Chronic wrist pain is one of the most common reasons for missed work and disability, following close behind lower back pain. About three times as many women are affected by wrist pain as men. It is generally noticed in the dominant hand first, with tingling, itching, numbness, or pain, and can develop in both. The hand or fingers may feel weak or useless.

Carpal tunnel syndrome develops when the median nerve, which runs through forearm into the hand, gets compressed into the carpal tunnel. The carpal tunnel is a narrow opening in the wrist made by bones, ligaments, nerves, tendons, and blood vessels. Some people naturally have smaller carpal tunnels, which may lead to the compression of that median nerve, and other people may suffer from injury and inflammation due to repetitive motions, arthritis, diabetes, hypothyroidism, fluid retention due to menopause or pregnancy, or poor ergonomics in the work environment. The median nerve has its origin in the cervical spine, so issues with the neck may manifest in the wrist or hand. Whatever the reason, carpal tunnel is painful and disruptive to daily life.

The American Chiropractic Association offers these tips on preventing carpal tunnel syndrome:

• Perform on the job conditioning, such as stretching and light exercises.

• Take frequent rest breaks.

• Wear splints to help keep the wrists straight.

• Wear fingerless gloves to help keep the hands warm and flexible.

• Use correct posture and wrist position.

• Try to rotate through jobs in the workplace to minimize repetitive motion stress, and see if your employer has or can develop an ergonomic work situation.

If you have already detected numbness or tingling in your hands, especially the thumb and first three fingers, see your chiropractor for treatment. Initial treatment may include cold packs to reduce swelling, resting the injured wrist, using splints to stabilize the wrist, and taking a break from the activities that caused the injury. Longer term treatments can include chiropractic joint manipulation and mobilization, stretching and strengthening exercises, and soft-tissue therapies. In some extreme cases, surgery may be advised to free the compressed nerve, but most chiropractors will only recommend that if more conservative measures have failed to improve symptoms. There are some studies that demonstrate that conservative care, including chiropractic manipulation, is as effective or more effective than surgery or steroid treatments.

Carpal tunnel syndrome can be difficult to diagnose, since some neuropathy in the hands can result from other causes. To diagnose carpal tunnel, Tinel’s sign (tapping the median nerve in the wrist to produce tingling in the fingers), Phalen’s test (a wrist flexion test to see how quickly a patient reports numbness or tingling in the fingers), x-rays or ultrasound, or electromyography (to see how well the median nerve is conducting information) can be used.

With care and treatment, pain from carpal tunnel syndrome can be managed, and function and mobility restored.

Exercises to maintain flexibility and mobility of the wrist and hand and to increase grip strength are increasingly important as people age, and will help minimize injuries to the wrists and hands as well. Your chiropractor can recommend a set of daily exercises that will help maintain the function of your hands and wrists as you age.