Carpal tunnel syndrome (CTS) is a condition where a nerve (the median
nerve) is compressed in a relatively tight or restricted space (called
the carpal tunnel), resulting in altered nerve function that includes
numbness and weakness. In order to fully understand CTS, let’s devote
this article to better understanding the anatomy of the carpal tunnel.
The
carpal tunnel is made up from eight bones (two rows of four carpal
bones that are stacked on top of each other) that are arranged in the
shape of a horse shoe. The "roof" of the tunnel is a ligament
(transverse carpal ligament) that stretches tightly across the two ends
of the horseshoe completing the formation of a tunnel—actually, an
upside down tunnel when looking at the palm side of the wrist. The
contents of the tunnel include nine tendons and their covering (sheath),
blood vessels, and on top of all that just under the roof is the median
nerve—the culprit that creates most of the symptoms of CTS. The cause
of CTS is simply anything that causes the contents inside the tunnel to
swell, which then compresses the median nerve up into the roof or
ligament, pinching the nerve. This can create numbness, tingling, the
falling asleep sensation and weakness. It’s important to point out that
the median nerve starts out from the neck, passes through the shoulder,
past the elbow, through the wrist’s carpal tunnel and ends in the
hand—specifically fingers 2,3, and 4. Therefore, the ENTIRE nerve must
be looked at for all CTS cases as pinching can occur anywhere along its
course from the neck to the hand.
It’s said that pictures are worth a thousand words, so let’s take a look!
Using the pictures here, familiarize yourself with the words and re-read the 2nd paragraph above, periodically looking at these pictures until you feel you understand where everything goes. Once you’ve accomplished that, you’ll be able to better appreciate CTS, how the anatomy relates to the condition, and appreciate the need to reduce the swelling inside the tunnel when symptoms occur. The treatment is simple: "PRICE" – Protect Rest Ice Compress Elevate—accomplished by bracing (especially at night), ice cup massage (5 min. until numb 5x/day), rest (light duty work), and therapy (see your chiropractor!).
