Carpal Tunnel Syndrome Can Often Be Misdiagnosed

Carpal tunnel syndrome (CTS) is a very painful condition and can be debilitating. However (CTS) is often misdiagnosed. The most common misdiagnosis is a syndrome that has very similar symptoms and is called thoracic outlet syndrome (TOS). This article will give a brief overview of CTS and TOS and explain some of the treatment options.

The Carpal Tunnel

The carpal tunnel is created by a band of tissue called the transverse carpal ligament that runs from the base of the thumb across the wrist and attaches to the opposite side of the hand thereby creating a tunnel that the tendons of the forearm and the nerves of the hand run through.

The arm and hand are innervated by a bundle of nerves called the brachial plexus. This nerve bundle travels from the lower cervical spine (neck) and the upper thoracic spine (upper back) C5 - T1, under the collarbone, around the pectoralis minor muscle and down the arm and into the hand. The brachial plexus can be impinged anywhere along this pathway and can cause symptoms similar to carpal tunnel syndrome.

True Carpal Tunnel Syndrome

True carpal tunnel syndrome is caused by an inflammation of the finger flexor tendons that run through the carpal tunnel. The nerves that share the pathway are then compressed and this is what causes the pain.

Thoracic Outlet Syndrome

Thoracic outlet syndrome (TOS) is the compression of the brachial plexus either at the cervical spine, the scalenes (neck muscles), pectorals minor, the clavicle or the forearm muscles and is characterized by pain, tingling, numbness and temperature change in the tissues. These are some of the same symptoms of CTS and are often the basis for misdiagnosis.

Medical Treatments

The solution for carpal tunnel syndrome developed by western medicine is to cut the transverse carpal ligament to release the pressure and allow the body to form scar tissue that will reform the tunnel. The problem here is that scar tissue formation is unpredictable and can sometimes make the tunnel tighter and allow for the CTS symptoms to return and possible get worse.

The surgical treatments for TOS can be more invasive but are not as commonly performed. One of the procedures is the removal of the first rib to release the pressure on the affected nerve and blood vessels.

Natural Treatments

Fortunately TOS and CTS can both be treated effectively without surgeries. A good massage therapist or physical therapist will be able to create an effective protocol for both syndromes. There are also a number of home remedies for these conditions. Some of the natural treatments include self massage, hydro therapy and stretches.

The following are natural remedies for carpal tunnel syndrome. I would recommend working with a good massage therapist for TOS because it is more difficult to do self massage for this condition.

Contrast hydrotherapy treatments help increase the blood flow and allow the body to heal faster by alternately constricting and expanding the blood vessels. Here is a good hydrotherapy treatment.

• Fill two sinks full of water and add some ice to one and make the other one hot, less than 110 degrees. If the water is hotter than 110 degrees there is a possibility of tissue damage. Submerge your forearm into the hot water and leave it for 3 minutes then put your arm into the cold water for 30 seconds. Repeat this procedure three times ending with cold.

Massage can help to heat up, lengthen and relax the tissues. Here are some easy massages you can to at home. 

• Take the injured hand palm up and bend the wrist slightly so the fingers are angled down. Use the thumb of the other hand to massage from the palm toward the forearm and over the wrist. Repeat this several times.
• Massage the forearm muscles from the wrist toward the elbow.
• Lightly massage with long strokes from the wrist to the armpit. This light massage can help move lymph toward lymph nodes resulting in reduced swelling at the wrist.

Stretching the forearm muscles and ligaments can help relieve pain. Here are three stretches you can do at home.

• Take your thumb toward your palm and make a fist with your fingers covering your thumb, straighten your arm with your thumb side up and turn your fingers toward the floor. Hold the stretch for up to a minute.
• Put your palm against a wall with your arm straight in front of you, angle your arm down for a better stretch.
• Extend your arm, bend your hand forward and turn it inward, bend your fingers in. Take the other hand and place over the back of the affected hand and pull toward you.

Carpal tunnel syndrome can be painful and debilitating but usually does not require surgery. I would highly recommend trying alternate natural treatments for carpal tunnel syndrome before considering surgery.