According to the Bureau of Labor Statistics, carpal tunnel syndrome afflicts approximately 8 million Americans per year. It is second only to back surgery in the number of musculoskeletal surgeries performed each year. Yet, few people really know what this syndrome is.
The word "carpal" comes from the Greek word "karpos," meaning "wrist." There is a small space between the wrist joint and its surrounding fibrous tissues, which is called the "carpal tunnel." It is through this tunnel that a median nerve receives all of its sensations of the fingers. When this median nerve is irritated, the result is carpal tunnel syndrome.
The symptoms of this syndrome include pain, numbness, and tingling in the fingers or hands, particularly the thumb, index, middle, or ring fingers. Loss of sensation in the fingers and weakness in the hands can also occur.
The Obvious and Unusual Causes of Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is usually caused by repetitive finger and hand use (especially with improper positioning). Such repetitive movements of the fingers and hands can cause the median nerve to become compressed and irritated as it passes through the carpal tunnel.
But there is another way that carpal tunnel can develop-through disease. Many diseases such as leukemia, multiple myeloma, and sarcoidosis can also lead to this condition. These diseases cause substances to be deposited around the median nerve, thus causing the irritating pain, tingling, and numbness of the hands associated with CTS.
There are several factors involved in developing carpal tunnel syndrome. These include:
1. Pre-existing conditions- the diagnosis of another illness in which symptoms include lack of blood flow to the hands, such as lupus, multiple sclerosis, rheumatoid arthritis, and hypothyroidism.
3. Smoking - which decreases blood flow to the median nerve.
4. Gender - women who are pregnant, taking birth control pills, taking hormone replacements, or going through menopause are sometimes known to develop CTS.
5. Age - people in the age range of 40 to 60 years old are more affected than any other age group.
Treatment During the Early Stages
As with any disease, it is the patient's choice as far as treatment is concerned. The severity of the symptoms should also be taken into consideration when deciding upon a treatment plan.
In the early stages of carpal tunnel syndrome, physical therapy, heat and massage treatments, and sometimes just simply shaking or stretching the hands can reduce or eliminate the uncomfortable sensations. Taking the supplement vitamin B6, has also been known to alleviate symptoms.
If these do not diminish symptoms, a doctor will often recommend that a splint be worn at night, and even during the day to reduce inflammation and stabilize the wrist. Steroid drugs such as cortisone are also an option and can last up to six months. The steroid helps shrink the swollen area around the median nerve, thus alleviating pressure and pain. A new and less painful way of injecting the steroid drug into the carpal tunnel is through an electric current, known as iontophresis.
Surgery - A Last Resort
As a last resort to cure chronic sufferers of CTS, a surgery is performed called carpal tunnel release. This surgery attempts to reduce the pressure on the median nerve by cutting the roof of the carpal tunnel. There are two ways of doing this: endoscopic surgery, or an open incision surgery.
Endoscopic surgery involves creating a tiny incision in the patient's wrist or hand through which a device with a television camera allows a view to the carpal tunnel. Open incision surgery occurs when the surgeon releases the nerve in the carpal tunnel through an incision in the wrist.
Regardless of which surgery is chosen, this procedure has resulted in tremendous improvements for the CTS sufferer, with little residual numbness and tingling.
Natural Carpal Tunnel Syndrome Treatments
In addition to standard medical treatments, there are a number of natural remedies that have been proven to relieve the symptoms of carpal tunnel syndrome.
Acupuncturists insert thin needles into specifics point on the body. It is believed that blockages along energy pathways in the body, called meridians, can cause lead to physiological symptoms or disease. Acupuncture releases these blockages, enhancing the flow of energy along the meridians, and hence the belief is that the free flow of energy will alleviate or eliminate physical issues.
A scientific explanation is that acupuncture may release natural pain-relieving chemicals into the body, promote circulation in body, and balance the nervous system.
Laser acupuncture, which uses a hand-held laser instead of acupuncture needles, is also used for CTS. One study looked at 36 people with median pain for a duration of 24 months. Fourteen had 1 to 2 surgical release procedures with no results. After three laser acupuncture sessions a week for 4 to 5 weeks, 33 people reportedly experienced no pain or their pain was reduced by more than 50%.
2) Vitamin B6
In several research studies, vitamin B6 deficiency has been associated with this syndrome. One such study by the Portland Hand Surgery and Rehabilitation Center in Oregon examined 441 individuals and found that higher levels of vitamin B6 were associated with fewer incidences of carpal tunnel syndrome symptoms.
A typical dose of vitamin B6 for carpal tunnel syndrome is 50 mg 2 to 3 times a day. Side effects may include increased urination. It may take up to 6 weeks to notice an improvement. The maximum intake from all sources should be less than 200 mg a day, unless otherwise recommended by a physician.
3) Herbal Medicine, Vitamins, and Supplements
- Enzyme supplements such as bromelain or combination enzyme products (e.g., Wobenzym) may help to reduce tissue swelling associated with carpal tunnel syndrome. It may take several weeks to notice results. Interestingly, bromelain is derived from pineapples.
- Vitamin B12 - a study looked at the effectiveness of vitamin B12 for people with CTS due to overuse of the non-paralyzed arm after stroke. For two years, 67 people in the study received 1500 mcg of vitamin B12 a day, while the control group of 68 individuals received no supplementation. After two years, there was significant improvement in the group taking vitamin B12 compared to the untreated group.
Yoga can assist in reducing the symptoms of CTS. A study by the University of Pennsylvania looked at the effectiveness of yoga for 42 people with carpal tunnel syndrome. People in the yoga group did 11 yoga postures twice weekly for 8 weeks and had a significant improvement in grip strength and pain reduction as compared to the control group, who wore wrist splints.
The best way to treat carpal tunnel syndrome, however, is to prevent the condition from occurring. In most cases, this can be done by limiting repetitive motions such as typing for long periods of time. Simple stretching of the wrist and fingers throughout the day may also prevent the median nerve from becoming injured. Stabilization of the fingers and wrist may also prevent further symptoms.
Though the symptoms of carpal tunnel syndrome can be painful and, at times, even debilitating, there are many treatment options-medicinal and holistic-that have brought relief to the millions who suffer from this condition each year.