Carpal tunnel syndrome is not the ‘tingle’ you want waking you in the middle of the night. Sometimes called CTS, carpal tunnel syndrome can start as numbness and tingling, then quickly turn into burning, pain and even weakness in your hand and forearm – making it hard to hold that coffee you desperately need!
But there is light at the end of the tunnel. Read on to learn more about carpal tunnel syndrome and what can be done to help.
What is Carpal Tunnel Syndrome?
Your carpal tunnel is a narrow passage on the palm side of your wrist, made up of the carpal ligament. Running through the carpal tunnel is your median nerve. Carpal Tunnel Syndrome is caused by compression of the median nerve.
When compressed, the median nerve becomes inflamed and affects mainly the first three fingers of the hand – the thumb, index and middle fingers. This may alter how you feel and/or how you use your hand. In more scientific terms, this means it could affect your sensory function and/or your motor function.
- Sensory function
Information: going from the extremities to the brain, like pain and numbness
- Motor function
Information going from the brain to the extremities, like using your muscles to pick up a glass
What causes Carpal Tunnel Syndrome?
Sometimes the causes of CTS are idiopathic, i.e. ‘cause unknown’. Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. For example, a wrist fracture, inflammatory conditions like rheumatoid arthritis or repetitive movements can cause swelling and inflammation. In many cases there is no single cause. It could be a combination of risk factors contributing to the development of CTS including (1):
- Pregnancy – the hormones associated with pregnancy cause general fluid retention, which can compress the nerve. Carpal tunnel syndrome triggered by pregnancy usually goes away soon after birth
- Wrist fractures
- Congenital factors – some people have a smaller carpal tunnel than others
- Overuse injury
Some common risk factors:
- Women between the ages of 40 and 60 years
- Pregnant women
- People with certain types of arthritis
- Anyone who experiences a period of rapid weight gain
- People who use their hands repetitively in their day-to-day activities, such as typists or assembly line workers.
What are the symptoms of Carpal Tunnel Syndrome (CTS)?
- Pins and needles
- Pain, particularly at night
- Darting pains from the wrist
- Radiated or referred pain into the arm and shoulder
- Weakness of the hand
- The little finger and half of the ring finger are unaffected.
How is Carpal Tunnel Syndrome (CTS) diagnosed?
In most cases CTS is diagnosed by the presenting symptoms. You doctor will perform a physical exam to rule out other causes and will look for signs of wrist swelling, deformities and tenderness. If doctor suspects CTS they may request imaging or a nerve conduction test that measures the speed of the nerve impulse through the wrist. If the speed is slower than normal it may indicate CTS.
Is Carpal Tunnel Syndrome (CTS) difficult to treat?
The problem is there are many conditions that mimic CTS, like Thoracic outlet Syndrome, a condition where there is compression of the nerves, arteries, or veins of the lower neck. Even wrist, shoulder and elbow problems can mimic the symptoms of CTS. Or is it actually irritation to the median nerve by the carpal ligament in the wrist? These things determine both the treatment and treatment outcomes.
How can Carpal Tunnel Syndrome (CTS) be treated?
Nonsurgical options include (2):
- avoiding positions that overextend your wrist
- wrist splints that hold your hand in a neutral position, especially at night
- mild pain medication and medications to reduce inflammation
- steroid injections into your carpal tunnel area to reduce inflammation
- Plenty of rest for the affected hand
- Diuretic medications to reduce your body’s retention of fluid by increasing the amount of urine passed
- medication into the affected area to reduce the swelling.
- Change mouse
- Massage therapy
- Diet adjustment
Surgery for Carpal tunnel syndrome (CTS): (2)
Surgery involves cutting the carpal tunnel ligament to reduce pressure on the underlying median nerve.
How can Evolve Natural Medicine help with Carpal tunnel syndrome (CTS)?
Chinese Medicine – The use of Chinese herbs has been around for centuries and has treat pain and inflammation. Recent studies (3) have been able to isolate the mechanisms by which this occurs. These mechanisms include reduction of pro-inflammatory pathways or cytokines, Cox-2 inhibition and antimicrobial effect.
Acupuncture – A recent review in The Brain a Journal of Neurology 2017 (4) found that both true and sham acupuncture reduced CTS symptoms, but true acupuncture was superior in improving peripheral and brain neurophysiologic outcomes. Researchers say their findings suggest that acupuncture may improve CTS pathophysiology by both local and brain-based mechanisms involving neuroplasticity of the primary somatosensory cortex. A 2012 review (5) of acupuncture randomised control trial found that acupuncture can improve the overall subjective symptoms of carpal tunnel syndrome and could be adopted in comprehensive care programs of these patients.
Nutritional supplementation – can be useful for reducing general inflammation of the body. Items such as fish oils, boswellia, turmeric can have powerful anti-inflammatory effects helping to relieve pain.
Diet – More recent understanding of the gut has shown that poor gut function can significantly increase levels of inflammation and pain in the body. As a result looking at diet and dietary habits may assist to reduce overall inflammation and therefore provide pain relief in issues such as carpal tunnel syndrome.
Author: Adrian Taricani
Registered acupuncturist, Evolve Natural Medicine
More about Adrian
M: 0491 738 260
- Rekik A. Muluye, Yuhong Bian, Paulos N. Alemu. Anti-inflammatory and Antimicrobial Effects of Heat-Clearing Chinese Herbs: A Current Review, Journal of Traditional Complementary Medicine 2014 Apr-Jun; 4(2): 93–98.
- Yumi Maeda, Hyungjun Kim, Norman Kettner, Jieun Kim, Stephen Cina, Cristina Malatesta, Jessica Gerber, Claire McManus, Rebecca Ong-Sutherland, Pia Mezzacappa, Alexandra Libby, Ishtiaq Mawla, Leslie R. Morse, Ted J. Kaptchuk, Joseph Audette, Vitaly Napadow, Rewiring the primary somatosensory cortex in carpal tunnel syndrome with acupuncture, Brain, Volume 140, Issue 4, April 2017, Pages 914–927, https://doi.org/10.1093/brain/awx015
- Khosrawi, Saeid et al. “Acupuncture in treatment of carpal tunnel syndrome: A randomized controlled trial study.” Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences vol. 17,1 (2012): 1-7.