Carpal tunnel syndrome is one of the most misdiagnosed syndromes I run across in my practice. There are a number of indicators that point to this condition. First you must have the right symptoms. There must be an altered sensation in the thumb, index finger, middle finger, and half the ring finger for carpal tunnel syndrome to be the proper diagnosis. If you have altered sensation in the whole hand, this can never be considered carpal tunnel syndrome because the median nerve which is the nerve in question only provides nerve impulses to those parts of the hand. In the case of the whole hand having altered sensation, more than likely there is an impingement of nerves at the front neck region where a muscle can impinge on the large group of nerves traveling down to the hand.
If there is altered sensation in just a couple of fingers, this also indicates that the symptoms are not the result of carpal tunnel syndrome. The symptoms must be in the right location to be the result of a specific cause. If you have symptoms in the right location to be considered carpal tunnel syndrome, then you can address the cause of the symptoms.
It is perceived by many in the medical field that the cause of carpal tunnel syndrome is compression of the median nerve in the carpal tunnel which is comprised of the wrist bones and a band of connective tissue which supports the tendons of the wrist flexors (bends the wrist with the palm toward the forearm) and finger flexors (closes the fingers). The premise is that the connective tissue band is too tight and needs to be stretched to make more room in the carpal tunnel. The surgery commonly performed to accomplish this goal is implemented by making a surgical slit in the connective tissue band thereby weakening the band.
The problem with this theory is that the connective tissue band never changed its tension. The symptoms are typically brought on by performing a specific activity, often times a repetitive activity. Muscles are responsible for performing activities. If the muscles are not strong enough to perform the activity, they have a tendency to strain. Once strained, they thicken. The wrist flexors and finger flexors pass through the carpal tunnel with the median nerve. Once there muscles/tendons strain and thicken, they compress the median nerve in the tunnel creating carpal tunnel syndrome.
The solution is to strengthen the appropriate muscles to resolve the thickening of the muscles/tendons thereby taking pressure off the median and eliminating the symptoms associated with carpal tunnel syndrome. Since the wrist and finger flexors are typically stronger than the wrist and finger extensors, they have a tendency to shorten. This sets them up to strain with activity. The answer is to strengthen the wrist and finger extensors. It is also important to strengthen the shoulder muscles to make sure that the forearm muscles are not overworking when performing functional activities. These should include the rotator cuff muscles and muscles between the shoulder blades.
I am confident that by addressing these muscular deficits, resolution of carpal tunnel syndrome symptoms can be resolved effectively and quickly. Surgery does nothing to address the true cause of the symptoms, and that is why most of the people I have come in contact with who had the surgery note that the symptoms returned at some time after getting surgery. Just remember, it is possible to have neurological symptoms being caused by a muscular deficit. The muscular deficit can only be resolved by utilizing aggressive, targeted strength training.
