Causes and Treatment of Carpal Tunnel Syndrome
Heat should not be applied in the affected area, since this only makes the condition worse.
Carpal tunnel syndrome can lead to symptoms like pins and needles and tenderness in our hands or wrists, and a feeling of weakness in the region. You may not be able to grip or grasp objects properly. These are symptoms which never disappear for a lot of people. Carpal tunnel syndrome can be disabling, because it stops sufferers from being able to use their hands, and the pain can be severe and in some cases, unbearable.
What can sufferers do about this problem? Is surgery the only option? Are there no other remedies or medicines that we can use to help heal this condition?
The solution recommended by conventional medical doctors for conditions like this is surgery. It is similar to when we have a problem with our car, and the mechanic orders us a new part from the manufacturer and replaces the old one with it. How many times have we heard or even talked about mechanics just changing parts and charging us for the privilege? Unfortunately, the medical system can treat you in a similar way to a car.
What is Carpal Tunnel Syndrome (CTS)?
The carpal tunnel is a narrow passageway in the wrist. The median nerve, which enervates the hand, runs through it. Various actions can narrow it even further, compressing the nerve and stopping it from working efficiently.
Compression of the median nerve causes changes in the hands. You might experience numbness and stop being able to move your hand normally. You could also experience constant sensations, pins and needles, tingling or a sudden nerve pain. There may also be weakness, and you may no longer be able to pick up or grasp objects with your thumb and index finger.
This occurs because the muscles in the hand that are controlled by your median nerve no longer receive the impulses necessary to be able to work correctly. With time, this situation can cause permanent muscle damage and we may significantly lose strength in our hands.
As mentioned above, the wrist area where the nerve passes through is called the carpal tunnel. This tunnel is narrow and any inflammation or thickening in this tunnel can compress or push on the nerve. When this happens, it may cause pain, numbness, pins and needles and/or weakness. This is what carpal syndrome is.
Carpal tunnel syndrome usually affects people between 30 and 60 years old and is more common in men than women. It isn’t very common, but people who are affected often have smaller carpal tunnels.
It is often thought that continually making the same movement with the hands and wrists causes the condition. There’s no reason why this should be the case, though it is recommended that we avoid making mechanical and repetitive movements. It is true that using manual tools that vibrate can cause this syndrome. For example, workers that use pneumatic drills to break up road surfaces are at risk.
However, there are some studies that suggest that carpal tunnel syndrome is caused by using a computer, a mouse and performing repetitive movements at work, playing instruments and practicing certain sports.
Other factors that may lead to carpal tunnel syndrome include:
- Repeatedly fracturing the wrist, and arthritis in the wrist
- A growth in the wrist, such as a cyst or tumor
- Rheumatoid arthritis (an autoimmune disease which affects the joints)
- Diabetes mellitus
- Obesity and alcoholism
- Liquid retention during pregnancy and menopause
Carpal is usually idiopathic, which means that its cause isn’t known, and so treatment usually revolves around minimizing symptoms, rather than eliminating the cause.
- The inability to pick up objects well with the thumb and index finger or hold things firmly with the hand
- Numbness or tingling in your thumbs and all the fingers except the little finger
- Tingling or pins and needles in the palm of the hand
- Difficulty carrying bags, due to weakness
- Pain which travels from the wrist to the elbow
- Painful hands and wrists
- Problems with motor function in the fingers
- Weakness in one or both hands
- Muscle atrophy at the base of the thumb (in advanced and chronic cases)
When to consult your physician
In order not to confuse the symptoms of carpal tunnel syndrome with the symptoms of arthritis (osteoarthritis) consult your physician when you experience the following symptoms:
- Constant pain which increases, even though you stretch out the wrists to try and relieve the pain.
- Cracking sounds inside the wrist when we move the wrist in some way or perform a certain exercise.
Once we know that we don´t have arthritis, we can choose from a range of treatments, depending on the severity of the symptoms.
Tests and examinations
The doctor may perform the “Phalen maneuver” and “Tinel’s sign”
- Tinel’s sign: lightly tapping on the median nerve at the wrist, which will result in distal tingling or pins and needles.
- The Phalen maneuver: flexing the wrist for 60 seconds to see if there is any numbness, tingling or weakness.
