Millions of Americans suffer from the pain and disability of carpal tunnel syndrome. Most do not know that conservative measures provide relief in the majority of cases.
Almost all people with the pain, numbness and weakness in the hands and wrists can be helped with manual medicine. The osteopath evaluates the nerves, blood vessels, and muscles first for any abnormality. Next is a structural exam to check for decreased range of motion of the wrist and hand. This is almost always abnormal. By opening up the canal where the median nerve and blood vessel travels, more oxygen can get to the tissue. Stretching the ligament that crosses transversely at the wrist also releases the joint and decreases pain and swelling. This is all part of osteopathic manipulative therapy.
The D.O. may also check lab work for hypothyroidism or autoimmune disorders such as rheumatoid arthritis. If you have a job involving repetitive motion or a large amount of computer work he/she will look at your mechanics and make suggestions. Less stress and better positioning of the wrist increases its strength and flexibility. A nutritional approach has shown 50 mg. of B6 to be effective in some cases. Of course traditional methods of splints, anti-inflammatory medicines, and exercises are also used.
Surgery and further testing of the nerves and muscles may be necessary if you do not improve with conservative measures. Shrinking of the muscles of the thumb or coldness of the tips of the fingers are serious findings.
References:
1. Journal of the American Osteopathic Association, January 1993; 93:92.
2. Journal of the American Osteopathic Association, August 1994; 94:647.
