You are driving down the road and you notice numbness and tingling in your fingers. You find temporary help by shaking and flicking the fingers, trying to “wake them up.” You’ve also noticed your sleep is becoming interrupted and the need to shake and flick the fingers in the middle of the night is becoming more frequent. If this sounds like you or someone you know, you’re not alone. This condition affects many workers as well as “stay-at-home moms,” as women are 3 times more likely to develop CTS due in part that the carpal tunnel itself is smaller than those in men. Also, women tend to work faster in fast, repetitive jobs, and are often hired specifically for that reason. Further, when workers are paid by the number of pieces they produce, the tendency is to try completing as many pieces as possible so as to make that much more over their base hourly wage.
Basically, CTS is caused by pressure building up in a small confined space through which a nerve (the median nerve) and 9 tendons converge into this tight opening into the hand. When repetitive work/fast movements are performed over hours at a time and day after day, the friction produced by the tendons rubbing against each other results in heat, swelling, pain, and median nerve pinching which produces the classic symptom of tingling/numbness into the 2nd, 3rd and half of the 4th fingers. Hence, those at greatest risk for developing CTS include line workers such as manufacturing, sewing, finishing, cleaning, and fish and/or meat packing. In 1998, 3 of every 10,000 workers lost work time due to CTS of which half missed more than 10 days of work. Considering the increased amount in today’s dollars of medical and disability costs, the average lifetime cost of CTS was estimated at $30,000 for each worker back in 1998.
So, how do you know if you have CTS? The early signs include occasional numbness or tingling in the fingers that you probably wouldn’t think much about since simply shaking your hand or flick the fingers, it goes away. As the numbness becomes more frequent and it does not respond by shaking and flicking the fingers as quickly, you might take notice. Without proper management, difficulty buttoning shirts/cuffs, writing, holding onto small objects, opening jars, all become gradually more pronounced. When sleep becomes interrupted, especially when it becomes necessary to get up and move around before being able to return to sleep, that’s when people usually decide, “I better see someone for this!”
Treatment success is directly related to how fast a person reacts by making a prompt appointment. The best results always occur when care is obtained quickly, when the initial symptoms first appear. In addition, there are sometimes underlying contributors or causes such as diabetes, arthritis, pregnancy, birth control pill use, hypothyroid, obesity, and other conditions that may need proper management in order to relieve the symptoms. Non-surgical care includes the use of wrist splints (especially at night when sleeping), anti-inflammatory measures (medications, gluten-free/paleo diet, vitamin B6 and others such as omega 3 fatty acids/fish oil, vitamin D3 in high doses, calcium, magnesium, CoQ10), work station modifications, forearm exercises, chiropractic manipulation of the neck and arm, acupuncture, and certain modalities such as low level laser/light therapy, can all be helpful.
Surgery should always be considered a “last resort” after all non-surgical approaches have been exhausted. Rarely is there a “medical emergency” that warrants prompt surgical release except in cases of fracture where the carpal tunnel canal is abruptly reduced in size. You need a “quarterback” to help guide you in the treatment/management process. Chiropractors are well trained to manage CTS and offer a non-drug, non-surgical solution to this potentially disabling condition.