Carpal Tunnel Syndrome (CTS) – A "Typical" Case Example

“I’ve been working on the line for 13 years and started noticing periodic tingling in my fingers. It didn’t last long and I didn’t think about it much. It gradually became more frequent and wouldn’t go away when I changed my activity or shook my hand or fingers. It started to really grab my attention when I started to drop things and couldn’t open jars as easily. That’s when I decided to see what was wrong. I didn’t know who to go to so I went to my family doctor and he diagnosed carpal tunnel syndrome. He gave me a splint to wear at night and some anti-inflammatory drugs that irritated my stomach, so I stopped taking them. The splint helped me sleep and I didn’t wake up as often. The doctor was talking about surgery to ‘un-pinch’ the nerve at my wrist if it didn’t get better soon, but I overheard some co-workers talk about seeing a chiropractor for their carpal tunnel problems and how much better they felt so I decided to try it.

“The chiropractor was very thorough and examined my neck, shoulder, and elbow, as well as my wrist and hand. He indicated that several areas were putting pressure on the nerve that goes into the hand and the pinch was not just at the wrist but higher up in my neck, shoulder, and forearm. He said if I wasn’t at least 50% better in 4 weeks, we would talk about other tests and treatment options and investigate it further. He worked on my neck, shoulder, elbow, forearm, and hand using manipulations and other methods to loosen them up. He said the nerve was getting pinched by the muscles working too fast and not getting enough rest. He gave me exercises to do several times a day at work to stretch the forearm muscles and had me continue the use of the brace at night. He also taught me how to ice massage the wrist for 5 minutes until it got numb, several times a day and he recommended I use 50 mg of vitamin B6 three times a day. After the 3rd week, I started to notice a decrease in the intensity, frequency, and duration of numbness and weakness. He had me fill out a Carpal Tunnel Questionnaire and my score improved a lot after the first 4 weeks. He said he may have to evaluate my workstation and make some modifications, if possible. He asked me a lot about the position of my wrist and hand when I work and didn’t seem to like the type of screw driver I was using. He called my boss and asked if a different type of screw driver with a power source and a pistol shaped handle could be tried and it was arranged. That seemed to really make a difference.”

Carpal Tunnel Syndrome (CTS) is a common problem that is usually cumulative, slow, and gradual in its onset, and can progress to a point where functions like buttoning shirts, threading a needle, and holding a newspaper are greatly affected. People usually don’t run to the doctor at the first signs of CTS as the initial symptoms are vague and initially not too impairing. Over time, CTS can become quite severe and often prompts a surgical recommendation, without trying a non-surgical approach first.

There are a number of studies published regarding the chiropractic management of CTS that show these non-surgical methods can be quite successful. One compared medical care consisting of non-steroidal anti-inflammatory drugs and nocturnal wrist splinting to chiropractic care consisting of spine and extremity manipulation, nocturnal wrist splinting, and ultrasound over the wrist. Both treatment approaches were helpful, suggesting the importance of trying either or even both of these non-surgical treatments prior to proceeding to surgery.