OPTIMAL HEALTH UNIVERSITY™
Presented by Marc Davis, DC
Carpal Tunnel Syndrome & the Lesser Known
Wrist Conditions That Mimic It

Carpal Tunnel Syndrome (CTS) gets a lot of press as being the primary culprit behind wrist pain. But there are a number of other diseases, harmful habits, spinal conditions and syndromes that can masquerade as CTS.

As a provider of holistic health care, Dr. Davis focuses on prevention and knows how vital it is to accurately uncover the true source of patients’ wrist pain.

Wrist Structure

The wrist consists of eight carpal bones arranged in two horizontal rows (four bones each). The proximal row consists of the scaphoid, lunate, triangular and pisiform bones. The distal row consists of the trapezium, trapezoid, capitate and hamate.

A network of ligaments lashes the two rows of wrist bones together – and to other ligaments as well.

Who’s at Risk?

Although wrist disorders may strike anyone, certain activities increase risk. Specifically, any sustained, repetitive movement stresses the wrist. Common instigators include assembly work, cashiering, playing video games and keyboarding on a computer. Any job that requires employees to continually grip with their hands, such as painters, plumbers, electricians, carpenters and artists, also compromises wrist health.

Is it Really CTS?

Overuse of the wrist may result in carpal tunnel syndrome: inflammation of the “tunnel” between the ligament that extends across the top of the carpal bones and the bones themselves (and the subsequent entrapment of structures in the tunnel, including nerves). Symptoms of this painful and debilitating condition include numbness, tingling and loss of strength.

While CTS is a major health concern, it is not always the cause of wrist pain. There is a glut of CTS imposters. That’s why it’s important for all individuals with wrist problems to have a complete chiropractic evaluation.

The following is a partial outline of conditions that may mimic CTS.

The Spinal Link to Wrist Pain

Research reveals that symptoms from problems in the spine of the neck (cervical spine) may be “confused clinically with carpal tunnel syndrome.” (Magn Reson Imaging Clin N Am 1995;3:249-64).

Most people are unaware that the spine has a direct link to wrist health. When spinal bones (vertebrae) become misaligned or restricted, the result is a condition known as vertebral subluxation. This outcome is linked to a variety of wrist conditions.

Chiropractors correct vertebral subluxations with safe and gentle maneuvers called chiropractic adjustments. In addition, Dr. Davis encourages patients to adopt the chiropractic lifestyle, a way of life that focuses on preventing health problems, rather than merely masking symptoms with medication.

The median nerve controls the thumb, index and parts of the middle and ring fingers. It extends from the fingers through the two rows of wrist (carpal) bones. From there, the nerve travels past the elbow, up the arm, through the shoulder, up the neck and finally to the spinal cord.

And that’s when things can get a bit dicey. The median nerve connects to the spinal cord through openings between vertebrae in the neck (cervical spine). When movement is restricted in these cervical vertebrae, the result is tingling, numbness and pain in the fingers and wrist.

Maintaining optimal spinal health, which includes regular chiropractic visits, is the key to wrist wellness. Chiropractic adjustments realign errant cervical vertebrae and free the median nerve to do its job without interference. Dr. Davis also keeps shoulder, elbow and wrist joints properly aligned.

Dr. Davis may further suggest rehabilitative exercises and discuss ways to minimize future on-the-job wrist injury (such as taking sufficient rest breaks).

Thoracic Outlet Syndrome

Known as TOS, symptoms of this affliction also mimic CTS. TOS involves the “compression of the neurovascular structures in the region between the scalene muscles and the first rib or by anatomical abnormalities, such as cervical rib, fibrous bands and other variations in the scalene musculature.”

Ulnar Tunnel Syndrome

Yet another CTS imposter may trigger wrist pain: ulnar tunnel syndrome (UTS).

Also know as Guyon’s canal syndrome, ulnar carpal tunnel syndrome and hypothenar hammer syndrome, UTS results from pressure on the ulnar nerve – also located in the wrist. The tunnel, which has no tendons passing through it, includes a small fat pad and the ulnar nerve, artery and veins. “The ulnar tunnel is more superficial and medial [centrally located] than the carpal tunnel, and the ligament covering it is thinner than that of the carpal tunnel.” (Am Fam Physician 1991;44:497.)

UTS symptoms are similar to those of CTS and tend to worsen at night (as happens with CTS symptoms as well). However, since the ulnar artery runs alongside the ulnar nerve, any process that entraps the nerve may also lead to arterial insufficiency, resulting in cold and painful fingers. (Am Fam Physician 1991;44:497).

“Most cases of ulnar tunnel syndrome develop when the heel of the hand is used for pounding and damage is sustained in the hypothenar region, the area of the palm below the little finger. Ulnar nerve disorders develop in 30 to 40 percent of patients with carpal tunnel syndrome.” (Am Fam Physician 1991;44:497).

