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Carpal
Tunnel Syndrome
- Tendonomuscular channel related
- Could Be Neck Related and not Wrist
Structure from Western
perspective
- Transverse tendon of
wrist - palmar side
- Carpal bones - more
dorsal side
- Tunnel between the
above two, containing nine flexor tendons
- The nine flexor
tendons surround the median nerve
Etiology & Mechanism
- Bone disorder -
fracture, bone spur, broken bone - room of tube is absolutely
smaller
- Inflammation of
transverse tendon of the wrist - room of tube is absolutely
smaller
- Inflammation of
contents in the tube, the nine flexors - room of tube is
relatively smaller, this happens most
Diagnosis - Two special
tests
- Wrist joint flexing
test - Hold thumb inside fist & flex wrist all the way
forward
- Forearm blockage test
- First measure blood pressure at cubital area
then retake with cuff on forearm & hold pressure at 90 - 100
(hold at the number that is midway between the original
reading). If there is pain down to the finger tip, it is a +
test for Carpal Tunnel
TCM perspective
- Could be wrist Bi syndrome due to blockage of Qi & Blood
in the channels
Etiology & Mechanism
- Wind Cold Damp Invasion
- Overwork causing either Qi & Blood stagnation
or Qi & Blood deficiency
Differentiation and Treatment
- Acute Stage - less than 6 mo.
- Chronic Stage - more than 6 mo.
Acute Stage Symptoms
- Compression of median nerve - same as
Qi & Blood stasis
- Swelling, acute onset, numbness &
tingling
- Sharp pain along 3 ½ fingers on
radial side
- Cold makes pain worse - due to
blockage
- Pain may radiate to forearm or upper
arm along Pericardium channel
- Local weakness and limitation of
movement of wrist joint
Basic points for acute stage Carpal Tunnel
Per. 4, 6, 7, 8; Lu 10, 9; He 7; SJ
4
Chronic Stage Symptoms
- Atrophy of thumb and thenar eminence
- Dull pain on thumb and index finger
with severe local weakness
- Pain worse after working
- Pale tongue, thin white coat
- Deep & weak pulse
Treatment principle
- Tonify Spleen & Stomach, strengthen Yangming chi’s
Basic points for chronic stage Carpal
Tunnel
LI 4, 5; Lu 7, 9; ST 36; SP 6; GB
34; BL 20, 21
- Massage good, traction and counter
traction
- Golden yellow powder decoction
- make a paste
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