Nerves becoming trapped outside of the spine are much less common than people think. Commonly talked about examples include entrapment in the ankle (tarsal tunnel), wrist (carpal tunnel), elbow (cubital tunnel), buttock (piriformis) and forearm (pronator teres). If there is trauma to an area, it certainly makes sense that the nerves in the area can be injured and/or the healing process can lead to tissue “entrapping” the nerve. But, without significant trauma, it’s quite rare to see this phenomenon.
While many patients tell me they indeed have carpal tunnel (or whichever), they usually describe symptoms inconsistent with that diagnosis (ie they say it affects the whole hand). Furthermore, they report that no clinician has investigated movements of the neck and mid back as part of the diagnostic process.
The nerves that end up in your periphery are commonly irritated as they exit your spine. If someone has symptoms in both hands or in both ankles, the likelihood that the spine (or something systemic) is the source increases dramatically. So while I agree that peripheral nerve entrapments can exist, I can’t remember the last time I found this to be a patient’s true diagnosis. Getting the correct diagnosis is the most important step in getting better after all. -- Laura
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!
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