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 Carpal Tunnel is a very common condition and can be very debilitating. The problem with carpal tunnel is the primary problem is not usually the wrist, but the wrist is usually what receives the most attention. That may sound strange, but it’s not hard to understand when you understand what is usually going on.


 Carpal Tunnel is most commonly attributed to repetitive micro trauma in jobs involving the hands like being a typist, doing computer work or being a cashier. While this is true, not everyone who does the same activities gets Carpal Tunnel, which leads to the obvious question why? Why do some people get the condition and others don’t?


 To answer that question you need to understand that Carpal Tunnel syndrome is rarely primary (an actual wrist problem) it is nearly always secondary to a weakened median nerve somewhere along it's course proximally (further up towards the spine). Approximately 95% of Carpal Tunnels are what is known in Chiropractic circles as a double crush phenomenon. The primary problem is actually along the course of the median nerve further up the arm but more typically in the neck. The primary or first lesion could be subluxations in the neck, one of several types of thoracic outlets syndromes, peripheral neuropathies or even elbow injuries. These conditions exist proximal to the wrist and weaken the median nerve before it ever enters the carpal tunnel at the wrist. This is the reason some individuals get Carpal Tunnel and others don’t. In an individual with strong fully functioning median nerves, the damage and or irritation that can occur inside the carpal tunnel with repetitive micro traumas is easily managed as the body observes, repairs and maintains itself.  However, in the individual with subluxations in the neck, TOS, peripheral neuropathies, elbow injuries etc, the weaken median nerve can't send or receive vital neural information properly. The result, normal wear and tear goes UN-repaired, the inflammatory process ensues and carpal tunnel develops. 


 If you suffer from Carpal Tunnel you should perform the Tinel sign just proximal to the Carpal Tunnel and again at the elbow along the course of the Ulnar nerve, (please click video link).                     The Tinel sign should reproduce or aggravate the symptoms of Carpal Tunnel at the wrist only if it is in fact a primary condition (normally cause by a subluxation of a carpal bone in the wrist). However, if Tinel sign also reproduces symptoms when preformed at your elbow into your wrist, you are certainly dealing with a double crush phenomenon which is affecting a significant part of your brachial plexus. The primary lesion will need to be addressed or the Carpal Tunnel syndrome has little chance of improving and could lead to significant disability or in far too many cases, unnecessary surgeries.


The standard medical approach does not address the mechanical nature of this syndrome in either the primary and double crush forms. Due to this, I make the following recommendation. In both primary and double crush phenomenon Carpal Tunnel cases a Chiropractor is the right choice as your primary care physician. If your case is not complicated by A/P issues, most Chiropractors have a high success rate . If it is complicated by A/P issues, seek a Chiropractor who does regional work.


            99 % of carpal tunnel cases should never see in inside of a surgical room.

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