Carpal tunnel syndrome is caused by the compression of the median nerve as it passes into the hand. The carpal tunnel is a narrow connection between the forearm and palm of your hand. Multiple tendons and the median nerve use the carpal tunnel as a passageway.

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The median nerve supplies sensation (feeling) to your thumb, index finger, middle finger, and half of the ring finger. It also supplies the thumb muscles. Compression of the median nerve, therefore, results in signs and symptoms affecting these areas. 

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Carpal tunnel syndrome symptoms

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Carpal tunnel syndrome will develop gradually, including:

• Numbness, tingling, or pain in the thumb and relevant fingers. If pain occurs elsewhere, the diagnosis of carpal tunnel syndrome is less likely. Symptoms may worsen when holding an object, like a steering wheel or phone. It can feel like an electric shock.

• Weakness occurs in the thumb muscles due to insufficient nerve stimulation. Look for atrophy or wasting of the thumb muscles and grip weakness – particularly the thumb’s pinching movement.

• If you notice any of the above symptoms, you should see a doctor for carpal tunnel syndrome treatment. Permanent nerve and muscle damage can occur if left untreated.

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Causes of carpal tunnel syndrome

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Carpal tunnel syndrome is pressure on the median nerve. But why does pressure occur in the first place? One common cause is inflammation of the surrounding structures, pressing on the carpal tunnel. The cause of most cases is unknown, however.

Numerous conditions are associated with carpal tunnel syndrome, including:

• Diabetes

• Obesity

• Fluid retention from pregnancy or menopause

• High blood pressure

• Thyroid dysfunction

• Autoimmune disorders

• Trauma or fracture of the wrist

Certain groups also have an increased risk of carpal tunnel syndrome, such as:

• Women are three times more likely to have carpal tunnel syndrome than men.

• Small carpal tunnel

• Previous fracture or wrist dislocation

• Jobs involving repetitive wrist movements, like bakers, musicians, writers, or assembly line workers. 

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Diagnosis and treatment

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Carpal tunnel syndrome is typically diagnosed based on history and examination. Tinel sign, for instance, involves lightly tapping over the inner wrist to elicit “pins and needles” in the median nerve’s distribution. Nerve conduction studies are useful but not critical. They measure the speed of a nerve impulse: the slower it is, the more likely compression has occurred.

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Nonsurgical treatment involves wearing a wrist splint, taking mild pain medication (like ibuprofen), treating underlying conditions, and even a steroid injection into the carpal tunnel. Chiropractors will perform gentle exercises and manipulation to reduce inflammation alongside standard management strategies. The Chiropractor will also be able to loosen any tight muscles around the wrist with massage and stretching. In addition, a Chiropractor will also assess the spinal joints in the neck to make sure the nerve supply to the wrist and surround muscles are adequate.

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If carpal tunnel syndrome persists, eventually, surgery is the only option. To decompress the median nerve – preventing permanent damage – surgeons cut into the band of tissue (flexor retinaculum) that holds the tendons and median nerve in place. This is known as “carpal tunnel release”.