Are you experiencing chronic thumb pain? Do you feel weakness, finding it hard to open jars and grip things? You might even be feeling numbness, tingling, or a burning sensation in your hand. If so, this blog is for you.
Today, we’re going to talk about carpal tunnel. If you, or someone you know, is stuck in that frustrating cycle where everyday tasks become a pain-filled ordeal, you’re not alone.
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Causes of Carpal Tunnel
Now, what are some of the things that may cause carpal tunnel?
1. Repetitive activity
Using the mouse all day, engaging in repetitive labor, or activities such as knitting or sewing can trigger carpal tunnel. However, we want to recognize that there’s always an underlying cause.
2. Other causes
Some less obvious factors include hormonal and metabolic issues, inflammatory problems, systemic inflammation, as well as conditions like type 2 diabetes and thyroid disorders, which are correlated with carpal tunnel.
It’s important to understand that carpal tunnel is a specific area. When referring to carpal tunnel, we mean the compression of the median nerve at the level of the carpal tunnel in the wrist after it exits the cervical spine at C5, C6, and travels down the arm into the hand.
As mentioned earlier, you may experience weakness and pain in basic activities, such as using your phone. However, jumping straight to surgery isn’t always the solution. Carpal tunnel compression can occur at multiple levels, starting from the spine, through the scalene area in the neck, pectoralis minor, and down to the pronator teres in the forearm.
Patients often consider surgery immediately, but this approach can lead to more scar tissue, trauma, inflammation, and additional problems. Successful outcomes from carpal tunnel surgery are rare in my experience with patients. While specific cases may warrant surgery, considering anatomical differences between individuals, such as gender-related structural variations, it’s important to always evaluate the mechanics involved.
Assessing Carpal Tunnel
When assessing carpal tunnel, we don’t focus solely on the affected area. We examine everything happening in the neck and spine.
Check Range of Motion
Firstly, check your cervical spine’s range of motion for any discomfort. Can you touch your chin to your chest, look up with your face parallel to the ceiling, and turn fully to both sides without pain or symptom reproduction? Ensure symmetry in movements between both sides and check for compensatory patterns.
Breathing
Now, assess your nasal breathing. Are you able to breathe nasally? Are you able to maintain your tongue at the roof of your mouth? This position allows for proper expansion and contraction of the abdomen during nose breathing, avoiding unnecessary strain on the neck and shoulders.
These basic assessments are important because any compensation in these simple patterns indicates a potential issue higher up in the chain. For instance, someone complaining of thumb arthritis and weakness may trace the problem back to median nerve issues caused by neck involvement.
When considering surgery for carpal tunnel, it’s vital to weigh numerous factors and examine all reasons comprehensively. I’ve witnessed numerous individuals successfully avoid carpal tunnel surgery by addressing underlying issues and achieving higher functionality, even engaging in activities that may strain their hands. It’s essential to explore these alternatives and delve into the root causes of movement, pain, or health issues whenever possible.
What Can You Do
Now, what can you do?
1. Immobilize affected area
During the acute phase (1 week) of your carpal tunnel symptoms, especially as you’re trying to figure out why it’s happening—be it repetitive use or any of the other factors I mentioned—it’s crucial to immobilize it as much as possible, particularly if you need to continue activities.
If you’re typing or using a mouse extensively, it’s helpful to use a brace to stabilize the carpal tunnel in that acute phase, even while sleeping. This can prevent uncomfortable positions during sleep and waking up with excruciating pain and weakness. Consider it a protective measure that can gradually be phased out as you start feeling better.
2. Identify repetitive activities and make changes
Identify those repetitive activities causing the issue and make some changes. Implement basic ergonomic adjustments at work, use wrist support, take breaks—the most crucial thing—and optimize your posture. Note that perfect posture doesn’t guarantee injury prevention, but you can observe where you might be compensating.
Throughout the day, focus on breathing and movement variability rather than fixating on the ideal desk posture. Every 30 minutes, change positions, move around, take short walks—think of them as movement snacks. This approach aligns better with your body’s preference for avoiding prolonged static positions. Spending hours with your neck forward or in one position can contribute to pain and inflammation.
3. Address inflammation
If the nerve is inflamed, there are things that you want to think about from an overall health standpoint. Looking at things like your diet, is there anything that you are eating, or maybe even drinking alcohol or excess coffee, or things that might be putting you in a more inflammatory state?
You can check out some of my other videos to understand that, but ultimately, there could be potential inflammatory triggers such as stress, food, bugs, toxins, trauma, and hormones.
4. Work on your movement
It’s important to note that everyone’s experience will be different, as the issues they face vary. For instance, do you struggle with instability in your shoulders? Or perhaps your core isn’t as stable as it could be? Another factor is motor control, which refers to your ability to sequence, time, and coordinate your movements. If any of these problems are present, it may cause you to compensate at the wrist and elbow, perpetuating the cycle of discomfort.
Working with a professional is really important. Get a great movement assessment or a physical therapist so you know how you’re moving and what you need to do to correct that.
5. Nerve glide
When the time is right, which is not in the acute phase of your carpal tunnel syndrome, is nerve glides. To do this, stand up and use a wall for support. Place your opposite hand on your shoulder and press it down firmly. Then, with your fingers down and your elbow bent, straighten your elbow, flatten your palm, and turn your head. It’s important to remember to depress your shoulder while doing this exercise. You can start doing it without a wall, but using a wall for guidance can be helpful.
Go back to the center. Breathe in and breathe out. You only want to go to the point of tension; do not create more symptoms. If doing a few of these worsens your symptoms, it’s not suitable for you right now. If you feel fewer symptoms, you likely have more nerve tension, making this exercise appropriate. I recommend starting with one set of 10; assess and feel how it goes. If it feels good, limit it to no more than three sets a day. Ideally, work with a professional to ensure appropriateness.
Think of it like flossing your teeth; just as dental floss moves through teeth, your nerves floss through muscles. You’re not stretching the nerve but encouraging it to glide through the tissue more freely. This is crucial when addressing chronic issues.
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