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Anatomical image of the carpal ligament and median nerve entering the wrist.

Stupid Medicine, Vol. 2: Carpal Tunnel Syndrome

If you are bored and want to self-induce a horrible headache, just Google “Carpal Tunnel Syndrome.”  The amount of incongruent and incomprehensible information is astonishing.

Carpal Tunnel Syndrome is our second entry in the Stupid Medicine files.

How does Carpal Tunnel Syndrome present?

WebMD defines Carpal Tunnel Syndrome as “numbness, tingling, weakness and problems in your hand because of pressure on the median nerve in your wrist.”

How Does the Medical Community Treat Carpal Tunnel Syndrome?

Predictably, the common treatments include:

  • Rest
  • Ice
  • Anti-inflammatory medication
  • Surgery in extreme situations

But to prevent Carpal Tunnel Syndrome, WebMD tells us to “try to take good care of your wrists and hands.” Among the suggestions:

  • Try to keep your wrist in a neutral position.
  • Use your whole hand, not just your fingers, to hold objects.
  • When you type, keep your wrists straight, with your hands a little higher than your wrists. Relax your shoulders when your arms are at your sides.
  • If you can, switch hands often when you repeat movements.

I would have added, “If the pain persists, try typing and eating with your feet, and if that doesn’t help, just cut your hands off entirely.”

By now, you should be starting to see why Carpal Tunnel Syndrome deserves a place in Stupid Medicine.

Learn more about Active Release Technique, Athletic Injuries, and Carpal Tunnel Syndrome.

What is Carpal Tunnel Syndrome Really?

Carpal Tunnel Syndrome is different than the carpal tunnel.  The carpal tunnel is a narrow passageway on the palm side of the wrist, made up of banes and ligaments.

Anatomical image of the carpal ligament and median nerve entering the wrist.

 

The Median nerve passes through the transverse carpal ligament, and it is here where most Median nerve entrapment occurs.

But it is seldom the cause of the problem.

Carpal Tunnel Syndrome is an entrapment of the Median nerve, but the Median nerve can get entrapped at up to five different areas of the elbow, arm, and wrist.  Equally important — and almost always ignored — is that the Median nerve branches off the Brachial Plexus, which is a group of nerves that originate from the neck and become the Median nerve around the area of the armpit.

Plate 808 of Gray's Anatomy of the Brachial Plexus

 

The Takeaway: Median nerve entrapment can and often will originate as high up as the neck and/or shoulder. 

So let’s revisit what WebMD taught us earlier:

WebMD defines Carpal Tunnel Syndrome as “numbness, tingling, weakness and problems in your hand because of pressure on the median nerve in your wrist.”

Fact: 50 percent of all carpal tunnel surgeries result in either a second surgery or an improvements of less than 10 percent. Now we know why.

If your wrist and hand specialist believes that Carpal Tunnel Syndrome is the result of a nerve entrapment at the carpal ligaments, then you specialist is missing the very common entrapment of the Median nerve at:

  • The neck
  • The axilla or armpit area
  • The inner bicep
  • The elbow
  • The forearm (two locations)
  • The palm
  • The thumb

Essentially, if the prescribed treatment is to operate at the wrist, even if you’ve had nerve conduction studies or similar tests, and the other seven possible locations of Median nerve entrapment have not been thoroughly evaluated, then the “specialist” is guessing.

Summary: Carpal Tunnel Syndrome Does Not Have to End in Surgery or Chronic Pain

If you suffer from Carpal Tunnel Syndrome, all is not lost.  In fact, it is an injury that responds surprisingly well to conservative care.  Schedule a visit with a practitioner well-versed in soft tissue techniques, specifically, Active Release Technique, to have an assessment.

In addition to soft-tissue work, Carpal Tunnel Syndrome patients need:

  • To be adjusted by a chiropractor to reduce stress on the nerves as they exit the neck.
  • A comprehensive stabilization program to rehabilitate the weak and injured areas of the neck, upper back, shoulder girdle, and arm.
  • A preventative plan to reduce the likelihood of recurrence.

They should also stay away from stupid medicine.

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