We’ve all been there. You’re typing away on your laptop, phone, or tablet and suddenly your wrists feel a little sore. You might even feel a shooting pain up your arms. Or maybe you notice that your hands are starting to tingle or go numb. Welcome to the world of tech wrist – a condition that’s becoming increasingly common as more and more of us spend our days glued to our screens.
One of the most common reasons people have wrist and arthritic pain is because of all the typing we constantly do in our lives. Dr. Danesh likes to call it the “Tech Wrist” – the constant typing and use of our hands which will consequently mean we have a higher propensity towards carpal tunnel syndrome.
Most physicians would say it’s because of compression of a nerve called the median nerve through the carpal canal – a canal that runs through our wrists. It’s covered by a thick band of fibrous tissue called the retinaculum. The next layer in will be the nerves, tendons, and blood vessels. The next layer is the carpal bones, somehow looking like a cluster of pebbles that make up your wrist joint.
Using a special ultrasound, we see all of those structures and figure out why somebody has numbness in their hand because it’s not always compression of that carpal nerve.
There are three reasons why you can get hand or wrist numbness. They’re not all related to carpal tunnel syndrome.
What is carpal tunnel?
The median nerve is sandwiched between a group of muscles in the upper part of the wrist. When we move our fingers, all those muscles are contract, but the median nerve running right through the center stays as is.
You can look at the nerve in two directions through ultrasound:
If we follow the nerve down, we can see how it comes up closer to the surface. But when it gets to the carpal tunnel, it flattens out and runs over all these tendons. We can distinguish the tendons by moving the ultrasound probe and we can see how it almost looks like the tendons are shiny as they should be inside the body.
Moving our fingers, the median nerve freely moving within the carpal tunnel is one that doesn’t really have any entrapments.
The retinaculum is what makes up the carpal tunnel. As we age, this fibrous sheath can thicken and start to create a compression of the median nerve within the canal all the way to a point where that nerve can then get entrapped. This becomes the first cause of carpal tunnel syndrome.
The second cause is a swelling of the median nerve, even if it was not getting irritated or entrapped by the retinaculum.
If we look at the median nerve at a cross-section angle. it has a certain width to it. It’s not the same size for everybody but it has to be a consistent, evenly-spaced nerve throughout the diameter. This means the nerve has no areas of swelling or edema. If the area of a nerve goes from 0.25cm to 0.50cm, it means that there has been some kind of irritation or entrapment for a long time that has caused the nerve to swell.
Now, every time the median nerve has to move in and out of the canal, it’s going to get trapped. People who have that kind of carpal tunnel, they’ll feel like zingers every time they move their wrists. It will feel like a little jolt of pain or numbness that goes through their hand.
The most common cause of carpal tunnel symptoms is the tech wrist. People are moving their hands all over the place.
The “bag of pebbles” (wrist bones) which makes up our wrist is in a dependent position and the ligaments have gotten loose, every time you move your fingers, your gravity is working to pull those pebbles downward. Eventually, where they’re going to sit is right on top of the median nerve. Those situations at carpal tunnel release where they come in and they cut the retinaculum that runs over the wrist, can be counterproductive.
Initially, people get better because it’s just released some of the tension on the nerve. However, over time, that destabilizes the carpal bones even more. Moreover, those pebbles will continue to be flexing in and out and constantly be compressing the nerve and causing irritation.
That’s why those carpal symptoms can wax and wane, and get better and worse. This has to do with the positioning of the bones in the wrist.
There are a few things you can do to fix your carpal tunnel. You could go to a chiropractor, an osteopath, or a physical therapist who does osteopathic manipulation. This will put your bones back into place. However, this is not a long-term solution. The long-term solution is to do some rehab that will stabilize your carpal bones, or even use an ortho biologic to glue the bones back in place.
If the cause of the carpal tunnel is a thickening of the retinaculum, injections around the retinaculum can help to release it. If the cause is a swollen median nerve, giving injections around the site of a swollen nerve will help reduce inflammation and pain.
For carpal tunnel’s three main causes: thickened retinaculum, swollen median nerve, and carpal bone instability, we’re here to help you find relief from your symptoms. For more information on these topics or any others related to hand and wrist pain. check out Wellwardmed’s podcast where we just did a little bit more in-depth discussion. You can listen online at iHeart Median, Spotify, and iTunes.
We hope you’ve found this post helpful. If you are experiencing any of the symptoms we talked about, please don’t hesitate to reach out for help. You can schedule a discovery call with us by clicking the button below and one of our experts will be happy to chat with you about your specific situation and recommend the best course of treatment for you. Thanks for reading!
If you’re experiencing any hand or wrist pain, please don’t hesitate to reach out for help. We’d be happy to chat with you and see how we can best support you in finding relief. Schedule a discovery call with us today. During this call, we can discuss your symptoms in more detail and come up with a plan tailored specifically for you.
If you haven’t joined our Private Facebook Group, please go HERE.
DISCLAIMER: The information in this email is not intended nor implied to be a substitute for professional medical advice, diagnosis, or treatment. All content is for general informational purposes only and does not replace a consultation with your own doctor/health professional