Carpal Tunnel and Casual Observations

I still find myself surprised when I see a person with a brace on their wrist, it never fails. It could be the waitress at my favorite restaurant or the cashier at the supermarket, but that little wrist brace always gives me pause and compels me to ask the question, "what's wrong with your wrist?"

Almost to a person the answer is: carpal tunnel. But the thing that surprises me more is that the person usually says how much pain they're still in, despite the brace. Maybe it's because their work is so stressful on the wrist. Serving tables is hard work and holding a couple of heavy plates with one hand can put a considerable strain on the wrist.

For many patients, the brace can be a life saver, getting us back to work and providing for our families. But for many others, they don't solve the problem. That's because simply limiting motion, while good in theory, could make the muscles of the wrist weaker. Also, wrist problems aren't always just a problem in the wrist. If the wrist and hand pain is actually coming from a pinched nerve in the neck, then the wrist brace will do little to help.

The important thing is to get the problem checked out. Is a small bone of the wrist out of its normal position? Is the mobility of the wrist asymmetrical and uneven? Is there a double-crush problem, with a pinched nerve not just in the carpal tunnel, but also where the nerves exit the neck area?

Our clinic does our best to help the pain of carpal tunnel. Usually a comprehensive approach is needed and we may need to adjust the bones of your neck and wrist to help restore proper alignment. If the vertebrae are twisted in the neck, they can narrow the openings where the delicate nerves emerge and travel down the arm to the hand. Sometimes the posture of the neck is affected and there is a loss of the normal forward curve of the neck. This can cause a stretch to the spinal cord and nerve roots.

If possible, we try to limit the use of braces and instead focus on strengthening the muscles of the forearm, or use deep tissue massage and stretching to increase muscle flexibility.