Carpal Tunnel Syndrome

By Christina Morris, L.Ac.

Carpal Tunnel Syndrome (CTS) is becoming a more common condition in today’s society. Carpal Tunnel Syndrome is due to compression or damage of the median nerve, located in the wrist. It is estimated that 1.2 million people consult a physician each year for this condition. Carpal Tunnel Syndrome affects mainly women between the ages of 30 and 60.

Carpal Tunnel Syndrome may occur in one hand or both simultaneously. Symptoms can include numbness, tingling, pins and needles, burning or excruciating pain in the thumb, index, middle, and half of the ring finger. Some people experience shooting pain up the arm and into the elbow and shoulder region. Pain occurs most often at night or in the mornings. Some people wake with pain and swelling of the hands. In the beginning the pain is often intermittent and may become more persistent with time. CTS may lead to a decrease of strength in the hand or hands. Many people with advanced Carpal Tunnel Syndrome have atrophy of the muscle tissue around the region of the thumb.

While the exact cause of this condition is not known, Carpal Tunnel Syndrome has been associated with repetitive strain. This disorder is common in professions that require repetitive use of the hands, but is not limited to these kinds of occupations. Certain factors seem to increase the risk of developing CTS, including obesity, menopause, diabetes, pregnancy, water retension, rheumatoid arthritis, bone dislocation or fracture, tendonitis, heart and renal failure.

There are several tests used to diagnose Carpal Tunnel Syndrome. One simple test is to place the back of the hands together with fingers pointing down, and the elbows pointing out to the sides. The wrists are at 90 degree angles. Hold this position for over a minute. If symptoms occur, the median nerve could be compressed or damaged, although, this test is not 100% indicative. Pain in the wrist and hand from tapping the region of the median nerve may also indicate a positive test for median nerve entrapment or damage. More sophisticated tests include an EMG (electromyography) and nerve conduction velocity. These tests are used to calculate neurotransmission speed, or the speed of nerve impulses in the wrist and read nerve conduction.

There are many therapies available for the treatment of Carpal Tunnel Syndrome. Treatments may include but are not limited to: nutritional support, wearing a splint, acupuncture and herbs, physical therapy, massage, osteopathy, chiropractic care, homeopathy, Feldenkrais or surgery. Medications like nonsteroidal anti-inflammatory drugs may aid in controlling pain and reduce inflammation, but should be avoided during pregnancy. Injections of corticosteroid may help, but seem to provide only temporary relief. Parrafin baths may also decrease pain temporarily and Vitamin B6 has been recommended to relieve symptoms. Additionally, a splint worn during sleep can offer the support needed to decrease pain and inflammation. Acupuncture and herbs have shown to have long term effects in the treatment of Carpal Tunnel Syndrome and can aid in the prevention of surgery. Surgery is often recommended before more conservative treatments have been tried. Surgery should be a last resort, because it is more invasive and it carries higher risks. There is no guarantee with any of these therapies and reoccurrence rates are higher when the underlying cause of the Carpal Tunnel Syndrome has not been treated.

The good news is there are ways to minimize the risk of Carpal Tunnel Syndrome. It is important to stretch and make sure the wrists have adequate circulation. The American Physical Therapy Association recommends a couple of exercises. They are as follows:

  1. Rest one forearm on the table, grasp the fingertips of that hand, and pull back gently. Hold this position for five seconds, then repeat the exercise with the other hand.
  2. Press the palms flat on the table, as if doing a push-up. Lean forward to stretch the forearm muscles and the wrist.

Other exercises that may be beneficial include:

  1. Rotating the wrists in circles for two minutes. Repeat this exercise 3 times a day, with ten repetitions for each hand.
  2. Placing a rubber band around the fingers and pushing out against the resistance of the rubber band. Repeat this exercise 3 times a day, with ten repetitions for each hand.

Certain vitamins and herbs can also be used as preventative measures; they promote overall health of nerve tissue and nerve function, improve and maintain proper circulation and relieve inflammation. Similarly, reducing or eliminating saturated fats and fried foods from the diet may also help decrease inflammation.

Proper posture is also very important. While at a desk sit up straight and keep the arms at a 90 degree angle to the desk. Avoid hyperextension and hyperflexion of the wrists. Preventative measures must be taken to reduce the risks of acquiring Carpal Tunnel Syndrome. Pain and discomfort can be avoided with proper education on prevention and therapies. Enjoy a pain free life!