We have been treating Carpal Tunnel Syndrome (CTS) since 1992 at Executive Express Chiropractic (formerly Front Street Chiropractic) in the SF Financial District.
It wasn't that long ago that patients and associates would look at me strange when I suggested that the source of CTS symptoms is usually in the neck (conditions such as vertebral subluxations, cervical disc bulges and herniations, disc degeneration, facet syndrome, spinal stenosis, and forward head posture).
I used to hear something like this every day..."The pain is in my hand...why are you checking my neck?"
My staff, my fellow doctors, my patient's primary doctors, my wife...everyone thought this was a little strange...that is until they witnessed the results we were getting treating carpal tunnel patients from the neck down to the fingertips.
The reason seems obvious now...now that it is almost a form of malpractice not to consider pathology in the neck (usually cervical radiculopathy ) when it comes to diagnosing and treating CTS symptoms.
WHY? Because the nerves that innervate or connect and control the arm and hand originate in the neck. And pressure on these nerves in the neck causes the same signs and symptoms as true carpal tunnel syndrome.
The nerve involved is CTS is called the median nerve. The median nerve originates in the neck. It is formed by branches of nerve roots from C5-C8 (C=cervical) which is the lower part of your neck. You have 7 bones in your neck (cervical spine)...and nerves exit from the left and right (underneath) of each bone. These nerves connect and form the 3 major nerves that control the arm and hand. The median nerve, the radial nerve, and the ulnar nerve.
The median nerve (named median because it travels down the middle of the arm) travels through an area of bones and ligaments in the wrist called the carpal tunnel, where it is susceptible to pressure from either the contents of the tunnel expanding (nerves and tendons from inflammation and overuse, repetitive stress injuries-RSI) or the diameter of the tunnel contracting (bones out of alignment from poor ergonomics, trauma, degeneration, and congenital defects, tumors). If either of these situations occur it can put pressure on the median nerve causing clinical CTS. In fact, by definition CTS is median nerve compromise in the carpal tunnel. True CTS is rare.
Again (and this can be hard to grasp)...pressure on the nerves in the neck that form the median nerve causes the same symptoms (in the hands) as CTS when they have pressure on them. Here are the most common symptoms:
Pain in the arm and hand or hands
Numbness and Tingling in the arms and hands
Weakness of grip
Night pain in the hand/s
Burning sensations in the hand
Clumsiness of hand/s
Swelling of the hand
So how do you know if you have CTS or if the problem is in the neck? You don't...you have to be checked by an expert to find out. A doctor that spends the majority of their day treating patients with neck, shoulder, arm and hand pain...like we do at Executive Express Chiropractic.
And...just because your doctor may correctly identify your carpal tunnel symptoms cause as originating the neck...it does not mean they know what to do about it.
I used to teach chiropractors from around the world how to treat carpal tunnel syndrome. My treatment approach is to work from the neck to the fingertips on both sides. We also address the entire spine because the spine functions as a unit. Heck...you could even have a short leg you don't know about that is causing imbalances in the spine leading to nerve pressure in the neck, resulting in CTS symptoms in your hand. Strange but true.
This is why so my people with hand pain find it hard to get the right kind of treatment and end up in a viscous circle of diagnostic testing, cortisone, pain pills, crazy treatments, and even surgery.
One of my chiropractic clinics in San Francisco was known as the Carpal Tunnel Injury Center for many years during the dot-com boom. Around this time we treated thousands of cases of CTS symptoms. I say CTS symptoms because true CTS is actually rare compared to the amount of patients with cervical spine related CTS symptoms.
Anyway...the bottom line is this. If you have CTS symptoms you need to find yourself a doctor that not only diagnosis CTS and it's related disorders day in and day out (and understands the neck-hand connection)...but that also has a proven method of treatment. This is often times not easy.
In any case...don't just head to the operating table or give up on getting better. It may be that you just have not found the right doctor...a doctor that knows CTS, and the CTS-cervical spine connection...and how to treat it.
*True CTS Facts: Women are more prone to CTS. Conditions such as Thyroid problems, hormonal imbalances, and high salt/high fat diets can predispose one to CTS. Smokers are much more prone to CTS as are pregnant women.
**Tumors in the neck or hand can also cause CTS Symptoms...but this is very very rare.