Davenport Chiropractor, Dr. Clay, has prepared a short slide show presentation on some causes of carpal tunnel syndrome and the treatments for it. For more information, please visit http://familycarechiropracticdavenport.com

1. Causes, Symptoms, & Treatments
Presented by:
Dr. Clay Kuethe

2. Carpal Tunnel (An Overview)
 Where is the Carpal Tunnel?
 The Carpal Tunnel is in your
wrist.
 It is made up of the carpal
bones and the flexor
retinaculum (transverse
carpal ligament).
 Pneumonic for carpal bones
 Some Lover’s Try Positions
That They Can’t HandleCarpal Bones

3. Carpal Bones
 Scaphoid
 Lunate
 Triquetrum
 Pisiform
 Trapezium
 Trapezoid
 Capitate
 Hamate

4. What Is In The Carpal Tunnel?
 The median nerve which
is the nerve supply for
the palm side of your
hand.
 The flexor tendons of the
muscles that flex your
wrist, hand, and fingers.
 Sometimes, arteries and
veins that supply the
hand.

5. Some Symptoms of Carpal Tunnel
Syndrome
 Numbness, tingling, and/or pain in the
thumb, pointer finger, middle finger, and half of
the ring finger.
 Usually no pain in the palm, sensory nerve given
off before entering the carpal tunnel
 Weakness or clumsiness in gripping
 Atrophy of the thenar eminence
 Pain in the wrist, forearm, elbow, or shoulder.
 Fingers turning purple
 Symptoms can be relieved temporarily by shaking
the hands, putting in hot water, or resting them.

6. Some Tests to Check for Carpal
Tunnel Syndrome
 Tinel’s sign: Involves
tapping over the carpal
tunnel to elicit
numbness or tingling in
the fingers(between
60%-80% effective)
 Phalen’s test: Pressing
the backs of the hands
together to elicit
symptoms (between
49%-64% effective)
 Reverse Phalen’s:
Pressing the palms of the
hands together (between
49%-64% effective)
 Pressure Provocative
Test: Putting direct
pressure over the carpal
tunnel to elicit
symptoms (100%
effective)

7. Causes of Carpal Tunnel Syndrome
 Women are actually 3
times more likely to have
symptoms of carpal tunnel
syndrome.
 Most often a result of a
person’s occupation.
 Activities requiring
continual use of the hands
 Repetitive motions using
force
 Prolonged flexion or
extension of the wrist
 Gripping
 Pressure over the palm
 Trauma
 Fractures
 Vibration
 Examples: data-entry, meat
cutters, assembly, construc
tion workers, and
musicians

8. How Do These Activities Cause
Carpal Tunnel Syndrome?
 Excess or strained
movement, such as
typing, mouse
use, assembly line
movements.
 Micro-bruises can form
along these tendons if
overused and as they
heal, scar tissue can form.
 Scar tissue forms in an
attempt to help stabilize an
area.

9. How Do These Activities Cause
Carpal Tunnel Syndrome? (cont)
 Scar tissue will connect
structures together, such
as tendons, in order to
give them stability
 The median nerve can
also become entrapped
when scar tissue forms
 This restricts the normal
movement of the nerve
in the carpal tunnel
 This results in more
pulling and tugging on
the nerve, which causes
inflammation.
 Inflammation irritates
the nerve and can also
draw fluid to the
area, causing swelling.
 Scar tissue formation can
also cause the nerve to
be compressed

10. What Else Could It Be?
 C6 or C7 nerve root
lesion (Subluxation)
 Disc disease of the
cervical spine
 Pronator Teres
Syndrome
 Cubital Tunnel
Syndrome
 Tunnel of Guyon
Syndrome
 Radial Tunnel Syndrome
 Posterior Interosseous
Nerve Syndrome
 Carpal Subluxation

11. C6 or C7 Nerve Root Lesion(Subluxation) &
Cervical Discogenic Disease
 Subluxation of either the
C6 or C7 vertebra can
cause inflammation at
the nerve root, which
can cause neuropathy in
the median nerve
 Will often have radiating
pain down the
arm, which may be
relieved by distraction of
the cervical vertebrae C6/C7
foramen
C6
C7

12. Pronator Teres Syndrome
 The median nerve is
compressed before it
reaches the carpal tunnel
in between the two
heads of the pronator
teres.
 Pain when pronating
flexed wrist against
resistance.
 Sensations in the palm
may be reduced.

13. Cubital Tunnel Syndrome
 The ulnar nerve becomes
trapped on the medial
side of the elbow.
 This can cause pain and
sensory deficits in the
ulnar nerve distribution
of the hand.
 The medial half of the
palm and 5th and the
medial half of the 4th
digit.

14. Tunnel of Guyon Syndrome
 Tunnel where ulnar
nerve and artery cross
the wrist into the hand.
 Hypothenar wasting and
sensory deficits in the
highlighted area.
 May also be the artery
becoming compressed
and causing sensory
losses.

15. Radial Tunnel Syndrome
 Entrapment of the radial
nerve in the lateral
aspect of the elbow.
 Pain with elbow flexion
of elbow and pronation
of wrist.
 Radial nerve supplies the
posterior aspect of the
hand and extensor
musculature of the
forearm.

16. Posterior Interosseous Nerve
Syndrome
 Entrapment of the motor
branch of the radial
nerve.
 Wrist extension will be
weak.
 Pain with forceful wrist
extension.

17. How Do You Treat It?
 Chiropractic
adjustments if the main
cause is cervical
degenerative disease or
subluxation.
 Chiropractic
adjustments of the
shoulder, elbow, or wrist
if there is a subluxation
of these areas.
 Myofascial release if the
cause is muscular or
connective tissue in
nature.
 Anti-inflammatory
medication to reduce
swelling and
inflammation.
 Surgery as a last option
to relieve pressure in the
carpal tunnel.

18. Have Questions? Just Call or Send
an E-mail
 516 W. 35th St.
 Davenport, IA 52806
 Phone: 563-388-6364
 E-mail: drclay@familycarechiropracticdavenport.com
 familycarechiropracticdavenport.com
 facebook.com/FamilyCareChiropractic1
 Twitter: @Davenportchiro