Carpal Tunnel Syndrome causes pain, numbness, tingling, and weakness into the palm. And these
three fingers, it can get so bad that it can cause pain at night that wakes
you up or keep you from falling asleep. And some people get so desperate that
they even get a surgery a carpal tunnel release surgery, in order to find relief,
know that carpal tunnel syndrome can nearly always improve 100% if you're doing the right things.
In this video, I'm going to explain to you everything you need to know about carpal
tunnel syndrome, as well as the diagnosis and treatment options for it. First off, let's
talk about the cause of carpal tunnel syndrome. A lot of people say that it's a self limiting
diagnosis, meaning it just comes on with no reason, at a certain age, usually people in their
40s 50s, especially and older, and then it just goes away for some and for others, it hangs around
to the point where they need to get a surgery. But let me explain to you the mechanical reason
that I treat my patients with I use this approach to treat my patients because then
the exercises become very clear the imbalances are super clear as well. In the hand here,
here's the palm and the wrist bones right here. These are the carpal bones.
That's why it's called the carpal tunnel, you have these bones and they form a valley,
you can see it right there. There's a little valley, right over the valley is a ligament. And
that ligament is what creates the tunnel where the nerve passes through as well as a bunch of
other tendons that help to close your fingers. That ligament right there connects the edges
of these bones as well as the muscles right here on this part of your palm. And this part of your
palm. If you look at my hand, this way, you can see how there's a little bit of an indentation
right there. That is where the ligaments sits. When you get those palm muscles stronger,
it lifts the ligament up and it makes more space for that carpal tunnel. And for the median nerve,
the nerve that runs right through there that leads to these parts of your palm in hand. It alleviates
the pressure the compression on the nerve to allow the nerve to be happier and not so painful.
When I see people that have severe chronic carpal tunnel problems. They often have flat
muscles right here in their palm. And so this part of their palm right here
no longer has a little bit of a valley in arch. This is actually an art in the poem,
it goes away and it flattens out and compresses ligament down against the nerve so that it makes
sense that strengthening those palm muscles is going to be very important. More on that later.
The second cause of carpal tunnel syndrome is way up in the neck and shoulder because
the same nerve that runs right through here, the median nerve actually begins in the neck when it
comes out of the neck bones the spine right here, these yellow things right here, it they bundled
together and they come under the collarbone. Then from there they spread out and go different
directions. There's different nerves, but the one that ends up going to your palm is the
median nerve. Right here under the collarbone is the second most common problem that I see
people that have carpal tunnel syndrome, that collarbone gets sunken down and it starts to
compress the bundle of nerves here known as a brachial plexus, it's that same bundle of
nerves that ends up forming the median nerve. If you can get pressure off the nerves right
here and get that collarbone up, then you can begin to depressurize the nerve way up here
in the neck. In order to do this you have to get stronger in your shrugging muscles
so that you can successfully maintain less pressure on the nerves up here in the neck.
It is so common for me to see people that have carpal tunnel syndrome also have a bunch of neck
problems. Because of this idea with that shrugging muscles being weak. Let me say
about the symptoms of carpal tunnel, you'll get numbness and tingling into the palm of the hand
right here. It can be painful as well it can throb ache, burn, all kinds of sensations can
go there because it's a nerve pain, and nerves control every single sensation in the body.
If the compression is there for long enough, you'll see what's called wasting away of the
muscle or atrophy, the muscle thins out and it goes away kind of you can get it back
as long as you can depressurize a nerve in those areas that I told you.
A common symptom related to the weakness is people drop their keys when trying to
open doors at the car, the house store or they'll drop cups drop utensils, their dexterity overall
decreases in the affected hand and picking up things like coins from a flat surface,
or tiny little screws becomes very difficult. Even buttoning shirts can be very frustrating
for these people. One of the biggest symptoms is pain at night that wakes you up. Inevitably,
at nighttime, you're not conscious of your position always and you might bend your wrist
a certain way to get comfortable at night. And if you're in an uncomfortable position
for your nerve, that pain can just shoot up. It's very sensitive for some and it doesn't let
them fall asleep as well. Now let me tell you how carpal tunnel syndrome is diagnosed. Most people
will look up the symptoms online or they may have heard of the symptoms from friends or family
members and they'll kind of self diagnose but when they see the doctor the doctor will do a physical
examination as well as hear your story and if you got all these symptoms that we just talked about,
you've got your about that age 40s 50s. And beyond, then there's a higher likelihood
that you truly have carpal tunnel syndrome. And they may order an x ray or an MRI to look inside
here and see they can see the inflammation or tell me things torn or broken as an x ray would
tell. But one of the most common tests that's done is a nerve conduction study.
And in this test, they'll stick needles into your nerve and pass a signal through there
to measure the signal speed through that median nerve that goes through that carpal
tunnel. And they may compare it to the other side as well or just compare it against the
normal values. And if your signal speed is lower than it should be, then they're going
to diagnose you with carpal tunnel syndrome. Now, if it's reached that point where you have
a nerve conduction study test that's showing as positive is that you have carpal tunnel syndrome,
then it's pretty bad because I often see patients here in the clinic that have all the signs and
symptoms of carpal tunnel syndrome, but their nerve conduction study is normal.
