February 10, 2015

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Pain/tingling in the Hand and Fingers. Is it Really Carpal Tunnel?

 

Carpal tunnel syndrome is a painful disorder of the hand caused by pressure on the Median nerve as it runs through the carpal tunnel of the wrist. Symptoms include numbness, pins and needles, and pain in the hand and the fingers (thumb, index, middle and part of the ring finger). Anything that causes swelling inside the wrist can cause carpal tunnel syndrome, including repetitive hand movements, pregnancy and arthritis.

 

Carpal tunnel is a legitimate and very common disorder, but what I do see too often at my Camden Chiropractic clinic is patients coming in with a misdiagnosis of carpal tunnel syndrome. It seems whenever a patient complains of any pain, numbness, tingling or pins and needles in the hand or fingers they are almost automatically given the diagnosis of carpal tunnel syndrome without investigating what else may be causing their symptoms.  I have seen many people who have had surgery for carpal tunnel and experienced absolutely no relief. This is because even though they had pain and symptoms in the hand and fingers, the actual cause was somewhere else.

 

The nerves of the arms and hands including the Median Nerve originate in the neck, and irritation or compression along the nerve may cause pain, numbness, tingling or pins and needles in the hands and fingers which may mimic carpal tunnel syndrome.

A tell-tale sign that the symptoms in the hands and fingers are not primarily due to carpal tunnel syndrome is if the person is also experiencing pain or symptoms in either the neck, shoulder, upper arm and/or forearm.

 

A very simplistic comparison is to think of the nerves travelling down the arm from the neck like a garden hose. If the hose is compressed at one point, the water will flow to that point, but not beyond. The same occurs with nerves, if it is compressed at the wrist (carpal tunnel), the nerve flow will be ok up until that point. This is why carpal tunnel syndrome will cause altered sensation after the wrist (the hand and fingers), but WILL NOT cause any symptoms above the wrist. Also, if the nerve is compressed at the forearm (pronator teres) or more commonly in the neck, then the nerve flow will be altered from that point.

 

What I see very commonly is if nerves are irritated in the neck, then they are left vulnerable for further compression in the forearm and also the wrist. The nerve roots in the neck can be irritated or compressed by a cervical (neck) disc injury, cervical spine degeneration and arthritis, cervical spinal stenosis (narrowing), and or a cervical joint injury.

 

The most important step with any pain is a proper diagnosis.  At Proactive Spine & Sports Medicine our first step is to diagnose exactly where the pain is coming from. We then utilise a variety of highly effective techniques to help with the symptoms and address the cause.

 

Techniques which work very effectively for patients experiencing pain, numbness, tingling and/or pins & needles in the hand and fingers include:

  • Spinal manipulation of the thoracic and neck

  • Mobilization of the joints in the wrist and elbow

  • Muscle and fascia release along the carpal tunnel and forearm

  • Neural Mobilization Techniques – to help the nerves move, stretch and glide properly

  • Dry Needling

  • Rocktape

  • Rehabilitation exercises to address any muscle imbalances

 

 

By Dr Danny Diab - Camden Chiropractor

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