Carpal Tunnel SyndromeCauses, Symptoms, & Treatments

Presented by:Dr. Clay Kuethe

Carpal Tunnel (An Overview)Where is the Carpal

Tunnel?The Carpal Tunnel is in

your wrist. It is made up of the

carpal bones and the flexor retinaculum (transverse carpal ligament).

Pneumonic for carpal bones

Some Lover’s Try Positions That They Can’t Handle

Carpal Bones

Carpal BonesScaphoidLunateTriquetrumPisiformTrapeziumTrapezoidCapitateHamate

What Is In The Carpal Tunnel?The median nerve

which is the nerve supply for the palm side of your hand.

The flexor tendons of the muscles that flex your wrist, hand, and fingers.

Sometimes, arteries and veins that supply the hand.

Some Symptoms of Carpal Tunnel Syndrome

Numbness, tingling, and/or pain in the thumb, pointer finger, middle finger, and half of the ring finger.

Usually no pain in the palm, sensory nerve given off before entering the carpal tunnel

Weakness or clumsiness in grippingAtrophy of the thenar eminencePain in the wrist, forearm, elbow, or shoulder.Fingers turning purple Symptoms can be relieved temporarily by shaking

the hands, putting in hot water, or resting them.

Some Tests to Check for Carpal Tunnel Syndrome

Tinel’s sign: Involves tapping over the carpal tunnel to elicit numbness or tingling in the fingers(between 60%-80% effective)

Phalen’s test: Pressing the backs of the hands together to elicit symptoms (between 49%-64% effective)

Reverse Phalen’s: Pressing the palms of the hands together (between 49%-64% effective)

Pressure Provocative Test: Putting direct pressure over the carpal tunnel to elicit symptoms (100% effective)

Causes of Carpal Tunnel SyndromeWomen are actually 3

times more likely to have symptoms of carpal tunnel syndrome.

Most often a result of a person’s occupation.

Activities requiring continual use of the hands

Repetitive motions using force

Prolonged flexion or extension of the wrist

GrippingPressure over the

palmTraumaFracturesVibrationExamples: data-entry,

meat cutters, assembly, construction workers, and musicians

How Do These Activities Cause Carpal Tunnel Syndrome?

Excess or strained movement, such as typing, mouse use, assembly line movements.

Micro-bruises can form along these tendons if overused and as they heal, scar tissue can form.

Scar tissue forms in an attempt to help stabilize an area.

How Do These Activities Cause Carpal Tunnel Syndrome? (cont)Scar tissue will

connect structures together, such as tendons, in order to give them stability

The median nerve can also become entrapped when scar tissue forms

This restricts the normal movement of the nerve in the carpal tunnel

This results in more pulling and tugging on the nerve, which causes inflammation.

Inflammation irritates the nerve and can also draw fluid to the area, causing swelling.

Scar tissue formation can also cause the nerve to be compressed

What Else Could It Be?C6 or C7 nerve root

lesion (Subluxation)Disc disease of the

cervical spinePronator Teres

SyndromeCubital Tunnel

Syndrome

Tunnel of Guyon Syndrome

Radial Tunnel Syndrome

Posterior Interosseous Nerve Syndrome

Carpal Subluxation

C6 or C7 Nerve Root Lesion(Subluxation) & Cervical Discogenic Disease

Subluxation of either the C6 or C7 vertebra can cause inflammation at the nerve root, which can cause neuropathy in the median nerve

Will often have radiating pain down the arm, which may be relieved by distraction of the cervical vertebrae

C6/C7foramen

C6

C7

Pronator Teres SyndromeThe median nerve is

compressed before it reaches the carpal tunnel in between the two heads of the pronator teres.

Pain when pronating flexed wrist against resistance.

Sensations in the palm may be reduced.

Cubital Tunnel SyndromeThe ulnar nerve

becomes trapped on the medial side of the elbow.

This can cause pain and sensory deficits in the ulnar nerve distribution of the hand.

The medial half of the palm and 5th and the medial half of the 4th digit.

Tunnel of Guyon SyndromeTunnel where ulnar

nerve and artery cross the wrist into the hand.

Hypothenar wasting and sensory deficits in the highlighted area.

May also be the artery becoming compressed and causing sensory losses.

Radial Tunnel SyndromeEntrapment of the

radial nerve in the lateral aspect of the elbow.

Pain with elbow flexion of elbow and pronation of wrist.

Radial nerve supplies the posterior aspect of the hand and extensor musculature of the forearm.

Posterior Interosseous Nerve SyndromeEntrapment of the

motor branch of the radial nerve.

Wrist extension will be weak.

Pain with forceful wrist extension.

How Do You Treat It?Chiropractic

adjustments if the main cause is cervical degenerative disease or subluxation.

Chiropractic adjustments of the shoulder, elbow, or wrist if there is a subluxation of these areas.

Myofascial release if the cause is muscular or connective tissue in nature.

Anti-inflammatory medication to reduce swelling and inflammation.

Surgery as a last option to relieve pressure in the carpal tunnel.

Have Questions? Just Call or Send an E-mail

516 W. 35th St.Davenport, IA 52806Phone: 563-388-6364

E-mail: drclay@familycarechiropracticdavenport.com

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