Carpal Tunnel Syndrome? or Median Nerve Entrapment

Gower Acupuncture with Tim Wright

Tingling in the centre of the palm, weakness of grip, sensation of numbness and tingling in the hand and fingers? You’ve got carpal tunnel syndrome… possibly…

What Is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is also known as median nerve entrapment. The median nerve runs from the palm of the hand up the forearm to the crease of the elbow. Carpal tunnel syndrome occurs when the median nerve is trapped or compressed at the wrist crease on the palm side between two little wrist bones – the pisiform on one side and the scaphoid on the other.

Whilst entrapment of the nerve can and frequently does occur at the carpal tunnel of the wrist. It can also occur further up the forearm and refer pain and weakness into the hand and fingers, mimicking carpal tunnel syndrome. But this isn’t carpal tunnel syndrome. It’s always important before you get a steroid injection or have an operation, to check that the nerve hasn’t been trapped further up the arm. There are other causes of pain and numbness in the hands…

What could Create Similar Symptoms to Carpal Tunnel Syndrome

Apart from systemic issue such as diabetic neuropathy, the other most pressing issue is to find why and where the median nerve may be getting trapped. Is there inflammation? Is there compression of the nerve by muscles?

Thoracic outlet syndrome is a compression of the brachial plexus that runs from the side of the neck down the arm. One of the sneakiest – and often under-diagnosed muscles is the scalene group of muscles. These run down the side of the neck and help to turn the head and laterally flex (pulling the ear down to the shoulder) the neck. Poor posture, or whiplash type accidents can cause significant issues in these muscles. Pain from tight scalene muscles refers down the arm into the fingers and sometimes into the upper chest and down the upper back towards the shoulder blade. Moving more locally, the forearm flexor group of muscles, which flex the wrist, can refer pain into the palm and fingers.

The Solution to Carpal Tunnel Syndrome?

Typical treatment for Carpal Tunnel syndrome starts with a wrist splint, progresses to a steroid injection, then if worsening, results in going under the knife where they cut the ligament spanning the wrist. Up to 20% of patients report a recurrence of pain post surgery ( Articles/PMC3838639). This may be due to scar tissue developing around the site of incision, or that there was another factor in play causing pain and weakness in the hand.

The Acupuncture Solution?

In my experience if you can abstain from heavy repetitive activities that aggravate carpal tunnel and haven’t been suffering too long, acupuncture can have a good outcome.

If the cause isn’t originating from compression of the carpal tunnel then you don’t have carpal tunnel syndrome. In this case I look at the muscles which may be referring pain into the palm and fingers or try to locate where the median nerve or brachial plexus may be getting compressed.

And this is at the core of most of my pain based treatments. I’m less interested in the diagnosis and more interested in the symptoms, trying to assess whether the issue is muscular, neurological or joint based and basing a treatment plan around that. / / Tel: 07764 254881



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