Most patients with carpal tunnel syndrome will put up with their symptoms for days and weeks until they are troubling enough to bring to a doctor’s attention. The doctor should rule out certain causes for the hand pain, such as diabetes, and focus the examination on the wrist but also other areas. For example, the nerves to the hand begin in the neck area, cross the shoulder and elbow, and enter the wrist tunnel before finally exiting into the hand. The nerve can be injured anywhere along these areas and produce symptoms mimicking carpal tunnel syndrome.
If there is inflammation, applying cool packs can help reduce swelling. If there is a sprain to a wrist joint (carpal bone), then this can be reduced with a chiropractic adjustment. Sometimes the hand symptoms actually come from an irritated nerve in the neck. This has been called the double-crush syndrome because the nerve is pinched both at the neck and at the wrist.
When the joints in the neck sprain and subluxate, the nerves that run between them can be compressed or irritated. There may not be much neck pain involved, but it lowers the function of the nerve. When the nerve gets to the carpal tunnel, it is already in a weakened state. Just a slight irritation at the wrist carpal tunnel can be enough to give the tingling pains into the hand.
Adjusting the subluxations of the vertebrae in the neck may then help to normalize nerve function into the arm and hand. Sometimes, patients will have both wrist injury and neck problems. In these complex cases, it is important that treatment is individualized to the patient’s needs.
Stretching and strengthening exercises of the arm can be helpful in people whose symptoms have abated. These exercises may be supervised by a chiropractor, who is trained to use exercises to treat physical impairments. Sometimes contractures develop around the wrist and arm and these can be released with stretches or deep massage.
Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may ease symptoms that have been present for a short time or have been caused by strenuous activity. One also has to consider the side effects of these medications and the fact that they are covering up pain signals. These pain signals are important and tell you which movements to avoid so that tissues are not stretched and healing can occur.
Conservative approaches should always be tried first before invasive surgery. Although thousands of surgeries are performed every year, most patients can resolve their pain with conservative measures.