2 Carpal Tunnel Cousins You Should Know About
Carpal tunnel syndrome is a very specific nerve disorder where the median nerve, which starts at the neck and runs from the forearm into the hand, becomes compressed or squeezed at the wrist. In some cases there may also be compression at the spine.
The symptoms of Carpal Tunnel syndrome include pain, tingling, and/or numbness in the wrist or hand. Often people suffering from CTS will lose grip strength, so much so that sometimes people find they cannot hold a coffee cup or even a pencil without difficulty.
A specific examination can easily pinpoint the correct diagnosis, but doctors are often rushed and make snap diagnosis based solely on symptoms.
That’s precisely (I’m using that specific word on purpose and you’ll see why later) why CTS surgery often fails and that’s why other treatments you may have had for CTS have not panned out. You may not have CTS after all!
Here are 2 “Cousins” to CTS. I call them “cousins” because they are related to CTS and are often misidentified as CTS, but are definitely not the same thing and require unique treatment strategies to eliminate them.
First cousin is a type of tendonitis (inflammation of a tendon or the tube-like sheath it slides through) called Lateral Stenosing Tenosynovitis (!), oh that’s a technical medical term, here’s the easier to remember version, DeQuervain’s tendonitis.
This condition involves a tendon of the thumb and wrist that is irritated usually by excessive writing or hand tool use. Once swollen, the tendon cannot slide easily through it’s sheath causing pain and sometimes a prickly burning sensation of the wrist or hand near the thumb.
This is often misdiagnosed as CTS. A competent doctor will precisely make this diagnosis with one manual test…they just need to bother to take the time to do it.
Once a correct diagnosis is made, treatment usually involves very short term splinting or bracing, rest from activity and specific therapy modalities designed to reduce inflammation and improve mobility of the tendon through it’s sheath. Then rehabilitative exercises and stretches are done to strengthen the area to prevent recurrence. Rarely are shots, surgery or other invasive procedures needed.
Uncomplicated recovery can take anywhere from 2 weeks to 2 months depending on severity.
The second cousin of CTS is called Thoracic Outlet Syndrome or TOS. TOS is a condition of blockage or irritation of the blood vessels and nerves as they pass from the side of the neck down into the shoulder to supply the upper extremity. Tightness of the muscles of the front and side of the neck are often the cause of the condition. Auto accidents, postural stress (prolonged desk, computer and phone use) and poor sleeping posture (stomach sleeping or poor fitting pillow) are all root causes of TOS. TOS symptoms include numbness, pain, tingling
of the hand, wrist or arm. Often patients will report waking up with their arm feeling like it is a “lead pipe.” It may improve once out of bed or may remain.
Females are much more prone to TOS probably due to their more complex neurovascular network in the area.
Once again, a competent examination will precisely uncover whether you are suffering from TOS or CTS. A few simple noninvasive manual tests will make the distinction.
Treatment involves removing inflammation and/or irritation of the nerves and relaxation of the muscles. Underlying postural and biomechanical problems of the neck need to be addressed to keep the condition from returning, as is ergonomic counseling to make work
posture less offensive. Uncomplicated recovery can be expected in 2-4 weeks in most cases.
A comprehensive examination by a competent Doctor of Chiropractic specializing in orthopedics can determine if your hand and wrist symptoms are carpal tunnel or if it is actually caused by one of these “cousins.” After initial treatment, he or she can also advise on at-home stretching exercises that can be done to help recovery and prevent relapse. In some cases, hidden spinal and neck problems can influence, and be the key to treating the cause vs. the symptom.
New space age medical technology exists that can pinpoint where the hand and wrist pain is coming from and can heal tendons and nerves practically at the speed of light.