Osteoarthritis is a form of arthritis characterized by the gradual wearing down of the cartilage tissue in joints. The condition is the most common cause of arthritis and will affect everyone who makes it to old age. However, it can develop earlier in life in individuals with certain gene variants as well as those with a history of trauma. A 2024 study found that among middle-aged and older adults, those with osteoarthritis were roughly four times more likely to develop carpal tunnel syndrome within the following four years. But how does osteoarthritis elevate the risk for carpal tunnel syndrome?

Carpal tunnel syndrome is a condition that results from a restriction of the median nerve as it passes through the wrist. It’s thought there are at least three mechanisms by which osteoarthritis reduces the space within the carpal tunnel, placing pressure on the median nerve: cartilaginous tissues in the joints located in the wrist wear down, leading to the formation of bony hypertrophies or bone spurs; localized inflammation; and altered joint movement. When combined with other risk factors for carpal tunnel syndrome like rapid, repetitive movements with non-neutral wrist postures and excessive forces, it’s easy to see how osteoarthritis in the wrist can contribute to carpal tunnel syndrome.

Interestingly, researchers have found that osteoarthritis doesn’t necessarily need to be localized to the upper extremities to heighten the risk for carpal tunnel syndrome. A 2024 study reported that the release of inflammatory cytokines into the blood stream due to pathological changes in other joints (such as the hip, knee, or shoulder) can trigger inflammation in the tissues comprising and passing through the carpal tunnel. Additionally, the risk for carpal tunnel syndrome increases in line with the total number of joints in the body affected by osteoarthritis.

When a patient seeks out chiropractic care for carpal tunnel syndrome, it’s not uncommon for the physical examination to look at the whole patient and not just focus on the wrist. This is because the symptoms most commonly associated with carpal tunnel syndrome are not always the direct and exclusive result of median nerve restriction at the wrist. In many cases, the median nerve may be restricted elsewhere along its course (like the shoulder or neck, for example) or factors elsewhere in the body like osteoarthritis or hormonal conditions may play a contributing role.

If osteoarthritis is noted, then the patient may receive treatment to address postural faults that place added stress on the arthritic joint. While osteoarthritis itself cannot be reversed, restoring more normal joint mechanics may help to slow its progression and reduce the inflammation that may also be a contributing factor in the patient’s wrist symptoms.