Carpal Tunnel Syndrome - Fact, Fiction and How to Fix It!

The term Carpal Tunnel Syndrome (CTS) was first applied as a diagnosis in 1939, but didn't become a house hold word until the 1990's when computer terminal work became common. That doesn't necessarily mean that the problem is primarily caused by computer or keyboard work, because the majority of cases are still observed in assembly type work.

CTS has since then become one of the most over diagnosed conditions ever. Virtually every time there is pain at the wrist it is being called CTS. Most lay people, and unfortunately many doctors jump to the conclusion that most wrist pain is CTS. The worst part of this is that it has also led to thousands of unnecessary surgeries. The first thing that you need to understand then is what true carpal tunnel syndrome is.

What is - and what is not - Carpal Tunnel Syndrome?

"Carpals" is a collective name for the eight bones that make up the wrist. Those bones form three sides of a "tunnel" where the fourth side is made up of the transverse carpal ligament. There is a lot of "stuff" in a fairly small space here. There are arteries and tendons and the median nerve. In true carpal tunnel syndrome the median nerve gets compressed along with the other contents of the tunnel.

Compressed nerves are fortunately quite rare in the human body. The design of the human body is actually very intelligent so the nerves don't get pinched very often. The function of the median nerve is to send signals to and receive signals from the thumb-side of the hand. That includes both the skin and the muscles of the thumb, index finger, middle finger and half of the ring finger. The muscles of the hand are primarily the thenar eminence, which is the thick fleshy part of the thumb, and the hypothenar eminence, which is the thick fleshy part on the "pinkie" side of the palm.

Here is a very important distinction often ignored in diagnosing. The thenar eminence is controlled by the median nerve, but the hypothenar is controlled by the ulnar nerve which does not pass through the carpal tunnel. That means that if the discomfort is not on the thumb side of the wrist and hand, it is not CTS. It cannot result from a compressed nerve.

A truly pinched nerve will be associated with some or all of the following. Pain, numbness, tingling, muscle weakness, muscle wasting, loss of coordination and grip control. And remember that it has to be on the thumb side in order to be a compression in the carpal tunnel since the ulnar nerve does not pass through it. Further more if you have pain at the wrist, or if you have pain but no numbness, tingling and muscle weakness, it is most likely not CTS.

What is the controlling mechanism?

If you have read any of my other articles you may start to get the big idea that all symptoms and all disease is caused by some sort of imbalance; Either a biochemical or toxic imbalance at the level of the cells or an imbalance of activity at the level of the brain and central nervous system (CNS). The body is intelligent and has healing built into the design. If it is not healing it is because it is being pushed out of balance. In the case of wrist pain, whether from CTS or not, the imbalance in question is between flexor and extensor dominance.

Every function of the body and the human experience is in some way related to the brain and CNS; this is also absolutely true in the case of muscles. At any given time the tension of all muscles is controlled by the brain. It is monitored, regulated and reinforced many, many times every second. And since muscles move joints and are the primary stabilizer of joints, the brain is what controls all joints, including the wrist; Not only when you move it or do something, but when you are resting and sleeping as well.

When you stand in the anatomical position, with your arms by your side and palms facing forward, the muscles on the front are called flexors and the muscles on the back are called extensors. When we use the muscles on the front more than we use the muscles on the back, we develop something called flexor dominance. We can observe this dominance as a change in posture, joint position or in muscle tone, but if you recall that all muscles are controlled by the brain, you soon realize that the fundamental imbalance is at the level of the brain. Muscle flexor dominance is a brain imbalance.

If you think about the two categories of people who develop CTS, people who use keyboards and mice as well as people who do a lot of gripping and grasping on the assembly line, often in a pronated position (with the palm facing down), you realize that those are indeed people who are prone to flexor dominance. Especially if you add the fact that with a sedentary lifestyle, most modern people rarely get much exercise at all for their extensors. So our lifestyle leads us all to have flexor dominance along with under developed extensors, even though this becomes especially apparent in certain job situations.

The obvious solution then is to restore the balance. We can change the tone of a muscle and indirectly the activity and stability of the brain by stretching and by exercising. So in this case we want to start stretching the muscles on the front of the body and exercising the muscles on the back of the body. For carpal tunnel specifically this means triceps exercises such as pushups on the floor or against a wall with hands close together. Exercise the wrist extensors, e.g. move the wrist backwards, away from the palm, with a dumbbell or an exercise band. Exercise the finger extensors by strapping a few regular rubber bands around your five fingers and separating them. Over time this will help to reestablish a more proper balance.

Where exactly is the problem then?

Also realize that if the wrist hurts, the only way we know that is if the message gets to the brain. Actually the only way we can have any experience at all is if some brain cells have been stimulated to give us an impression of a sensation. In fact, that is the only thing we know for sure when we experience something; that a few brain cells have been stimulated. For example if you have an itch on your hand and you look down, but there is nothing there, the source of the stimulation could be anywhere between the hand and the brain or even only in the brain itself. Similarly, the signal that results in pain could be generated anywhere between the place where you perceive the pain and the brain.

So in the case of wrist pain there may be nothing wrong at all at the wrist. The nerve from the wrist passes through the fore arm, past the elbow, through the upper arm, through the shoulder, past the neck bones into the spinal cord, and from there through a series of "relays" on its way to the cortex where the signal is finally received. It passes over, under, and past muscles, tendons, bones and joints on its path. An imbalance, compression or lack of movement at any of those places could give you the perception of wrist pain.

Therefore I strongly recommend that, in addition to doing the exercises described, you see a chiropractor who is knowledgeable in neurology, applied kinesiology or at least extremity adjusting, and who can evaluate and release interference along the entire pathway of the nerve. Only if the nerve pathway is unhindered along its entire course can you get complete resolution.

Summary.

So to sum it all up; most wrist pain does not result from a compression of the carpal tunnel. Surgery should never be the first course of action. The median nerve (thumb side) runs inside the carpal tunnel, but the ulnar nerve (pinkie side) does not. Actual compressed nerves are more likely to result in numbness tingling and muscle wasting than in pain, and if there is pain it usually has some stinging, electric sensation to it.

Even if you have all these symptoms and you have nerve compression it does not mean that you need to have it cut open. Imbalances can be corrected by a good chiropractor in conjunction with exercise. Your body can heal it if the cause of the problem is addressed.

Explore your options and seek many opinions before you accept the label of Carpal Tunnel Syndrome and even more opinions before you have surgery (even if your insurance pays for surgery but not for chiropractic). Surgery is irreversible.