Carpal Tunnel Mistakenly Diagnosed Thoracic Syndrome Sioux City

Carpal Tunnel Mistakenly Diagnosed Thoracic Syndrome Sioux City

Thoracic outlet syndrome is often confused with carpal tunnel syndrome, even though it has significantly different symptoms. Society has become very aware of carpal tunnel; ”¬†a condition which produces pain, numbness, and tingling in the thumb, index, and middle finger¬†“. People suffering from carpal tunnel often describe weakness with repetitive hand activity. Clumsiness can develop when performing fine movements such as knitting, typing, sewing, writing, or painting. The pain or numbness gets worse with continued activity, but improves with rest.

 

 

Nerves in hand - median and ulnar nerve

Median and ulnar nerves in the hand. The nerves start in the neck and run down to the hand.

Carpal tunnel is an entrapment of the median nerve, and can occur anywhere from the wrist to the elbow or shoulder. It can also be as a result of a disc herniation or arthritis compressing nerves as they leave the spinal cord. Compressing a very specific nerve produces symptoms in its path. The median nerve helps control sensation and strength in the thumb and index and middle fingers; this is why we see symptoms in these fingers.

 

Thoracic outlet syndrome is a compression of the artery or nerve bundle as it cuts under the pectoralis minor muscle near the shoulder. Compressing the artery or nerve bundle at this location causes symptoms in the thumb and all the fingers. It does feel similar to carpal tunnel in the sense that sufferers can experience pain, numbness, tingling, or weakness in their hands with activity, especially during repetitive or fine intricate movements. It tends to get worse when the hands are utilized above the head for prolonged periods of time. Thoracic outlet syndrome is often improved with rest and by avoiding activities which aggravate the condition.

 

Carpal tunnel, ulnar tunnel, and TOS

Carpal tunnel causes pain, numbness, tingling, weakness or burning in the thumb and next two fingers. While ulnar nerve entrapments cause those symptoms in the little and ring finger. Thoracic Outlet Syndrome affects the whole hand.

The major difference that people should notice is that thoracic outlet syndrome will affect all the fingers and thumb; whereas carpal tunnel will only affect the thumb, index, and middle finger. During an examination we will go through a series of tests differentiate between carpal tunnel and thoracic outlet syndrome. These tests will help us identify a carpal tunnel compression at the wrist, elbow, shoulder, or neck. The tests identify a cubital tunnel or ulnar nerve entrapment which produces numbness and tingling in the little and ring finger. Alternately, by reproducing symptoms in the entire hand with specific tests, we may identify a thoracic outlet syndrome entrapment at the pectoralis minor muscles,

 

Once a correct diagnosis is obtained, specific treatment plans can be given for carpal tunnel syndrome from the wrist, carpal tunnel from the elbow, carpal tunnel from the shoulder, cubital tunnel syndrome, thoracic outlet syndrome from pectoralis minor compression, scalene syndrome, or cervical disc herniations. Each of these types of injury has a distinct cause, and specific treatments to which it best responds.

 

It is not uncommon for a person to initially believe they have carpal tunnel syndrome because of the information provided to the public through news reports and other media. However, the location of symptoms in the little and ring fingers should help a patient realize that they are experiencing a different injury and need a different type of treatment.

 

Links

Carpal Tunnel From The Elbow
Cubital Tunnel Syndrome
Cervical Disc Herniation
Elbow, Wrist and Hand Pain Conditions