And sadly, some healthcare professionals tell them they don't have carpal tunnel syndrome,
and I'm thinking it just hasn't gotten that bad yet, it's on its way we don't need to
wait until they have a positive nerve conduction study test. Let's start treatment right now to
make sure it doesn't cause any further problems. Now speaking of treatment, let me tell you the
treatment options that are commonly done. For carpal tunnel syndrome,
the first thing your doctor is going to do is tell you to rest it, they'll also recommend
wearing a brace or a splint, especially at night. So one of those braces that goes
over your wrists right here may come up your form some and it may cover up your palm and
it should still allow your fingers to move. Sometimes we'll recommend one that doesn't
allow your thumb to move. If the symptoms are more in the thumb. The brace or splint will
have a plate a metal plate, sometimes a plastic plate something hard that keeps the wrist fixed
in this position. And they may recommend that you wear this at night especially if you're
having the night symptoms, you're not able to fall asleep at night or you're waking up in the middle
of night because of the carpal tunnel problem. They may also recommend activity modification. In
other words, using a better keyboard or getting a better desk setup if you have a computer job where
you have to use a keyboard, getting an ergonomic mouse and the keyboards that are split in half so
your arms can be just in the perfect position. All those things can be done but they're only
going to have marginal benefits. Your doctor might also recommend over the counter pain medications
if you already been trying that they may recommend prescription strength pain medications,
if you've been trying medications, and you found that medications like ibuprofen, naproxen,
the NSAID family medications aren't that effective in alleviating your pain, especially at night.
That's because you have a nerve problem. And those medications are better at handling soft
tissue problems like tendon, ligament, muscle, even bone and joint cartilage problems. If you
really need pain medication, you might ask your doctor for a medication that
helps the nerves like Gabapentin or Lyrica. Of course, there's side effects to all these
medications. So consider that. But it might be what you need to get a good night's rest so that
you can do the other stuff that's going to fix your carpal tunnel problem for the long term. In
some cases, they may recommend doing an injection of cortisone or some other steroid injection
to get the inflammation in the area down. Your doctor might also recommend physical
therapy for which just from my own experience, as a physical therapist,
we rarely ever get referrals from doctors for carpal tunnel syndrome, but we see carpal tunnel
syndrome patients all the time because they find us and know that we can help them out.
And if physical therapy doesn't work, then your doctor is going to recommend doing a
carpal tunnel release surgery, that's the most common surgery done for carpal
tunnel. And what they'll do is they'll go in there and find that ligament that covers up
these bones right here to make the tunnel. And they'll slice a ligament open to release space
there and allow the nerve to not be compressed. Now in my opinion, this is a short term solution.
It's not an end all be all fix it forever type solution. Because that ligament is very important
for making sure that the space in there increases if you're doing the right exercises. And if you
cut that ligament, you're kind of setting yourself back I've actually seen more patients here in the
clinic that had had carpal tunnel release surgery and still have carpal tunnel pain, because they
didn't fix the underlying root problem. And they're very angry and upset when they
learned that they could have just done certain exercises and it probably could have prevented
having the surgery. But they didn't know that at the time and they were doing the best that they
could based on what doctors were telling them and the doctors doing the best they could based
on what they know and how they've been trained. Now, let me tell you how to fix the root problems
of carpal tunnel syndrome. Going back to that ligament that connects the bones in the palm
right here. You've got to use that ligament by getting the strong the muscles around the
palm right here, the ones at the base of the thumb and at the base of the pinky.
They're called the thinner and hypothenar eminence says there's a bunch of little
muscles in there. If you can get those muscles stronger. By doing grip strengthening exercises,
we like to use this tool to start people off that strengthening the tool helps to
get these muscles stronger. And over time, as you get stronger and stronger, it starts to lift
that ligament up and gives the best support long term for the bones or the carpal bones.
Now, that's just one aspect of it because this median nerve starts up in the neck. So
you also have to consider what's happening at the neck. Very often, we see people have very
sloped shoulders or shoulders are kind of down. And they should be resting a little bit higher,
but they've gotten used to having their shoulders down because their shrugging muscles are weak.
So we are almost always starting our carpal tunnel patients on shrugging exercises that
help get their muscles up here stronger. So we'll have them just reach up like this
and shrug as hard as possible without letting the head get out like that. Because that also
keeps the nerves uncompressed in the neck. Because of the spine bones, the neck joints
can compress the nerves if you if you start to let your chin jet out like that. So you
have to make sure to keep your chin slightly tucked in like you're making a double chin.
And we have people hold it for 10 seconds. And there's a whole protocol we take people through.
I've got videos on how to do this as well here on our channel. If you go down into the description
below, you'll find a link that has our playlists of all our carpal tunnel videos, and you can find
more help there. You'll also need to loosen up your stiff neck joints. And you might get that
done through a physical therapist, potentially a chiropractor, and there's ways to do it yourself
that we've talked about here on our channel. At the end of the day, the entire nerve
pathway for that median nerve that goes into the palm and fingers needs to be
considered so that it's decompressed and all the muscles are imbalanced around it
to give it its space to live and to function. If you can do that with the proper exercises,
then you should be able to get your carpal tunnel syndrome symptoms all the way down to where you're
feeling normal, and you can be active again. Hey, if you thought this video was helpful, please
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