Carpal Tunnel Syndrome Swelling - A Secondary Effect

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Swelling of structures within the carpal tunnel is usually a secondary effect of the nine flexor tendons and median nerve having to glide through the carpal tunnel which has decreased in size, causing friction and resulting in the irritation and swelling of the soft tissue structures within.

Computers and Carpal Tunnel Syndrome


How does the carpal tunnel decrease in size? The thenar eminence, hypothenar
eminence and palmaris longus muscle (Also palmar fascia from the palmaris longus muscle covering the anterior portion of the hand) which runs over the TOP of the carpal ligament, plus the flexor muscles of the forearm which tendons run through the carpal tunnel, become overly short and tight, compressing the carpal ligament from above and within as well as pulling the carpal bones inward causing the carpal tunnel to become smaller and impinging the median nerve. The carpal tunnel cannot expand due to the fact that the carpal ligament does not expand, therefore keeping the carpal tunnel from actually becoming larger, or the hand from folding in half lengthwise, as if you were touching the backside of the little finger and thumb regions together. Leaving the carpal ligament in place is also important in order to keep the flexor tendons from "bowing" and is used as a fulcrum point for leverage as it is necessary for a strong grip.

   
Because the finger and wrist flexor and finger adductor groups are exercised on a daily basis with virtually every activity we perform, they become stronger, shorter and tighter, thus causing the carpal bones to shift inward, collapsing the carpal tunnel and making it smaller. As daily hand motions are continually performed with the carpal tunnel now reduced in size, the result is increased friction of the nine flexor tendons and median nerve within the carpal tunnel. And what does friction cause? Irritation and swelling to the soft tissues within the carpal tunnel. This is why surgeons severe the carpal ligament, making more room for the flexor tendons and median nerve. If the carpal tunnel is returned back to its original size by lengthening the short, tight flexors and strengthening the weak, extensors, the carpal tunnel is returned to its original state, the friction and swelling is eliminated and the symptoms disappear.

Now, if the carpal tunnel is not collapsing on itself, then what would cause the narrowing of the carpal tunnel and related swelling? The carpal bones could be growing larger, but they are not. (Unless some form of bone disease is present.) Maybe the flexor tendons are becoming thicker and are causing the decreased space within the carpal tunnel, and the carpal tunnel really isn't collapsing? This would not fit most cases, but is possible. So, to correct tendons and their sheaths which have become thickened, it would still be suggested to perform active and passive stretches in order to elongate the hands flexor / adductor tendons, making the tendons thinner and therefore increasing space within the carpal tunnel, and again, to strengthen the extensors/abductors in order to shorten them and pick up the slack created by lengthening the flexor / adductor muscles.

Either way, performing active stretches to the finger and wrist flexors and finger adductors and performing active carpal tunnel exercises for the finger and wrist extensors and finger abductors will help correct instances relating to the primary cause of swelling caused by friction within the carpal tunnel, whether the space within the carpal tunnel has reduced in size because it is collapsing or whether the tendons and their sheaths have become thicker.

Author: Mr. Anliker is a Therapist and Inventor of Therapeutic Exercise Products that are utilized by Corporations, Consumers and Medical Facilities around the world for the prevention and rehabilitation of repetitive strain injuries.