Have you experienced wrist pain, hand pain, or numbness in your fingers? Maybe you’ve felt this condition while sitting at the computer typing out work assessments, during a long session of playing video games, or swiping left or right on a phone or tablet screen repeatedly. Perhaps you lift weights and experience it in the middle of an intense workout, or while holding heavy construction tools. Whatever the cause may be, whether it’s from typing for long periods of time, holding a phone for a long time, or holding a jackhammer, the immediate conclusion people think of is a condition known as carpal tunnel syndrome.
But what is this syndrome? Is all wrist pain automatically carpal tunnel syndrome, or is it possibly something else?
Carpal tunnel syndrome (CTS) is an entrapment neuropathy.1 Think of a pinch in a hose line caused by stepping on it, and you can visualize a similar compression of the nerve as it travels down through the wrist and into the hand. The nerve, in particular, known as the median nerve, travels through a bony area in the wrist called – you guessed it – the carpal tunnel.
The carpal tunnel itself is a narrow passageway inside your wrist surrounded by bones and ligaments. Compression, or pinching, of the median nerve, can create symptoms including numbness, tingling, and weakness in the hand, wrist, and arm.2
Carpal tunnel is the most common of neuropathies, or nerve conditions, with over 90% of neuropathic cases being from carpal tunnel compression.1
Carpal tunnel can be caused by a variety of circumstances and conditions as well. CTS is more likely to occur in people who hold vibrating tools or work in an assembly line, engage in work that requires repetitive flexing of the wrist such as typing, take certain medications, have inflammatory conditions, or have poor wrist and hand ergonomics.2
The most common causes of carpal tunnel syndrome include genetic predisposition, history of repetitive wrist movements such as typing, or machine work as well as obesity, autoimmune disorders such as rheumatoid arthritis, and pregnancy.1 However, repetitive motions are a high-risk factor in developing carpal tunnel symptoms due to the repetitive activities inflaming the tendons that run through the carpal tunnel. This inflammation can lead to compression of the median nerve.3
Symptoms usually start gradually, in one or both hands during the night, with frequent numbness or tingling in the fingers.4 Some people report their hands and fingers even feel useless, clumsy, and unresponsive or even feel swollen, although little or no swelling is apparent!
Unfortunately, many cases of the wrist and forearm pain are automatically diagnosed as CTS without truly examining all possible causes of the pain, or even confirming if the painful condition is truly CTS.
The million-dollar question: Is every hand and wrist issue created by an issue with the nerve inside the carpal tunnel? The short answer: no!
Another condition, called Pronator Teres Syndrome (PTS), is very similar to CTS in the way it manifests. PTS causes similar sensations to carpal tunnel syndrome, including weakness, tingling, pain, and numbness.
However, Pronator Teres Syndrome is caused by a muscle in the forearm – it has nothing to do with the carpal tunnel in the wrist and hand!
Pronator Teres Syndrome describes a condition where the median nerve is also compressed, but the cause is distinctly muscular.5 The Pronator Teres muscle in the forearm becomes over-used: think of excessive repetitive motions involved in our usual activities of daily living. Maybe the repetitive motion is from an aspiring college tennis player perfecting her swing daily or someone who works in a kitchen, ladling soup, and washing dishes. Maybe it’s the guy who wants to Do-It-Yourself a new kitchen in his home, and he’s swinging a hammer to break up old kitchen fixtures. Whatever the repetitive cause, the same motions cause scar tissue, adhesions, or muscular restrictions to set up housekeeping inside the muscle and entrap the Median Nerve, causing forearm, wrist, and hand symptoms – much like CTS.
Both syndromes cause similar pain but must be treated differently to achieve the desired results. Imagine being treated for one condition with no change in pain and no results – when you actually have the other and need a different treatment altogether!
Many cases of carpal tunnel can be treated conservatively or without surgical intervention. Splinting, changing your daily routine, chiropractic care, soft tissue work, and other forms of treatment exist that safely improve and resolve a painful wrist condition.4
Keep in mind, there are other conditions that can affect the wrist, forearm, and elbow. We only addressed two common causes here. If you are dealing with any kind of discomfort in your wrist or hand, call today and get started on the road to recovery!