Dr. Steven G. Clarke / Chiropractic Physician

High Street Rehab
25 High Street / Nutley NJ, 07110 • Essex County, New Jersey
973-235-1515

Medicare and Most Insurance Accepted
Office Hours: Monday, Wednesday, and Friday: 7:30 - 7:00
Tuesday: 12:00 - 6:30     •     Thursday, Saturday, and Sunday: Closed

Treatment of Carpal Tunnel Syndrome / CTS

Carpal Tunnel Syndrome (CTS) is compression of the median nerve usually in the wrist region. The median nerve starts in the neck, passes through the shoulder region, down the arm through the wrist to the hand and into the first 3 fingers. The tunnel is made up of 7 bones forming an archway, the roof, with a wide ligamentous band forming the floor. This is similar to an archer's bow with a taut string. When the ligament, or string, is relaxed, the tunnel collapses. This syndrome has become more prevalent due to repetitive micro-trauma of the underside of the wrist. An example of micro-trauma would be improper position while typing or data processing for a prolonged period of time. Your work or sport that requires the wrist to be in forward bent (flexion) or backward bent (extension) position can cause comprehensive pressures inside the wrist space to increase five or tenfold.

Excessive muscular overuse may lead to hypertrophy of the muscle/tendon complex in the wrist region or fibrous scarring of the tendons. One of the major indirect causes for CTS is weakness of the major wrist ligaments. This results in pressure on the median nerve. CTS can also occur from a sprain to the wrist area causing the ligaments to stretch or tear. The seven bones in the wrist then lose their natural arch thereby allowing the tunnel to collapse resulting in compression of the median nerve. Fractures of the wrist bones or forearm may also cause median nerve compression.

TREATMENT/NON-SURGICAL APPROACH TO CARPAL TUNNEL!
The first thing to be done is to get a detailed history of trauma to the wrist and how you do your job. Dr. Clarke will do a thorough exam to rule out other causes for your problem by examining you neck, shoulder, elbow, wrist and hand. This is a very important phase of you care. If not done thoroughly, it may mean unsuccessful results.

Sometimes pressure on the median nerve in the neck or shoulder can mimic the symptoms of CTS. We will determine whether the CAUSE of your problem is in the wrist or neck. To confirm your diagnosis, your doctor will use various tests such as specific muscle tests and x-rays. Clinical research has shown that a non-surgical approach is the conservative treatment of choice. Your doctor can easily treat CTS with adjustments to the wrist followed by bracing of the wrist in a position of physiological rest. It is important to have proper nutrition during the healing process. Dr. Clarke may recommend a B-6 supplement for improved function of the synovium, the sheath that surrounds the tendons.

A series of frequent adjustments will be necessary to realign the bones of the wrist so that the archway tunnel is re-established along with proper joint motion - so vital for wrist function and movement. The uses of anti-inflammatory or steroid injections are not recommended because carpal tunnel is not a chemical problem. Carpal tunnel is a mechanical pressure problem. Some therapies, such as ultrasound, muscle stimulation, massage, and warm wax dips, may be used to decrease inflammation and pain. If necessary, anti-inflammatory medication may be indicated. As pain decreases, strength and flexibility exercises will be performed and given to be done at home.