Double Crush

Like CTS, UTS has a spinal connection. According to one scientific study, “Lower cervical spine disease sometimes occurs concomitantly with entrapment of the ulnar nerve at the wrist. This condition, termed the ‘double crush injury,’ may produce ulnar nerve symptoms that are referred proximally into the upper arm, shoulder, neck and chest wall. In such cases, both the cervical spine and the wrist must be treated.” (Am Fam Physician 1991;44:497).

In addition to chiropractic care, prevention of UTS includes careful handling of tools and use of protective gloves.

Sprains, Strains, Tendonitis & Other Traumatic Injuries

“Traumatic injuries include fractures, dislocations and ligament tears often seen in contact/collision sports.” (Am J Sports Med 2003;31:1038).

A ten-year review of all injuries at the Olympic Training Center (Colorado Springs, Colo.) revealed that 8.7 percent involved the wrist and hand. Researchers noted that the majority of these injuries were sprains and contusions (64 percent). In collision sports, such as football, hand and wrist injuries account for 15 percent of all injuries (Am J Sports Med 2003;31:1038).

The incidence of wrist problems was much higher in sports like gymnastics, ranging from 46 to 87 percent of participants.

Besides sports injuries, other accidents may spawn traumatic injuries. Sprains, strains and tendonitis may also result from non-traumatic, chronic overuse.

Scapholunate Injuries

The lunate and scaphoid carpal bones are bound together by the following three ligaments:

1. Volar radioscapholunate ligament
2. Scapholunate interosseous ligament
3. Dorsal scapholunate ligament

Scapholunate injuries, the most common type of wrist injury involving ligaments, results from excessive extension of the wrist – such as occurs when falling on an open hand with fingers splayed in a fan-like pattern. Symptoms range from significant swelling to decreased range of motion and tenderness (Am J Sports Med 2003;31:1038).

Carpal Scaphoid Fractures

The most common wrist fracture associated with athletics involves the carpal scaphoid bone: one of four bones located in the proximal row of the wrist. “It accounts for 70 percent of all carpal fractures and is most prevalent in the 15- to 30-year old population.” (Am J Sports Med 2003;31:1038).

Epicondylitis

Commonly referred to as “tennis elbow” when it occurs laterally and “golfer’s elbow” when it occurs medially, epicondylitis is associated with a variety of sports and occupational activities (J Am Acad Orthop Surg 1994;2:1-8).

Symptoms of lateral and medial epidondylitis include elbow pain, in addition to weakness in the wrist and fingers (J Ky Med Assoc 1990;88:349).

Diseases and Harmful Habits

Nerve entrapment and symptoms associated with CTS can also be brought on by diabetes, smoking, alcohol consumption, rheumatoid arthritis and hypothyroidism: although these disorders typically produce simultaneous symptoms in both arms, not just one (Am Fam Physician 1995;51:103-16).

One Last Word on Prevention

Make an appointment today with Dr. Davis and discuss ways to adjust your work and postural habits to minimize wrist and neck pain. Don’t wait for the pain to signal it’s time for another visit!

Optimal Health University™ is a professional service of PreventiCare Publishing®. The information and recommendations are appropriate in most instances. They are not, however, a substitute for consultation with a health-care provider such as Dr. Davis. Copyright, 2004.

Dr. Marc Davis adjusts patients at Davis Family Chiropractic, a thriving, wellness-oriented office located next to Fred Meyer in Fisher’s Landing. To subscribe to Dr. Davis’s complimentary monthly newsletter “In Good Hands™”, call our office at (360)823-2225 and it will be delivered to your home.

Here’s Your Opportunity

If you are suffering from wrist or hand pain, numbness, tingling or weakness, don’t procrastinate, just call the office, come on in, and we will check you for FREE, using painless technology called Computerized Surface EMG Testing.

The Carpal Tunnel/Wrist/Hand Evaluation is a series of quick and painless tests that help determine:

1. What is the true cause of your problem?
2. Is surgery in your future?
3. Is there any non-surgical way of eliminating the problem quickly and easily?

The test is quick, easy and, most importantly, painless! This machine, the EMG, is so good at what it does, it’s used by NASA on its astronauts. When the test is done, YOU WILL GET A COMPUTER PRINT-OUT THAT SHOWS A PICTURE OF WHERE YOUR PROBLEMS ARE LOCATED.

What’s important is that you take a moment now to schedule your Carpal Tunnel/Wrist/Hand Evaluation and EMG test before the window to help you without surgery may pass. If your problem worsens, it may be more difficult to evaluate, take longer to fix, and may need surgery. So get this test soon.

This No Obligation, FREE Surface EMG Test and Carpal Tunnel/Wrist/Hand Evaluation will be available to you FREE only as openings are available through the month. (Regularly $240.00.) Just call Tammy, Jeannie or Tonia at 823-2225. Remember, there are a limited number of openings, so call today.

Of course, if you have any questions first, give us a call. We’ll answer any questions you have about your condition or concerns, and then you can decide if you want your problem looked at.

Congratulations on taking responsibility for your own welfare!

Click to close window