Carpal Tunnel Syndrome

Repetitive Stress Injuries (RSI’s) are one of the fastest growing occupational injuries reported by the US Bureau of Labor Statistics. Carpal Tunnel Syndrome (CTS) is the most common in this category. The carpal tunnel is a narrow tunnel formed by eight small carpal bones and the transverse carpal ligament, through which passes the median nerve and nine flexor tendons. When the wrist is held in a straight or neutral position, the finger flexor tendons glide along the walls of the carpal tunnel. When the wrist is bent, the tendons become like ropes or cables dragged back and forth across a pulley. This repetitive movement performed hundreds or thousands of times daily irritates the tendons causing them to swell up within the carpal tunnel, pressing on the median nerve. If the problem is not addressed, the nerve becomes damaged leading to partial or complete loss of the motor function of the affected hand(s).

Initial symptoms may be experienced as numbness or “pins and needles” tingling in the hand or swelling on the palm side of the hand by the ball of the thumb. Pain usually occurs later. Sometimes the pain can be so severe at night that it awakens the patient from sleep. RSI’s like CTS can be caused by:

1) Repetitive motion or prolonged activities
2) Awkward postures involving bending the wrist
3) Forceful exertion
4) Localized contact stress such as having an object pressed against the wrist area
5) Vibration
6) Temperature extremes

Adding to the problems is the psychological stress of having CTS, which further adds to muscle tension, leading to reduced blood flow to the muscles, tendons and nerves. If the blood supply cannot reach the damaged tissue and the tissues do not receive enough oxygen, the nerve cannot heal. The blood carries oxygen and nutrients to the affected area, and carries away waste products. Oxygen and nutrient deprivation causes the nerve tissue to degenerate. When this happens, nerve flow is affected and the nerve cannot heal.

A traditional medical form of treatment has been with anti-inflammatory medications, injections, splints and surgery. Surgery by cutting the carpal transverse ligament to make the tunnel larger has not been very effective. Eighty percent (80%) of surgical patients experience pain again approximately two years after surgery. What else can you do? There is a new cutting-edge treatment in treating injuries such as carpal tunnel syndrome called Active Release Techniques (ART). This should be considered before medical intervention.

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