm, or if you also experience pain in the cervical spine then another diagnosis must be made. A complete exam, along with specific x-rays, is helpful in making the proper diagnosis.

There are many ways to treat carpal tunnel syndrome depending on the severity, among other considerations. In most cases, Specific Chiropractic Manipulation of the carpal bones performed in a specific manner can be very effective in relieving the pressure on the median nerve. Specific biomechanical adjustments coupled with soft tissue techniques, such as ART (Active Release Technique), have experienced a success rate of 80% and above (according to an independent study performed in Colorado Springs, Colorado in 1999). Specific exercises to strength the weakened tissue should complete the treatment protocol.

Some Physicians may prescribe medication and /or inject cortico-steriods which may temporarily alleviate pain and swelling. However, it often does not treat the actual problem and the symptoms may return. Surgery may be recommended in extreme cases, but surgery may lead to scarring of the transverse ligament, as well as creating instability of the carpal (wrist) structure. The scarring can further irritate the median nerve causing the symptoms to return. Since surgery only has a success rate of up to13%, all other means of treatment should be exhausted prior to consent.

As one of the most widespread occupational hazards, carpal tunnel syndrome is painful and debilitating. If you experience any of the symptoms above don’t wait for it to “go away”. Early treatment will lead to a quicker and easier recovery. Regardless of which treatment is used, full recovery will only come about by avoiding stressful situations and changing ergonomics (such as bar angle and height) and habits. Seek advise from your Sports Chiropractor, Medical Doctor, Trainer, Physical Therapist or your coach.

Dr. Terry Weyman is a Sports Chiropractor who specializes in the active person. He is the clinic director of the Chiropractic Sports Institute in Westlake Village, Ca. www.gotcsi.com