The early symptoms associated with carpal tunnel syndrome (CTS) are often easy to overlook or ignore because they don’t interfere too much with one’s ability to carry out their daily activities. As such, many people don’t consider it worthwhile to take the time to make and attend a doctor appointment to deal with the issue. In fact, many individuals with CTS wait months or even years before seeking care when their symptoms become too activating, limiting, and bothersome to ignore. But what if there was a way to figure out if those small complaints were indicative of early CTS from the comfort of home?
In a 2019 study, researchers evaluated the hand movements of 22 CTS patients (seven with CTS in both wrists) and 11 age-matched controls in search of simple diagnostics that could be performed outside of a clinical setting. Investigators ended up focusing on the movement of the thumb as it moved through its full range of motion.
Researchers found that the thumbs of CTS patients moved significantly slower in certain directions when compared to those without CTS. This criterion was consistent in 27 of the 29 CTS-positive wrists, a 93% sensitivity, with a 73% specificity in the non-CTS wrists.
The researchers are using this data to program a mobile app that can be used by individuals outside of a clinical setting determine if their early symptoms warrant contacting their healthcare provider for further examination. The app can also be used in workplace settings to identify workers who may be at increased risk for CTS so that preventative measures can be taken (such as changes in ergonomics, tools, or work processes).
Perhaps the most important benefit from an app that helps identify CTS patients early on is that the condition is much easier to treat when the symptoms are mild. When a patient delays care, secondary issues can manifest, scar tissue can form, and associated soft tissues can weaken. If a patient waits too long, a full recovery may not be possible, even with surgery, and they might have to learn to live with ongoing and life-limiting symptoms.
Doctors of chiropractic are trained to diagnose and manage CTS, often with a combination of manual therapies, specific exercises, anti-inflammatory recommendations (ice and nutritional), nocturnal splinting, and ergonomic modifications. They will also check elsewhere along the course of the median nerve to make sure there are no issues in the neck, shoulder, elbow, or forearm that may contribute to the patient’s CTS symptoms. If non-musculoskeletal causes are suspected, the patient may be referred to a specialist or their medical physician for additional care.
