Carpal Tunnel Syndrome: Compression or Compartment Syndrome?
Carpal tunnel syndrome (CTS) is a condition that results from the compression of the median nerve (a major nerve in our body) as it passes through the carpal tunnel at the wrist, causing wrist pain (Rattray & Ludwig). To distinguish CTS as a compartment syndrome rather than a compression syndrome, we first look at what constitutes a compartment syndrome. According to Porth, a compartment syndrome is the result of increased pressure in a limited space that compromises circulation and threatens the activity and function of the nerves and muscles (Porth & Matfin, 2009). In terms of the structure of the forearm, it is described by Robert B. Salter as where the median nerve and flexor tendons pass through a common tunnel whose rigid walls are formed by the carpal bones and joints and the transverse carpal ligament (flexor retinaculum).
Any disorder that takes up space in this already crowed tunnel compress the most vulnerable structure, the median nerve (Salter, 1999). CTS fits the anatomical and pathological features of a compartment syndrome. Its musculoskeletal boundaries indicate a structural compartment formed by the carpal bones and flexor retinaculum. The symptoms of CTS are consistent with increased pressure compromising function of nerves and muscles in the wrist.
How can carpal tunnel syndrome be reduced and treated?
At the workplace, workers can do on-the-job conditioning, perform stretching exercises, take frequent rest breaks, wear splints to keep wrists straight, and use correct posture and wrist position. Wearing fingerless gloves can help keep hands warm and flexible. Workstations, tools and tool handles, and tasks can be redesigned to enable the worker’s wrist to maintain a natural position during work. Jobs can be rotated among workers. Employers can develop programs in ergonomics, the process of adapting workplace conditions and job demands to the capabilities of workers. However, research has not conclusively shown that these workplace changes prevent the occurrence of carpal tunnel syndrome.
Tatyana Tomachynska, Registered Massage Therapist