Do I Have Carpal Tunnel Syndrome?

Many people believe they have carpal tunnel syndrome (CTS). The majority have been told by their medical doctor that they have CTS. Others have mistakenly concluded that because they have some numbness and tingling in their wrist or hand, they must have this neurological disorder. Still others have ongoing forearm, wrist, or hand pain (possibly localized to the thumb and/or index finger), and are led by articles they've read on the Internet to diagnose themselves with CTS. Almost all of this is in error.1,2
Why are so many diagnoses of this condition mistaken? The primary culprit is lazy clinical decision-making, compounded by a failure to understand correctly the workings of the musculoskeletal system. Carpal tunnel syndrome is a specific diagnosis which involves mechanical pressure on the median nerve as it passes through a small tunnel in the wrist created by tiny adjoining bones. There's not much room in this carpal tunnel and its dimensions can be narrowed further by inflammatory conditions such as osteoarthritis or rheumatoid arthritis. Pregnancy can lead to CTS owing to increased fluid retention. Repetitive stress may lead to inflammation of tendons that cross the wrist. Such inflammation may lead to soft tissue swelling which compresses the carpal tunnel, causing CTS. Various other disorders should also be considered when CTS is suspected.
Importantly, CTS is not a catchall diagnosis to be used when a person has forearm, wrist, and/or hand pain. If a person really has CTS, he or she will have specific symptoms. The person will awaken at night owing to pain and/or numbness and tingling. Symptoms will be precisely located to the thumb and index finger (possibly involving the middle finger). Wrist pain may or may not be present. Also, the person will demonstrate a weakness of pinch grip involving the thumb and index finger. If these signs and symptoms are not present, the person does not have carpal tunnel syndrome. Usually, the diagnosis is clearcut and does not require special tests such as electromyography.
Remarkably, most physicians, regardless of specialty, are unaware of these important criteria. If the patient has pain and/or numbness in the hand, the patient has CTS. Case closed. This lack of sophistication leads to real harm done to the patient, such as unnecessary tests which waste time, cost a lot of money, and may result in damaging surgery which is not curative as it was directed at a problem that really wasn't there.
In marked contrast, chiropractors are highly trained in accurate analysis of musculoskeletal problems involving the shoulder, arm, and hand.3 When patients have symptoms mimicking those of carpal tunnel syndrome, chiropractors use their broad knowledge and experience to correctly evaluate the situation. For example, spinal dysfunction, muscle spasm, and trigger points can all cause symptoms which appear to be those of CTS. Chiropractors are able to see through this masquerade and effectively address the real underlying problems.
1Ibrahim I, et al: Carpal tunnel syndrome. Review of the recent literature. Open Orthop J 6:69-75, 2012
2Uchiyama S, et al: Current concepts of carpal tunnel syndrome: pathophysiology, treatment, and evaluation. J Orthop Sci 15(1):1-13, 2010
3Bialosky JE, et al: Heightened pain sensitivity in individuals with signs and symptoms of carpal tunnel syndrome and the relationship to clinical outcomes following a manual therapy intervention. Man Ther 16(6):602-608, 2011

Location

Find us on the map

Office Hours

Our Regular Schedule

Wyandotte Office

Monday:

8:30 am-12:00 pm

1:30 pm-7:00 pm

Tuesday:

8:30 am-12:00 pm

Wednesday:

8:30 am-12:00 pm

1:30 pm-6:00 pm

Thursday:

Closed

Friday:

8:30 am-12:00 pm

1:30 pm-6:00 pm

Saturday:

Closed

Sunday:

Closed

  • "Dave, Hard to put into words how much better I feel. After I left your office, I returned to the shop preparing to go home due to my pain. A customer came in needing a set of 4 tires. I somewhat resisted but decided to gut it out. Halfway through the set I realized I headache was gone. Amazing. Thanks so much for your care and professional expertise."
    Mike
  • "Definitely The Best Experience

    Dr. Silbert is a caring, compassionate and extremely knowledgeable practitioner. My appointments not only relieved my pain but also my mind, as he patiently gave me more insight as to what was really happening in my body. He was very reassuring and confident that he could help my condition. Definitely the best experience I have ever had with anyone in the medical field."
    Kate J.
  • "Active Release Therapy

    I found the staff at this office to be very friendly and helpful. They made me feel like an old friend. Surprisingly I was recommended by an ER doctor for “Active Release Therapy ” on my back and was surprised to learn that Dr. Silbert is the only chiropractor within about an hour drive that does this therapy. It is a slow process and I’ve only had 2 appointments but I would recommend them to anyone. Thank you."
    Cindy R.
  • "My training has resumed my competitive level

    While home training this summer, I began to encounter discomfort while working out. The joints around my knee were giving me pain. My greatest fear was I would have to give up my bobsled racing. A family friend recommended I see Dr. Silbert. After one visit I noticed a difference right away. My body is moving better and my training has resumed my competitive level. The success of my office visits has made my teammates want to see Dr. Silber."
    Valerie S. USA Women Bobsled Team