Carpal tunnel syndrome occurs when the median nerve gets trapped in the carpal tunnel - a specific space (a tunnel) in the wrist which houses the median nerve and several tendons. The median nerve sends sensation to CERTAIN fingers in the hand (see picture). If your pain/numbness/tingling is in other areas (for example, the whole hand) then the nerve is almost positively being irritated somewhere else! Thus, treating you for "carpal tunnel syndrome" probably won't do the trick. In most instances the nerve is being irritated in the neck; in rare instances the nerve could also be getting pinched in the shoulder area. You don't need to have neck or shoulder pain for this to be the case. In many patients, the only symptom they have from a pinched nerve in the neck is pain or tingling somewhere else in the arm or hand. As with any issue, it's extremely important to diagnose the problem correctly. Then you get to the work of treating it correctly!
The musculoskeletal system is comprised of bones, muscles, and all the tissues that support them, such as ligaments and cartilage. This system works closely with the body's other systems, of course – especially with the nervous system which directs movement of these tissues. How well our muscles, bones, etc. function is related to myriad factors; nutrition, genetics, and weight are three examples among many. Excess weight on a person's frame is one factor that can have negative effects on the musculoskeletal system.
A 2008 article in the International Journal of Obesity entitled "The impact of obesity on the musculoskeletal system" highlights nine musculoskeletal conditions associated with obesity: osteoarthirits (knee, hip, hand), low back pain, diffuse idiopathic skeletal hyperostosis, gait disturbance, soft tissue conditions (for example, carpal tunnel syndrome, plantar fasciitis), osteoporosis, gout, fibromyalgia, and connective tissue disorders (rheumatoid arthritis).
Evidence of obesity's correlation with knee osteoarthritis is strong. A hallmark of osteoarthritis (also known as arthritis) is degeneration of joint cartilage. As more body weight is placed through the joint, it makes sense that it is more likely for the padding (the cartilage) to wear down. If this degeneration creates extra pain when weightbearing, the person is then less likely to perform activities on his or her feet. Thus a viscous circle is at work since weightbearing movement is essential for good musculoskeletal health.
Third on their list is gait (walking) disturbance. It is apparent even to the untrained eye that obesity causes alterations in one's walking pattern. One example is at the hip joint. With extra fat on the thighs, a person's legs are forced outwards, creating a "waddling" gait. As a result, the knee and ankle no longer move under the hip in a vertical, stacked line as they should. When joints, muscles, and tendons are no longer moving in their correct alignment, they are more likely to break down. Excess weight is a contributing factor with flat feet too, and how our body strikes the ground is very important. When the arch is no longer there to support our body and absorb shock, the deleterious effects are translated throughout the body.
Excess weight is also a leading cause of obstructive sleep apnea, a disorder in which the throat muscles block airflow at rest. The treatment of sleep apnea in turn negatively affects the musculoskeletal system as well. To encourage normal breathing, patients are often instructed to sleep with their upper trunks elevated. Sleeping is a time when our bodies get a break from gravity's compressive forces via lying down. In an age when people spend most of their day sitting (not to mention bending forward approximately 3,500 times per day), time spent lying down is helpful in countering the day's forces on the musculoskeletal system. Keeping the upper trunk elevated means that the spine is staying bent forward and compressed for large portions of both the day and night.
Movement is crucial for a healthy body. And movement is also the optimal remedy for healing musculoskeletal injuries. With or without excess weight on our frames, expert physical therapy utilizing movement is the best choice to correct the problem. One doesn't need fancy machines for treatment, and it is only in very rare cases that a person needs an x-ray/MRI, injection, or surgery. People need to be taught which movement(s) their body needs to help heal itself, which is where I come in. And I love doing it. --Laura
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