Carpal Tunnel Syndrome (CTS) is a very common condition that affects millions of people a year.  It is a condition that is commonly caused and aggravated by our growing reliance on computers.  The syndrome is caused by pressure and irritation to the median nerve as it passes through the wrist to the hand.

What Is The Carpal Tunnel?

The carpal tunnel is a tunnel formed by the carpal bones on the dorsal side of the wrist and a fibrous band called the flexor retinaculum on the palmar side.  The median nerve, which begins in the lower neck, travels down through the arm pit, to the inside of the bicep muscle, over the front of the elbow, along the front of the forearm to the hand.  As it passes the wrist it travels through the narrow carpal tunnel.


What Are The Symptoms of Carpal Tunnel Syndrome?

Compression of the median nerve in carpal tunnel syndrome can cause the following symptoms:

  • Numbness and Tingling in the thumb, index finger, middle finger and half of the ring finger.
  • Pain in the wrist and hand
  • Pain that radiates from the wrist back up the forearm.
  • Weakness in the hand, especially when grabbing or holding things.
  • Pain and stiffness in the fingers in the morning.

The above symptoms are commonly worsened at night or when doing repetitive things, such as using a computer or other repetitive activities such as using a hammer.

What Causes Carpal Tunnel Syndrome?

Many of the causes include activities or positions that tend to over strengthen the flexor muscles of the forearm and hand.  This tends to put the wrist in a bent position that can further compress the median nerve.  Worsening of the symptoms at night occur, because many people sleep with their wrists bent or flexed.

Conditions That Can Cause Carpal Tunnel Syndrome

The following conditions can lead toward CTS:

  • Obesity
  • Pregnancy
  • Hypothyroidism
  • Arthritis
  • Diabetes
  • Kidney Problems
  • Autoimmune Disease
  • Misalignment (subluxation) of the wrist bones (carpal bones)

How Is Carpal Tunnel Syndrome Diagnosed?

There are many conditions that can cause pain in the wrist, hand, and forearm.  Carpal tunnel syndrome is a very specific problem requiring specific treatment, so an accurate diagnosis is extremely important to successful treatment.  After an accurate and thorough medical history is obtained, a physical examination is performed from the hand and wrist and up to the neck.  This is done to rule out other conditions.  The physical examination will include orthopedic tests, neurological tests, palpation and x-ray.  Many times a nerve conduction velocity test (NCV) and electromyography (EMG) will also be performed.

Laboratory testing may also be ordered to determine the contributing conditions, such as hypothyroidism or diabetes.  Once the contributing condition is determined, an appropriate treatment program can be instituted.

How Is Carpal Tunnel Syndrome Treated?

Incorporating a multidisciplinary approach to carpal tunnel syndrome will provide the best results.  At Advanced Healthcare, we utilize techniques from physical medicine, chiropractic, physical therapy, and nutrition to successfully apply treatment.


  • Many times the bones of the wrist will misalign, putting pressure on the median nerve.  Misalignments of the neck, shoulder and overall posture will create a situation which will place more stress on the wrist, eventually causing inflammation and irritation to the median nerve.  Chiropractic adjustments correct these misalignments creating relief and return to function.

Physical Therapy

  • Many times, with CTS, there is a tightening of the flexor muscles of the wrist and forearm, and weakening of the extensor muscles.  Stretches and strengthening these areas can help to alleviate pain and correct the problem.

Physical Medicine

  • Many times using an anti-inflammatory and wrist brace can give the wrist time to heal and allow the inflammation to resolve.


  • There are multiple nutritional supplements which have been proven to reduce inflammation and alleviate pain of carpal tunnel syndrome.

What Is Double Crush Syndrome?

This is a syndrome in which compression or entrapment in one area of a nerve can increase the possibility of compression in another part of the nerve, such as the carpal tunnel.  The median nerve can be compressed in many areas along it’s pathway to the hand.  Compression can occur in the following areas:

  • In the cervical spine (neck) as is it exits between the spinal bones (vertebrae) on its descent towards the hand.  Osteoarthritis and disc problems will contribute to compression.
  • In the Thoracic Outlet, which is the area where the neck meets the shoulder.  Compression can be caused by a cervical rib, tightening of the neck muscles, and/or tightening of the pectoral minor muscle in the upper chest.
  • In the elbow as the nerve passes under and between muscles, tendons and ligaments.
  • In the forearm as the nerve passes through the pronator teres muscle.
  • Lastly in the carpal tunnel.

Determining whether there is a double crush syndrome is vitally important to successful treatment.  Many people are treated for carpal tunnel syndrome, unsuccessfully, because other contributing areas are not properly addressed.  Many people receive carpal tunnel syndrome, with limited to no relief, because of the above fact.

If you are continuing to have problems and symptoms and you are not getting answers, then stop being frustrated!  Help is available!

Call Advanced Healthcare of the Palm Beaches at 561-232-3553 to schedule a complimentary consultation.

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