Masquerading as Carpal Tunnel Syndrome

Most people have heard about carpal tunnel syndrome (CTS) as it’s the most common of the peripheral neuropathies or pinched nerves in the extremities, but few have heard of pronator teres syndrome.

Carpal tunnel syndrome occurs when the median nerve is pinched or compressed while passing through the wrist. However, the median nerve originates in the neck and must pass through several anatomical regions before reaching the wrist and ultimately the hand. One of these areas is the elbow where the median nerve passes between the two heads of the pronator teres muscle. The good news is that pronator teres syndrome is much less common than CTS. The bad news is that it can produce similar symptoms in the hand and can even co-occur with CTS.

That’s why when a patient seeks chiropractic care for carpal tunnel syndrome symptoms like pain, numbness, tingling, and weakness in the hand, a doctor of chiropractic will examine the entire course of the nerve to identify where the median nerve is pinched. This can include the wrist, the forearm, the elbow, the shoulder, and even the neck. Chiropractors will also review a patient’s history for non-musculoskeletal conditions that may be associated with an elevated risk for CTS, such as type 2 diabetes, which may necessitate co-managing care with other healthcare professionals.

Once the potential musculoskeletal causes are identified, which may include pronator teres syndrome, treatment can proceed. In most cases, doctors of chiropractic will utilize manual therapy techniques such as joint manipulation and mobilization to improve joint motion, along with soft tissue manual release methods to relax tight, tender muscles. A chiropractor may also use physical therapy modalities such as pulsed ultrasound, electromagnetic field, electrical stim, and/or the use of therapeutic lasers. Additionally, patients may be advised to temporarily modify their job function, make ergonomic changes to their workstation, use a nighttime splint to keep their wrist in a neutral posture during sleep, or make dietary changes to reduce inflammation (which may include using herbal supplements like ginger, turmeric, and Boswellia).

Most studies show that the best outcomes or results are obtained when conditions like pronator teres syndrome and CTS are caught early in the mild to moderate stage of the condition. Waiting too long can result in scar tissue formation around the nerve making satisfying results more difficult to obtain regardless if management is non-surgical or surgical.

Author
Dr. James Sheehan Dr. James Sheehan is an expert in the treatment of neck and back pain.

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