Soft Health and Healing Clinic

CARPAL TUNNEL SYNDROME NEWS

The carpal tunnel is a small passage in the wrist that is made up of bones(carpals) on three sides and the transverse carpal ligament on top. The tunnel contains flexor tendons, that serve to flex the fingers, and it provides a pathway for the median nerve to supply the hand. Repetitive flexion and extension of the wrist may cause swelling of the tenosynovium, referred to as tenosynovitis. Due to the limited space in the carpal tunnel, the tenosynovitis applies increased pressure on the median nerve producing carpal tunnel symptoms.

Although it is widely accepted as THE cause for the syndrome, the carpal tunnel isn't the only area of the body where the median nerve may be impinged. We must take into account that nerves travel directly from the spinal cord, bundle together to form part of the brachial plexus, and go all the way into the extremities. Therefore, the disturbance of the nerve could take place anywhere along that path.

To use an analogy, we all remember how a kink in a garden hose affects the water coming out the opening. The hose either expels less water or no water at all, depending on the ser verity of the kink. The same goes for your nerves. You can have a slight or extreme impingement that would affect the nerve and what it supplies, from that point forward. The following

Definitions:

Carpal: From the Latin word carpus meaning the wrist

Carpal Tunnel: A tunnel-like structure of the wrist formed by carpal bones and the transverse carpal ligament

Flexors (of the forearm): A group of muscles that serve to close the fist, flex the hand at the wrist and flex the arm at the elbow (see picture below)

Extensors (of the forearm): A group of muscles that serve to open the fist, extend the hand at the wrist and extend the arm at the elbow (see picture below)

Tenosynovium: A protective sheath that surrounds tendons

Median Nerve: A nerve that begins in the neck, travels down the arm to supply the palmar side of the thumb, pointer finger and half of the middle finger

Brachial Plexus: A bundle of nerves, veins and arteries which supply the arms

Areas Of Concern

Scalenes: Your scalenes are a group of three muscles originating on your vertebrae and inserting onto your collar bone, ribs and sternum (breast bone). They serve to rotate and flex the head at the neck. The brachial plexus passes through two of the scalenes, making it a common area for impingement.

Clavicle (collar bone) and First Rib: The plexus passes through this small area as well.

Pec Minor: The pectoralis minor muscle serves to depress the shoulder and aids in exhaling. The brachial plexus passes in between this muscle and the ribs.

Flexors & Extensors: The nerve travels under the biceps and into the forearm, where it is frequently trapped by tight flexor & extensor muscles.

Oponens Policus: A muscle that originates on the bridge of the carpal tunnel. It is responsible for drawing your thumb into the palm of your hand. When tight, it pulls on the transverse carpal ligament, creating pressure within the tunnel.

Facts About Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) results in more than two million visits to physicians' offices each year.
CTS strikes approximately three times as many women as men.
CTS is one of the most common job-related injuries.
Although it may be aggravated by work, CTS frequently occurs in people who are not working with their hands.
Approximately 260,000 carpal tunnel surgeries are performed each year in the U.S., and 47% of these are considered to be work-related.
According to data from the Bureau of Labor Statistics, in 1994, carpal tunnel syndrome accounted for 1.7% of workplace-related conditions in private industry that resulted in work loss.
Almost half of CTS cases result in 31 days or more of work loss.
If not properly treated, CTS can cause irreversible nerve damage and permanent disability of varying degrees.
CTS accounts for roughly 10% to 17% of repetitive strain injuries.
CTS is not a byproduct of the computer age. Meat packers complained of CTS symptoms as long ago as the mid-1800s.

Intensity/Soft Laser Therapy

Unlike other therapies, Laser actually cures the cause of the pain which secondarily (and quickly) relieves the symptoms.

Pain relief can be substantial during the treatment due to the fact that LILT aids in the production and release of beta-endorphins (morphine like substances that inhibit the sensation of pain) and cortisol, a precursor to cortisone.

In the case of carpal tunnel caused by tenosynovitis LILT has been proven to reduce inflammation. Edema is also substantially reduced because the lymphatic system ducts (in which bad proteins are carried away) can double in size.

In the case of adhesions or muscles causing the impingement LILT increases the production of collagen (the building block of connective tissue) that is required to replace old tissue or repair tissue injuries. Laser not only increases blood flow to the area but has been shown to increase the formation of new capillaries in damaged tissue.

In most cases, patients' activities need not be restricted as healing continues while activity goes on.