Carpal Tunnel? Not Necessarily…

I had a client come in once who told me she had Carpal Tunnel Syndrome. While I was discussing her medical history with her, I discovered her doctor diagnosed her based on the numbness she felt in her left hand. However, the doctor did not perform any specific tests to determine the site of her nerve impingement..

I decided it would be best to “explore” her muscles and nerve passageways to see if I could find where the nerve signals to her hand were being interrupted. I started with the muscles on the left side of her neck. As I worked to ease the tension I felt in those muscles, I noticed the client lift her hand and touch her thumb to each of her fingers.

“Am I making the numbness worse,” I asked her.

“No, the opposite,” she said. “I have feeling in my fingers again. I haven’t been able to feel my fingers for two years!”

In my 9 years of experience as an LMT, I have seen a number of cases just like the one I described above. Often, I do run across a client who truly has CTS. But just as frequently, I see people who insist they have carpal tunnel issues and we find the impingement somewhere other than their wrist.

The nerves that control your hands and fingers branch off from a network of nerves called the brachial plexus. As the brachial plexus nerves travel from their origin near the vertebrae in the neck to the fingertips, they pass through, under, and in between a number of structures in the body. These include the following:

1. Scalene Muscles—these muscles run from the side of the neck vertebrae    down to the first and second ribs. They resemble the guide-ropes that             support a camping tent. (To feel them yourself, touch the side of your neck             with your fingertips and rub firmly back and forth. If you feel something like      taught bungee cords beneath the skin, you have found your scalenes.) If these          muscles get tight, they can pinch the brachial plexus as it passes in between,        thus interrupting the signal to the fingers.

2. The clavicle and ribs—the nerves of the brachial plexus pass under the     collarbone, between it and the ribcage. Some posture issues can pull the           clavicle closer to the ribcage, thus entrapping the nerves that run through the            narrow space. (In my experience, this is not very common, but it is possible.)

3. Pectoral Muscles and ribs—one of the deepest muscles of the chest            (pectoralis minor) attaches to the 3rd-5th ribs and a point of the shoulder    blade that protrudes to the front of the body. If this muscle is tight, it presses     the nerves running deep to it against the ribs.

4. The Cubital Tunnel—if you have ever struck your “funny bone,” then you know where this place is. At the elbow, you can feel two bumps. One is the        point of your elbow, the other is a bump that protrudes from the medial side      of the arm. The space between these two bumps is the cubital tunnel, another          passageway for nerves. Inflammation of this area can lead to congestion,       which will affect the nerves at this point.

5. The Carpal Tunnel—finally, we can discuss the carpal tunnel, which is the space formed by a ligament that crosses the palm side of the wrist, and the            archway formed by eight tiny bones called the carpals. Not only do nerves      pass through this space, but so do many tendons of forearm muscles that             attach to bones in the hand and fingers. So, there’s not a lot of extra space    within the tunnel. If inflammation occurs and the sheaths that surround the             tendons become congested, it can place pressure on the nerves, resulting in           true carpal tunnel syndrome.

As you can see, there are many places along the nerve pathways where an impingement may present as numbness/tingling farther down the line. You’re probably thinking, “okay, that’s how the problem happens…how can it be fixed?” Massage therapy is able to release tension in the surrounding muscles and reduce inflammation of soft tissue. However, the more training the therapist has the better they will be able to assess and treat the ailment by addressing specific components of the problem. I always encourage clients, to seek out well-trained, knowledgeable therapists for specific problems like the one I have described in this post.

So, if you are having issues with your hands and fingers, please get in touch with me and we will determine if massage therapy is a good option for you. If you’re reading this blog from somewhere else in the country, I can help you find a reputable therapist in your area.

–Robin


Robin Faux, LMT (NM lic. 5600) has been practicing and studying massage therapy for more than 10 years. She has a degree in Integrative Medical Massage Therapy and has numerous certifications in techniques designed to relieve pain for her clients. When not massaging, Robin teaches anatomy and physiology to massage therapy students at MTTI in Las Cruces. If you want to get in touch with her, please call 719-650-9349 or email her at rfauxlmt@yahoo.com.