When is Carpal Tunnel Not Carpal Tunnel?

There is often the assumption that numbness in the hand is due to carpal tunnel syndrome. However, oftentimes these symptoms can be coming from the neck. A recent patient at my PhysioWorks clinic in Huntsville Alabama showed how important it is to take a thorough examination so that the right treatments are used. I have seen patients who have had surgical treatment to carpal tunnel only to find their pain was unresolved.

[@helicart]

1.
If tendon hypertrophy or inflammation were the main drivers of CTS, then symptoms would be more consistent over 24 hours, which they are not. The overwhelming majority of CTS have neuro symptoms and pain worse during sleep hours. Why so? Because interstitial fluid during awake hours tends to shift to the lower limbs. During sleep hours, that fluid tends to redistribute especially into the upper limbs. The increased fluid in the carpal tunnel puts mechanical pressure on the median nerve. If one gets up from bed and walks around for 15mins+, the symptoms will ease.
Conservative approaches to CTS that physical therapists are typically not taught :
- reduce salt intake to reduce excessive ISF.
- aim for healthy bodyfat %. excess fat is deposited within the carpal tunnel and its contents ectopically.
- avoid pro-inflammatory foods and drinks. inflammation for such contributes to fluid retention and swelling.
- trial a daily 1000 Calorie deficit for a week. This will reduce immunoreactivity to various foods and emotional states.
- do myofascial release along the entire forearm flexor compartment, and the whole path of the median nerve including the palm and fingers. Often there are impingements and adhesions to the median nerve that compromise blood perfusion into and out of the nerve and its sheath.
- do peripheral nerve sliders to facilitate unimpeded nerve movement.
- do distal RUJ, RCJ, intercarpal and inter-metacarpal mobes. These can add some compliance to the carpal tunnel, and thereby reduce sensitivity to elevated ISF ingress.
2.
Having Cx radiculopathy or neuropathy will not give a positive Tinel's or Phalen's. You can prove this to yourself by doing these two tests on all your Cx pathology patients.
It is possible to have CTS and Cx pathology concurrently.

[@jsaldana510]

He's amazing. When you put your thumb and closed your hand and pulled forward what was called. When I did that I felt pain.

[@mikeheistand3824]

Beautiful exsplinantion

[@villanuevaruth21]

👍Thank you , I think I have a neck pain also and a carpal tunnel tendon

[@dariuszkaliszewski1801]

Great video thank you.

[@annehammond9258]

Thankyou I’m trying everything you have to offer,my hands are very sore,had carpal test was told yes I have Carpal,Now I’ll try working on my neck.Certainly would like to avoid surgery..Thankyou

[@WriterK]

I reside in Canada and it has been 2 years I am suffering from all these pain. The terrible orthopedic doctor has not been able yet to discover what really the problem is in my hand. no diagnose, all false may be this and maybe that and finally no treatment. I am 42 year old female and very active always, mentally and physically. I use computer a lot, for work and study so I type a lot. and I exercise as well, I take supplements regularly and I am on intermittent fasting. So overall, I am well health conscious, but I am not a doctor to treat my own physical health!!

[@mikeheistand3824]

I believe this is what I have

[@bmp713]

What does it mean if you have bad numbness and tingling on your thumbs but the nerve study only showed Cubital Tunnel ulnar compression?
I barely have any symptoms on my little fingers but much worse on my thumbs.

[@mgm957]

Great video. Had carpal release in 8/21. Still having symptoms. I've also a c4 - c6 fusion and c6 c7 8/20. Had right arm pain. Carpal on right too. Conduction test affirmed carpal. Also get shoulder pain. Wondering if ive been mis diagnosed for carpal. Prob a good PT would help. In Connecticut.

[@annejamesreliancemortgages6683]

Try looking up a corrective chiropractor. I have been through much the same-two rotator cuff surgeries I wish I'd never had. Now I have had xrays and a thermography at Dr John Bergman's office in Huntington Beach, Ca. Wow. Look him up here, he has 750,000 followers. Finally getting straightened out!

[@TheMargo420]

I too had this problem. I am sure my CP" misdiagnosis" is from my neck. The surgery did damage to my hand.

[@m711214]

I think i have this problem which dr should i goto and which test i can do like MRI etc

[@ilovechrist9780]

What did you do about his neck?

[@bernadettenelson6843]

How do you tx CTS if it’s from the neck?

[@pops1pops178]

Will aemg yesterday ruled out it's not carpeltunnel

[@Jim202030]

This is nice video. I have always been very physically active both with work and my hobbies. Roofer / rockclimber for example. Now.. I am a computer programmer , also bad for wrists lol. I also do a lot of phiso studies pertaining to my personal training and I think a lot of people get these nerve issues in many spots and don't realize they can alleviate the pain with therapy. EVERYONE things they just go take their fat asses to the doctor and have them fix their problems with pills or surgery. When understanding their own bodies and simple treatments would improve their pain instantly and eventually go away completely. I am not saying don't go to a doctor, but maybe try something first. Its all connected. Yea yea.. wall of text.

[@ilovechrist9780]

For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life. - John 3:16 from the Bible 💕💕

[@ShepherdsChapelonYT]

Let's turn to God let's repent and ask for forgiveness,let's study God's word. Theseasonorg explains the whole bible God bless.

[@AlphaGeekgirl]

@@ShepherdsChapelonYT How about let’s not spam people’s TH-cam channels with your religious BS

[@ShepherdsChapelonYT]

@@AlphaGeekgirl I share truth where I'm lead