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Why Tight Muscles Cause Carpal Tunnel Syndrome
By Julie Donnelly, LMT
Our body is a symphony of parts that gives us strength, mobility, and the flexibility to do fine movements such as picking up a pin. We are a perfect design of use, and most of us don't even give it a second thought - until something goes wrong!
This incredible "machine" is driven by a complex, and yet logical design of pulley's & levers, called muscles and tendons.
Every day you call on muscles that allow you to do precision movements, eventually causing repetitive strain on the fibers. This article discusses the muscles that cause carpal tunnel syndrome: hand and wrist pain, and numbness of the thumb and first two fingers. Most people are familiar with the term carpal tunnel syndrome, which is also referred to by the initials "CTS." A basic understanding of the anatomy of the various muscles you use daily is the beginning of preventing, or reversing, this painful condition.
A muscle is a large grouping of individual fibers that all work independently to pull on a tough fiber called a tendon. The tendon has no ability to move on its own and simply connects the muscle to the bone at a specific spot, usually just across a joint. The muscle contracts and pulls on the tendon, which is attached to the bone, making the joint move. Muscles always pull, never push. This is an important concept to understand when one is seeking to find the source of a painful joint.
The next piece to carpal tunnel syndrome is a phenomenon called the gate theory, which is commonly called "the phantom limb". The gate theory was coined during WWII when physicians realized that amputees were suffering pain in limbs that no longer existed. The Gate Theory explains that when a nerve has pressure anywhere along its length, you will have numbness at the endpoint. In the case of the nerves of the neck that go down to your arm and hand, an impingement will cause numbness in your fingers. An impingement on the median nerve will be diagnosed as carpal tunnel syndrome, while tension on the ulnar nerve will be diagnosed as "ulnar neuropathy."
Nerves give the body the ability to have sensation, and they also direct the muscles to contract and release, creating movement. When a nerve is being impinged by any other structure, you will feel tingling or numbness at the end of the nerve. You could even lose strength because the muscle is receiving an incomplete message, similar to the way a poor electrical signal will cause static on your radio. In the case of the hand and wrist, the key is the location of the median nerve which begins in the neck, passes under a tendon in the front of your shoulder, goes down your arm and through your wrist (the carpal tunnel), and ends in your hand.
The median nerve begins in your neck, behind a muscle called scalenes, and this is where the problem starts. The scalenes bring your head down, a movement you do all day long. When you hold your head in the same position for and extended period of time, the muscle actually shortens due to a phenomenon called "muscle memory". When you go to lift your head, the now-shorter muscle will press on the bundle of nerves called the Brachial Plexus and your hand will go numb. This condition is commonly called thoracic outlet syndrome, but it is also one of the key causes of carpal tunnel syndrome.
Your wrists are an amazing piece of engineering, with 8 small bones called carpal bones lying next to each other. The carpal bones, and a ligament that crosses over them like a bridge, create the carpal tunnel of the wrist. The tendons of the flexor muscles, on the underside of your forearm, pass through the tunnel and move your fingers into a fist. The tendons of the extensor muscles, on the upper side of your forearm, attach to the carpal bones on the top of your hand and also to your fingers, enabling you to open your hand from the clenched position. The carpal bones, directed by the pull of various muscles attaching to them, give us the ability to move our wrists in a full circle, bending, turning, and even allowing us to support our weight on our palms! When the nerve is trapped within the carpal tunnel, usually because a muscle is having an impact on the bones or tendons that affect the dimensions of the tunnel, you experience the pain and numbness that is called carpal tunnel syndrome.
The thumb muscle is often totally overlooked by most healthcare practitioners who are treating carpal tunnel syndrome. The muscle, called opponens pollicis originates on the ligament that forms the bridge to the carpal tunnel, and it inserts at the thumb joint. This muscle is responsible for pulling your thumb in toward the center of your palm. However, when it becomes tight, due to repetitive strain injury, it pulls on the ligament and puts direct pressure onto the nerve which is passing through the carpal tunnel.
Tension in the flexors, extensors, and/or opponens pollicis, will cause you to have a false-positive result to a test for carpal tunnel syndrome. You'll be told you have the median nerve is entrapped in the carpal tunnel, and that you need surgery. The nerve is definitely being impinged within the carpal tunnel, however, the key question is "why"! Most physicians don't address the "why", and therefore the muscles are ignored as a possible cause of the problem. Yet, by simply locating the spasms that have formed in the muscles during the repetitive strain, and then releasing the trigger points, relief is immediate. It behooves you to treat each of the muscles before considering surgery. In the vast majority of cases surgery can be avoided, and pain eliminated quickly and easily.
© 2003
Julie Donnelly is a licensed massage therapist specializing in the treatment of chronic pain and sports injuries. She has co–authored several self–treatment books, including "The Pain–Free Triathlete" and "Carpal Tunnel Syndrome–What You Don′t Know CAN Hurt You." She teaches Julstro self–treatment workshops nationwide and is a frequent presenter at Conventions and Seminars. Julie may be contacted through her website: www.julstro.com.
