Wrist splints and surgery! These are often two of the first things that will enter a person's mind when they think of carpal tunnel syndrome treatment. It is estimated that carpal tunnel will effect somewhere between 3-7 people out of 100 every single year. Carpal tunnel is the single most expensive upper extremity disorder there is. It costs the United States around 2 billion dollars a year in surgical procedures and many times that in lost man hours. These numbers are projected to only increase as we become a more sedentary and technology driven society.
So what exactly is carpal tunnel syndrome? Well to fully understand that, we need to understand just a little bit of anatomy. Take a look at your forearm, what’s the most narrow part? The answer is fairly obviously your wrist. The wrist is an intricate and densely packed area of bones, muscles, ligaments, blood vessels and nerves. It also has a very high amount of mobility. With all of the structures and movements the wrist must perform the body has to make very good use of the very small amount of space it has to make sure that your hands can do all the things they are required to do. In order to do this, the body has an organizational system that walls off different structures into specific areas. Now the area in question is of course referred to as the carpal tunnel. This tunnel is very small but manages to cram 9 tendons and one nerve known as the median nerve in it. These tendons are responsible for many of the functions of the hands. Everything from gripping a screwdriver, to typing, to texting with your thumbs requires these tendons to constantly be sliding through this tiny tunnel. Now the body has carefully designed this tunnel as to be just big enough that each tendon and the lone nerve should have enough room to function normally. So where is the problem? and what is causing millions of people to buy splints and complain to their coworkers about an inability to perform their basic daily tasks?
The answer to this question is actually pretty simple. In our modern world we are constantly using the muscles in compromised positions. Typing is one of the worst culprits, as we sit with bent wrists at our desks for hours on end these muscles contract and relax thousands upon thousands of times. Eventually these muscles and the surrounding tissues get irritated and inflamed. Now what happens when a tissue gets inflamed? It gets flush with fluid and gets bigger, as this inflammation continues it causes more and more irritation which causes more inflammation which...well you get the picture. Now there are a few different things that we can do in an attempt to remedy this issue. One of the most commonly prescribed methods is to simply splint the wrist. This feels good because we have kept any kinks out of the wrist, and have thereby maximized the space in the carpal tunnel. While this seems great at first, it really doesn’t fix any underlying issue and the pain and numbness will return as soon as the splint is removed. Unfortunately the second option that is often undertaken is to simply get rid of the tunnel. This is done by basically cutting through the roof of the tunnel. While this has had a reasonable success rate of relieving some pain and numbness, there is always the risk of permanently damaging the nerve as the tunnel is cut open. There is also the fact that surgery does not have a 100% success rate and is changing the very mechanics of the wrist. The third option is to go after the very root of the problem. By actively relaxing the muscles of the wrist, breaking up adhesions caused by the irritation and mobilizing the bones around the carpal tunnel, it is possible to relieve some of the pressure. As the irritation and inflammation decreases so does the pain and the wrist can return to its normal function.
There is a common misconception that when a problem in the body arises, its because the body is somehow lacking, or incapable of looking after itself. The reality is that our bodies are able to heal and function properly the vast majority of time, we just need to make sure the body is getting the resources it needs so it can take care of itself. When you keep inflammation down, keep stressors under control and bring our body through its essential and required motions, the body should be able to fully take care of itself.