Carpal Tunnel Syndrome (CTS)
Carpal Tunnel Syndrome is a common condition that can often be disabling and significantly interfere with regular work or recreational activities. True CTS is caused by compression of the nerves as they pass through the Carpal Tunnel – which is a opening located at the wrist. It is common for the nerve to be compressed and irritated at other structures as well, particularly at the elbow and forearm, which will mimic carpal tunnel syndrome (see nerve entrapment syndrome). It is essential to determine at which specific site the nerve is being entrapped because treatment at the wrong site will be ineffective and prolong the injury.
Regardless of the location of entrapment, excessive tension in the surrounding muscles will put pressure and tension on the surrounding nerves, resulting in a loss of blood flow to the nerve and surrounding soft tissues. This will initiate a response in the body to lay down scar tissue in an attempt to heal and stabilize the area. Over time this health and function of the nerve will be affected and lead to symptoms such as pain, numbness, tingling, and weakness in the wrist and hand. If this scar tissue is not addressed it will build-up and lead to further compression and damage to the nerve, requiring surgery. Failure to address this scar tissue as an underlying mechanism of CTS will result in failure of many traditional Carpal Tunnel treatments.
It is essential to conduct a full examination of the nerves as they travel from the shoulder to the hand to determine the specific location of compression that is responsible for the symptoms. Once the specific location of compression is found treatment must be directed at this area. If there are multiple areas of compression all areas must be addressed. Myofascial Release Techniques (MRT) is an effective tool to address the scar tissue that can compress and irritate the nerve, and release this compression to restore the health and function to the nerve. Low intensity laser therapy can also be helpful in settling inflammation and pain associated with CTS. Home stretches and advice is commonly required to speed recovery and prevent future recurrences.