Carpal Tunnel Syndrome

There are many issues that can cause tingling in the arm and hand.  In this edition of Get In Motion I would like to offer information that will keep patients from considering unnecessary carpal tunnel surgery.

If you have nerve type symptoms in your arm (i.e. burning, tingling, numbness), your answers to the following questions will reveal if you have carpal tunnel syndrome (CTS):

Do the symptoms follow the median nerve’s pattern?  It carries sensation for the palm side of the thumb and first 2.5 fingers.  If your symptoms are in other places, then you do not have CTS.

Did the symptoms start above the wrist?  If so, it is likely that a nerve is being compressed at another site, higher up its path.  It could be the Median, another nerve, the bundle of nerves at the shoulder, etc.  It is unlikely that carpal tunnel surgery would be productive in this case.  “Double Crush” is a term that describes compression of a nerve at two different places.  This is common because assembly line workers, for example, often have repetitive injuries and poor posture, causing injury at the carpal tunnel and at the shoulder.

Conservative care for nerve injuries must include multiple approaches.  Soft tissue work such as Active Release® is needed to release the muscle, tendon or ligament compressing the nerve.  Flossing and tensioning exercises should be prescribed to get the nerve moving again and healed, as described by David Butler.  Then the patient must be advised how to change the causative posture or movement.

Carpal Tunnel Release Surgery is a needed treatment option.  But it should only be considered on those patients with confirmed median nerve pathology at the carpal tunnel and after failing four weeks of conservative care.

If you should have any questions or need help with your situation, please check or call 615-302-4747.