What is Carpel Tunnel Syndrome?
The carpal tunnel is a narrow nerve and tendon passageway in the wrist made up of ligaments and bones. Carpal tunnel syndrome, also known as median nerve entrapment, occurs when there is swelling or irritation in the median nerve or tendons in the carpal tunnel. Symptoms include burning, tingling, or numbness in the palm of the hand and the thumb, index and middle fingers. The symptoms often first appear during the night. As the condition progresses, people feel pain, weakness, or numbness in the hand and wrist.
Any activities that involve highly repetitive use of the hands, especially flexion of the fingers, can result in CTS. Those at risk include computer users, carpenters, assembly-line workers, meat packers, musicians, and mechanics. Sports activities such as rowing, golf, tennis, downhill skiing, archery and rock climbing also can place pressure on the hand and wrist. In addition, the syndrome can be caused by underlying disorders that affect the carpal tunnel, including arthritis, thyroid problems, gout, and diabetes.
The treatment of CTS is determined by the cause and severity of compression of the median nerve. If the disease is secondary to another problem, like as arthritis, diabetes or gout, treatment of the primary condition will often resolve the CTS.
In most cases CTS is caused by repetitive stress, therefore treatment usually relies on a combination of medications and lifestyle changes, such as splinting and avoidance of activities that aggravate the condition. Splints, available in pharmacies, help keep the wrist extended taking pressure off the nerve. Physicians may prescribe anti-inflammatory drugs or inject corticosteroids into the wrist. Steroidal drugs and NSAIDs may help to reduce pain in the short term. However, steroid drugs come with a risk of side effects and are a poor long term strategy.
In the most severe cases, surgery to relieve pressure in the carpal tunnel is also an option. During surgery, the carpal ligament (the “roof” of the carpal tunnel) is surgically separated to relieve the pressure.
An anti inflammatory approach to treating carpel tunnel syndrome
Carpal tunnel is a reversible condition, however, greater attention to lifestyle choices is needed to reduce inflammation naturally. In particular:
- Take a 2-week break from repetitive activities that may be contributing to strain or pressure on the median nerve. Alternate between activities or tasks to reduce the strain on the wrist
- Animal experiments and clinical intervention studies indicate that omega-3 fatty acids have anti-inflammatory properties and can be useful in the management of inflammatory conditions. Fish oil, which is high in omega 3, works by down-regulating the levels of pro-inflammatory cytokines, which are shown to be elevated in people with CTS
- Avoid salt and all foods containing sodium. They promote water retention and may aggravate carpal tunnel syndrome.
- Avoid high glycemic foods like white sugar, white flour, white rice and pasta.
- Avoid pro-inflammatory trans fats, including hydrogenated oils, margarines, vegetable shortening and all foods made from them.
- Wear wrist splints at night during sleep. Wearing splints at night is important because fluid redistributes throughout the body when reclined. Fluid volume increases in the upper part of the body and puts pressure in the carpal tunnel.
- Wear a forearm brace, a narrow cuff worn just below the elbow that reduces fluid content in the carpal tunnel.
- Use a wrist rest in front of your keyboard and keep your keyboard level, not elevated, at your computer workstation. Your elbows should ideally be bent at a 90-degree angle and forearms parallel to the floor.
- Keep hands warm. Wearing far infrared gloves stimulates cellular metabolism and promotes the regeneration of skin and muscle tissue in hands and wrist.
- Cut down on caffeine and smoking which reduce blood flow to your hands. Nerve tissue is the most sensitive to reduced blood flow.
- Warm up your wrists in the morning. A simple routine such as the following may greatly reduce the incidence of CTS:
- Hold your hands in front of you as if pushing on a wall. Count to five
- Relax your wrists and fingers.
- Make tight fists with both hands.
- Bend both fists downward. Count to five.
- Repeat each step 10 times.
- Shake arms loosely while they are hanging at your sides.
In many cases acupuncture, in combination with the above suggestions, can be highly effective in managing carpal tunnel syndrome. The primary aim of treatment is to reduce inflammation and restore proper circulation locally in the wrist.
If you are someone who struggles with carpal tunnel syndrome and you live in Victoria BC consider booking a free 20 minute health consultation today to discuss how acupuncture and Chinese Medicine can help you
Silas Rosenblatt, R Ac