What is Carpal Tunnel Syndrome with Iyad Salloum

Mark: Hi, it's Mark from Remarkable Speaking. I'm here with Iyad Salloum of Insync Physio in North Burnaby. And we're going to talk about specifically, what is carpal tunnel syndrome. How are you doing Iyad? 

Iyad: Good, Mark. How are you today? 

Mark: Good. So, what is it? 

Iyad: So yeah, carpal tunnel syndrome. It happens to be the most common type of entrapment neuropathy out there. It counts for about 90% we think of all neuropathies, because it's so prevalent in their population. And what it is, it's some form of compression of one of our nerves called a branch of the median nerve that feeds the thumb and of our first three or four fingers, depending on the person. So people will tend to come in presenting with varied symptoms, like tension, numbness, tingling, burning. I usually tell people it's kind of what you would feel when you'd hit your funny bone. Those kinds of symptoms, maybe a little less severe, but it tends to be a little more recurrent and debilitating for some people.

Mark: And what do people typically, if people come in and they think, okay, the back of my hand hurts or it hurts when I do this. Is that carpal tunnel? 

Iyad: So the back of the hand tends to be something else. We have another nerve that supplies the back of the hand. You could have something from the neck that affects both. And that's a different story. This position can compress the carpal tunnel, but then we would for us to have what we think is carpal tunnel, we'd have to have some sort of sensory symptom or even maybe a weakness of the thumb for in the palm area. So that's where we would assess because that's what the nerve that passes through the carpal tunnel will innervate and feed. So backside, you know, it could be related to something else, but it definitely wouldn't present that way with carpal tunnel syndrome.

Mark: And so, you hear it a lot about people using mousing and doing that, is that, are they getting it in here or are they getting in like more of the along, in the forearm? 

Iyad: So you could have stuff in the forearm because your nerves have to travel through here. So that same median nerve has to travel through the front of your forearm. So you could potentially get stuff there from repetitive work. For mousing again, on its own, like, I mean, there's a lot of people who can mouse and not have symptoms. And then there are some who just can't cope with it. So there's some individual variability. You can get that. But this is where I think us being very good at looking at where is this thing coming from?

Is really crucial because you have a lot of people who think they have carpal tunnel, but it's actually somewhere else in the forearm, in the neck and the shoulder, where the nerves is getting sensitized. And they just happened to feel a little extra in the hand. But if it's not kind of more limited to that hand and kind of isolated to testing that we do specifically in the hand. We wouldn't be able to just conclusively say that it's carpal tunnel syndrome because they could feel it there, but it's not coming from there.

Mark: Are there any instances where people are kind of in a specific position of some kind that will cause this carpal tunnel syndrome? 

Iyad: Yeah, you can have a lot of compression. So if you're kind of doing a lot of this, which stretches the transverse carpal ligament on the neural structures and the blood supply of the hand and wrist. You can get some of these sensations. Obviously getting tingling once isn't carpal tunnel syndrome. You would have to get this thing where the nerve and the tissue gets repeatedly sensitized, and then you develop a bit of a, let's call it like a lower threshold to, like you'd need a little less to kind of aggravate your symptoms. And then it comes to the point where it's day to day stuff. Some people will tell you like doing day-to-day stuff like brushing their teeth becomes tough sometimes and gripping and basic things like that.

Some yoga athletes that we've seen who are very, you know, dedicated and do this regularly and hold long, long positions. Yeah it's possible, definitely. But again, it's one of those things where just doing it once or feeling it once it doesn't necessarily mean that you're going to have, or that you have carpal tunnel syndrome, but it's definitely something that we would assess.

That's one of the key things we would look at is what is actually the provocative movement or movements and how do we change or offload that potentially as we take them through a treatment.

Mark: Carpal tunnel syndrome. If you need some expert help, the guys to see in Vancouver or in North Burnaby, are Insync Physio. You can book at insyncphysio.com. Either location. Or you can call them. Vancouver's (604) 566-9716. North Burnaby is (604) 298-4878. Get expert help on your hand issues. Thanks Iyad. 

Iyad: Thanks, Mark.