Tendonitis and Carpal Tunnel Syndrome Explained

I am seeing an increasing number of clients with Tendonitis and Carpal Tunnel Syndrome (CPS) so I thought I would post on this subject since seeking treatment through conventional pathways can be frustrating and often unproductive.

The first question to ask is: why are these conditions becoming more commonplace?  Tendonitis (inflammation of the tendon causing pain and swelling) or “tennis elbow” typically results when a tendon becomes tight and inflamed due to overuse.  Simple, right? Not necessarily.  These nerve compression conditions can result from tension or overuse and can be exasperated by even relatively mild neck and shoulder conditions.  Tendons and nerves in the extremities or in the peripheral joints (the elbow) become more vulnerable when the neck and shoulder are tense or when the brachial nerve complex (nerves that exit through the shoulder) becomes partially impinged – common with rounded shoulder posture and/or repetitive arm/shoulder movements. Electronic devices, desk work, occupations that require repetitive hand/arm/shoulder movement all contribute to rounded shoulder postures and neck/shoulder tension in general. Perhaps it is no surprise that with the increase in the use of electronic devices and texting that there is an increase in these conditions.  Even a history of whiplash or cervical trauma can play a role in tendonitis or CPS.  This is because the extremity portion of the nerve can lose its blood supply and nutrients and become more susceptible to injury and compression – a condition termed “Double Crush Syndrome” or “Multiple Crush Syndrome”. Multiple Crush Syndrome is now thought to be a causative factor in the majority of CPS and tendonitis cases (See the PubMed abstract below for a quick reference). Tense muscles in and around the joints can also overload joints (such as common with the thumb or elbow) leading to arthritis and a great deal of pain.  Many of these conditions are avoidable and can be managed with precise soft tissue manipulation on affected tissue.

Anti-inflammatory medications, cortisone injections and then surgery are the standard medical recommendations for  tendonitis/tendonosis (“tennis elbow”;) and Carpal Tunnel Syndrome with usually little or no mention of therapeutic massage or soft tissue manipulation as a treatment option.  None of these treatments address soft tissue dysfunction – a primary cause for the vast majority of these conditions. Many hand/finger/wrist conditions get thrown into this condition category without specific identification or investigation of root causes. For example, a cortisone injection may address symptoms only, and only if that pain is actually caused by inflammation.  In many cases, inflammation is not even a factor.  Severe pain often exists without actual inflammation. Furthermore, injections and surgery while sometimes effective temporarily, can leave scar tissue causing even more nerve or tissue damage and more pain in the weeks, months or years following surgery.  Unfortunately, I usually end up seeing clients weeks or months after they’ve seen doctors or physical therapists or following surgeries -many of which provide temporary results or produce other problems in the nearby nerves or tissues due to surgical scarring.

The good news is that these conditions are very easy to treat by an appropriately trained massage therapist or bodyworker. Look for a therapist with specific clinical training in rehabilitative or therapeutic massage. Substantial pain relief is typically realized in the initial session.  The source of the pain can often be traced up the arm, shoulder, neck or all three and unhealthy tissue can be addressed directly and the area will heal permanently. If caught early, treatment can be in as few as 1-3 sessions.  More severe cases may take 6 sessions or more.  Even in severe cases clients are usually able to resume their daily work activities during the treatment.  It would seem that this is a much better deal than being out of commission entirely following surgery for 6-8 weeks with no guarantee of permanent relief. Unless of course you really would LIKE to be out of commission entirely 🙂

Interested in learning more? For a scientific peer-reviewed article abstract explaining why surgical treatment may not relieve symptoms, go to this link:

Caroli’s disease: an ultrasonic diagnosis