Although it went by a different name at the time, the condition we now know as carpal tunnel syndrome was first described in the medical literature in the 1850s. Affecting millions of people at any given time, carpal tunnel syndrome is the most frequently diagnosed nerve entrapment injury in the upper extremities. It is often attributed to occupational demands, particularly those that require sustained or repetitive use of the hands and wrists.

Symptoms of carpal tunnel syndrome classically include pain or numbness and tingling in the sensory distribution of a nerve. That can include the palm side of the thumb, index finger, middle finger and part of the ring finger. The median nerve is vulnerable to irritation as it passes through the carpal tunnel at the wrist, which is where carpal tunnel syndrome gets its name.

In the early stages, symptoms are usually only felt at night and may awaken people from sleep. As the disorder progresses, symptoms generally become more frequent and at other times in the day. In more -advanced cases muscle function of the hand can be affected, sometimes resulting in atrophy of the thumb pad.

Treatments for carpal tunnel syndrome have historically been directed at alleviating irritation of the median nerve as it passes through the wrist. These typically range from conservative approaches such as braces, exercises, and manual therapy, to more invasive procedures such as injections and surgery.

Despite advances in treatment, some people with carpal tunnel syndrome end up becoming chronic. One reason is a failure to account for the neck as a source of symptoms.

The median nerve is made up of several smaller nerves that originate at five spinal levels in the neck and upper back. Once the median nerve is formed, it courses down the arm and passes through the carpal tunnel before terminating in the hand. Nerves are continuous structures, and as a result, are vulnerable to irritation at different sites along their route. Symptoms may appear anywhere along the course of a nerve, even in areas far away from the location of agitation.

As it pertains to the median nerve, irritation to one or more of its associated spinal nerves can cause symptoms that resemble carpal tunnel syndrome. It’s for that reason that the neck should always be assessed in those suffering from the condition, especially when other treatments have proved to be unsuccessful.

The best way to conclude that the neck is relevant in carpal tunnel syndrome is to see if there is a relationship between neck movements and the signs and symptoms in the hand. Determining if that association exists is one area that the McKenzie Method shines, and if there is a connection, assessment often reveals a neck movement that can remedy the problem without having to treat the wrist.

If the neck isn’t adequately assessed, treatments will likely fail.

Dr. Jordan Duncan is from Kitsap County and writes a monthly online health column for Kitsap News Group. He is the owner of Silverdale Sport & Spine.