The following information has been gathered and compiled through personal experience, while traveling, teaching T’ai Chi, Qi Gong, Chinese Herbal medicine, martial arts and other health related subjects. The article also contains feedback from students and anecdotal information from readers of my columns. The following are my opinions and deductions from those sources.
If your hands fall asleep at night, you have a weak hand grip, pain, burning, tingling or numbness in the fingers or thumb or loss of the use of the hand due to weakness or pain, you likely have carpal (carpal means wrist) tunnel syndrome (CTS). Most doctors can diagnose the problem without expensive tests and high tech equipment.
There are eight small bones on the palm side of your hand that make up one side of the “tunnel.” A long flat ligament makes up the tunnel’s other side. Several blood vessels and a nerve pass through the tunnel. The nerve , median nerve, controls movement and is involved with feeling in the thumb and first three fingers. The median nerve originates in the vertebra of the neck at the spinal cord and runs down the arm after passing over the shoulder and passes through the carpal tunnel. We usually associate CTS with pinching or entrapment of the nerve at the wrist, but if it gets pinched anywhere along the route, you can experience CTS.
The usual procedure is immobilization of the wrist, and if that doesn’t work it’s followed by cortisone injections and finally surgery. Since I don’t diagnose or prescribe, I can only state the experiences, anecdotal, that people who I’ve known have experienced. No one I know has ever had lasting relief from cortisone, or its derivatives. Surgery consists of cutting the ligament in an effort to relief pressure on the nerve. If the problem is elsewhere, between spinal cord and wrist, both procedures can prove ineffective. Surgery also leaves the wrist in a permanently weakened state.
Finding, and being sure of, the cause may prove to be a better solution than treating a symptom. The reader may want to see my personal experience with misdiagnosis and assumptions in my article, Bursitis: What is it? before making a deaccession that can’t be undone. If the nerve is being pinched in the spinal column, neck, shoulder or arm, is surgery on the wrist the answer?
If there has been trauma to the wrist, hyerflexing (bending the hand at the wrist beyond its normal range), or jamming, the small bones where the nerve passes through the tunnel can be knocked out of place, putting pressure on the nerve. The nerve may be inflamed resulting in swelling and filling of the tiny space between the ligament and the small bones.
Jamming or hyperflexing the wrist can occur while overextending yourself doing simple chores around the house, catching yourself from a fall, bending the wrist backwards while incorrectly getting out of a chair, bowling, weight lifting, doing gymnastics or opening a stuck window can cause the problem. Anything that forces the wrist beyond its normal range, and while under pressure, can cause dislocation of the small carpal tunnel bones.
If the bones are out of place, a competent chiropractor or osteopath, who is versed in treatment of the wrist, can reposition them. One the bones are in their proper place, it’s necessary to wear a wrist brace while healing. The brace needs to stabilize the wrist and not allow it to be bent backwards or hold the wrist in a constant backward bent position. People who have had this type of problem tell me the best brace is one that’s made for bowlers. The brace can be purchased at shops that sell sports and bowling equipment, and that it costs less, and works better, than braces made for carpal tunnel syndrome.