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Carpal Tunnel and "Manual Techniques"


"Manual techniques" refers to massage, deep tissue mobilization and manipulation of joints. These procedures are performed by chiropractors as a mainstay of their treatment. Two recent scientific studies have shown that these techniques are helpful at reducing carpal tunnel symptoms. Sometimes scar tissue and tightness of the muscles of the forearms develop. Specific stretching exercises are used to allow more flexibility of the wrist. Your wrist joints, and the muscles that move the hand, are integrally linked. Disturbance in one system will over time affect the other area.

When you have pain, you tend to move your wrist much less. Some patients even use braces and splints to reduce movement almost completely. While this can be necessary for a few patients in the short term, over time it just makes the muscles inflexible and progressively weaker. This can lead to a vicious cycle producing even greater pain, which makes you move less. This cycle needs to be broken in order to regain function of the wrist again.

It is important to mobilize the joints of the wrist and stretch the shortened muscles. It is also important to have a correct diagnosis before beginning treatment. Is the problem only in the wrist? Some patients will also have a neck sprain that makes the nerve that passes through the carpal tunnel more susceptible to pressure and inflammation. This is called the double crush syndrome because there is pressure at both the neck and the wrist.

Looking at your carpal tunnel symptoms in a comprehensive way can address many of the quality of life symptoms. Just covering up the pain with medications and not using your wrist anymore doesn't really seem practical. Taking large amounts of pain and anti-inflammation drugs (NSAIDs) can cause undesirable side effects. Stomach bleeding and irritation occurs in too many patients. In rare cases kidney and liver problems can develop.

A doctor of chiropractic can diagnose the cause of your carpal tunnel symptoms. The examination may include x-rays the rule out certain diseases and to check the alignment of the wrist bones and neck vertebrae. Sometimes it's the wrist that needs to be mobilized, and in other cases the neck is more the cause of the problem. With adjunctive manual techniques such as exercise, stretching, and deep tissue work, this combined approach can provide relief for many sufferers with this difficult problem.