What is Carpal Tunnel Syndrome or CTS?  Simply put, it is the entrapment and/or compression of the median nerve.  We have 9 tendons that pass through the carpal tunnel which is made up of 8 carpus bones and the carpal ligament that makes a band around the inside of the wrist to hold all the tendons, nerves and ligaments in place.  The median nerve passes through this opening and can become irritated.  When the tendons become irritated due to overuse, they can become inflamed and put pressure on the median nerve causing various issues – pain, numbness, tingling, loss of gripping ability or hand strength.  The pain can be felt in the wrist and hand as burning, weakness and pins & needles sensations that are felt in the thumb and first three fingers of the affected limb.

At any point along the nerve path that serves the hand, the nerve can become entrapped or irritated.  Anywhere along the nerve path if muscles become overly tight and squeeze or compress this nerve, CTS symptoms can result.  Even if there are no issues with the carpal ligament at all.  One such area is where the nerve passes through/along the elbow.  There is a small muscle located in this area that is very susceptible to overuse and can cause some of the same symptoms as true CTS.  This muscle, the Pronator Teres can become very tense or hyper-tonic and can press on the median nerve as it travels down toward the hand.  There are actually many other causes of CTS-like symptoms that come from muscles no where near the wrist.  Other causes can be misaligned bones in the wrist, a fracture or trauma to the wrist, arthritis, gout, trigger points in the forearm, and sometimes even hormone changes due to pregnancy.  Surprisingly, neck and shoulder problems are the most common cause of wrist pain.  When the actual cause of the pain is located in an area other than where the pain is felt, this is called referred pain. This referred pain often leads to misdiagnosis by doctors.  There are several tests your massage therapists can do to determine if you have true CTS or if the pain is being referred from another muscle group.

As with all muscle pain conditions, the earlier the pain is addressed, the more effective the treatment will be and the sooner the condition can be resolved.  Massage therapy is a proven, effective treatment for this complex condition.  I have seen many cases of this syndrome successfully resolve with a combination of massage therapy, stretching and self-care that have helped many avoid the cost, pain and downtime of surgery.