The most common examinations include:
- X-rays of the wrist, which your doctor will use to decide if the ligaments and tendons have been affected where the median nerve runs through the wrist. This is what causes the compression inherent to carpal tunnel.
- Electromyography: used to evaluate and record the electrical activity produced by the skeletal muscles.
- Nerve conduction velocity.
These tests will show your doctor if you really have carpal tunnel syndrome, after the Tinel sign and Phalen maneuver have been carried out.
We can try immobilizing the wrist with a metal wrist support (a splint) overnight for a few weeks. If that doesn’t help, it might be necessary to use it during the day for a month. Try to avoid sleeping on your wrists and use cold compresses.
There are a number of medications used for carpal tunnel syndrome, including non-steroidal anti-inflammatory medicines, such as ibuprofen and Naproxen. Corticosteroid injections can help with the symptoms a period of time.
Carpal tunnel release is a surgical procedure where the ligaments are cut, releasing the pressure on the nerve. The surgery is effective in the majority of cases, but it doesn’t always help, and may take months to heal.
The symptoms normally improve with other treatments, but around 50% of cases need surgery.
How to prevent carpal tunnel syndrome – postural recommendations
There are many changes that can be made at work and at home in order to take pressure off of your wrists, including:
Keeping the wrists in a neutral position
- Make sure that when you are resting, you wrists are extended, relaxed and straight. Avoid repetitive movements.
- Your computer screen should be at the same height as your eyes. The keyboard should be low enough so that when you are typing, the wrists aren´t bent upwards.
- Avoid grasping and unscrewing things with three fingers, which puts pressure on the wrists. Use your whole hand. If you use your hands at work, rest them for a couple minutes every so often and switch hands regularly.
When you’re sleeping:
Keep your arms against the body and the wrists straight. If your wrists end up underneath your body, it can cause pain and swelling.
Use ergonomic designs.
Use tools designed to reduce wrist injuries. Special devices for the computer, such as ergonomic supports for the mouse and keyboard drawers can really help with wrist problems. Rest once in a while and stop working if you experience pain or tingling.
Exercises for the wrists and hands help improve the circulation and reduce tension in the wrists and hands.
- Circle the wrists. Start with the palms faced down, then rotate both wrists five times to the clockwise, and five times counterclockwise.
- Tensing your thumbs, by turning your hands up and out, then stretch your thumb downwards with the opposite hand. Hold it there for around 10 seconds, then repeat with the other hand. Do this exercise five times.
- Extend your five fingers, by stretching them out, so there is as much space between them as possible for a count of 10. Repeat five times.
- Press a rubber ball between fingers and palm, ten times. Then stretch out your fingers, and repeat with the other hand.
You may have to make changes to your working life, or your recreational activities. Some types of work involve tools that vibrate, and which often aggravate this condition, or may cause it. Carpal tunnel syndrome is common among professional musicians (like pianists, flautists, etc.).
Remedies for carpal tunnel syndrome that you can make at home
The popular remedies currently used help to lower inflammation and therefore relieve pain.
- An infusion using St. John´s Wort: Boil 3 hypericum leaves, or St. John´s Wort, for 10 minutes in a cup of water. Drink it when cool. If you have a cup per day, you will notice that the pain lessens and the tingling that usually occurs in the wrist and hand gets better. St. John´s Wort also has a calming effect, and helps to break the viscous cycle of psychosomatic effect that pain can cause over time.
- Flax oil: Take one tablespoon of flax seed oil for two weeks (or up to four weeks). According to data collected during recent research, the fatty acids this seed contains actively help reduce inflammation.
- Consume Vitamin B6: Eat foods that contain this useful vitamin, such as potatoes, brown rice, bananas, green vegetables and chicken breast. Or you could take 2 milligrams per day as a tablet or capsule.
- Using cold compresses on the hands and wrist. This helps reduce inflammation. Don´t apply hot compresses or use hot pads, because they may make the problem worse.
In addition to the above, making sure you have good circulation helps with the condition, and good nutrition and regular exercise are essential for good health.
As long as we treat this condition properly, we won´t have complications. But without treatment, we could damage the nerve permanently.
It´s important to remember that, though our surgeon may insist on surgery, surgery is not always necessary and may even worsen the situation in some cases. If we made a real effort to improve the condition and use the remedies mentioned here before approaching a surgeon, we may be able to heal the condition ourselves. If they don´t help, we can seek alternative solutions.