Carpel Tunnel Syndrome & Nerve Entrapment

I see plenty of clients in my practice who have wasted weeks, months or years getting the wrong treatment and diagnosis for their hand pain or numbness. Many find themselves seeing multiple medical specialists, getting injections and sometimes wasting time undergoing unproductive Physical Therapy Treatment while their pain stays constant or worsens.  All too often people diagnosed with Carpal Tunnel Syndrome (CTS) have surgery only to find that their symptoms have not improved or they return a few years after the surgery.


One reason for this is a phenomenon known as “Pseudo-Carpal Tunnel Syndrome.” Another is “Double Crush Syndrome.” Both are reversible soft tissue imbalances easily treated with myofascial release and a well planned orthopedic structural massage session.  What is a soft tissue imbalance?  It’s when muscles, tendons, ligaments and fascia on one part of the body (or arm or neck in this case) begin to get overworked while another opposing group of muscles gets weakened and unhealthy.  This imbalance can put undue pressure on joint structures and nerves ultimately cutting off blood supply to a nerve causeing pain, tingling or numbness.  These types of soft tissue imbalances can occur anywhere in the body.



Pseudo-CTS happens when other muscles are tight along the arm, neck, or chest on the same side as the symptomatic wrist. A tight pronator teres, a muscle located near the elbow, can affect the median nerve, causing neurological symptoms in the wrist. So can the scalenes, a muscle group found on the front side of the neck. So can the pectoralis minor, located deep to the pectoralis major in the chest.  When tight, any of these muscles can clamp down on the median nerve or the brachial plexus, a nerve bundle that supplies the median nerve.  The client or patient may never actually feel pain in these areas, which complicates the diagnosis.


In the case of Double Crush, there may be a minimal impingement to the median nerve at the wrist, but sometimes not enough to create symptoms if only that one structure is involved. But add to this imbalance a tight pectoralis minor, or scalenes, or pronator teres, and that nerve is now crushed at two locations (hence the name “Double Crush”), creating enough impingement on the nerve to now create symptoms in the wrist. Take the pressure off one of these other structures, and the wrist is often no longer symptomatic. And after a course 4-8 Structural Massage sessions, surgery is often not necessary.  Some milder cases can be addressed with as few as 3 treatments.

Because medical specialists are trained to focus on the area of complaint, they rarely investigate other non-symptomatic but causative structures, often leading to misdiagnosis and unfortunately, sometimes unnecessary surgery. Few will suggest soft tissue manipulation (massage) and even fewer are connected to well trained therapists that can treat their patients.