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Carpal tunnel syndrome often presents itself as numbness, tingling, pain, and wasting of the muscles on the thumb side of the hand -- this is the area that is supplied by the median nerve.

Surgery is often recommended by physicians as the best treatment. However, it is a serious undertaking, and sometimes a more conservative approach might be better. To know what route to take, we first need to have a good understanding of the different causes of Carpal Tunnel Syndrome.

The carpal tunnel is actually formed by an arch of four bones, the carpal bones, which form the back of the wrist. The front of the wrist is formed by the flexor retinaculum, a strong ligament which spans the arch. The tunnel thus forms between them.

The tendons that bend our fingers, and the median nerve all pass through this tunnel from the arm to the hand. What happens in Carpal Tunnel Syndrome is that, for various reasons, the space in the tunnel becomes overcrowded, the nerve gets compressed, and the result is that the nerve no longer conducts signals as it should.

The palm of the hand, including the thumb, first three and a half fingers, and also the backs of the same fingertips are all supplied by the median nerve. The rest of the hand is covered by the ulnar nerve. Therefore Carpal Tunnel Syndrome can cause symptoms only in the thumb-side of the hand. Any symptoms on the other side are NOT Carpal Tunnel Syndrome.

It is ultimately the compression of the median nerve that leads to carpal tunnel syndrome.  Medical testing for carpal tunnel syndrome usually entails the use of an electromyelogram (EMG).

This entails putting one electrical probe into the median nerve on either side of the carpal tunnel.  An electrical current is then put into the nerve on one side and checked to see if it is picked up by the probe on the other side.  If the current is diminished to a great degree, it is deemed that carpal tunnel syndrome is present.

The treatment most commonly recommended is the surgical cutting of the flexor retinaculum so as to provide more room for the nerve in the tunnel. This often works very well -- but it is by no means the only solution.

So what causes Carpal Tunnel Syndrome? The first common cause is a deterioration of the joints between the carpal bones. This causes the tunnel to collapse and, in turn, compresses the median nerve. The second cause is a swelling of the tendons. The enlarged tendons take up more space, and so put pressure on the nerve.

Choosing the right treatment depends on knowing which of these is the cause in any particular case. However, and EMG cannot tell you that and so reliance on the EMG alone for diagnosis can result in unnecessary surgery.

If the cause is swollen tendons (tendonitis) then, I believe, it is better treated by tackling the cause of the inflammation -- such as too much stress or tension on the tendons -- than by surgery.

Too much repetitive use of the muscles in the forearm cause them to tighten up. This then makes the tendons tight too, and that can cause them to become inflamed and swollen -- a common cause of Carpal Tunnel Syndrome.

Treatment for tendonitis can include stretching, pysiotherapy, ergonomics (eg typing posture), chiropractic manipulation, nutritional support etc. These are all a lot less invasive and have fewer side effects than surgery.

This does not mean that surgery is not a viable option.  My preferred method, of course, is to begin with the least invasive form of therapy.  If these options do not bring relief of symptoms, then surgery can be looked at seriously.

----If you are tired of suffering from carpal tunnel syndrome, then why not read more articles by Dr. Steven Trembecki, D.C. on chiropractic treatments. You can see and utilize a unique version of this article at  http://www.uberarticles.com/articles/?id=831