Carpal Tunnel Syndrome

Carpal Tunnel Symptoms, Causes & Treatment

Carpal tunnel syndrome occurs when the median nerve is compressed within or adjacent to the carpal canal in the wrist. The median nerve provides feeling and movement to the thumb side of the hand.

The area in the wrist where the nerve enters the hand is called the carpal tunnel. The carpal tunnel is normally narrow, so any swelling or inflammation can cause compression of the nerve. It is the most common entrapment neuropathy of the upper extremity, affecting approximately 1:1000 people a year. It occurs most often in people 30-60 years old, and more commonly in women.

Causes of Carpal Tunnel Syndrome

• Repetitive motions of the hand and wrist (e.g. typing, writing, sewing, painting, playing musical instruments): most common cause of carpal tunnel syndrome.
• Trauma to the wrist area
• Thickening of the transverse carpal ligament or synovial sheath
• Infections
• Fluid retention (e.g. menopause, pregnancy) in the soft tissue of the wrist
• Mass in the palm or carpal tunnel
• Dislocation of carpal bones

Risk factors

• Women: 3 to 6 times more likely than men
• Age: 40-60 years
• Alcohol abuse
• Overuse of caffeine or tobacco
• Obesity
• Food allergy
• Hypothyroidism
• Pregnancy
• Use of oral contraceptive pill
• Rheumatoid arthritis

Signs and symptoms of Carpal Tunnel Syndrome

• Numbness or tingling in the thumb, the first two or three fingers, and the palm
• Pain in wrist and/or hand; pain may extend to elbow
• Weakness or lack of coordination of muscles in hand
• Weak grip or difficulty carrying bags
• Wasting of the muscle under the thumb

Differential diagnosis

• Hypothyroidism
• Rheumatoid or osteoarthritis
• Gout
• Infection
• Amyloidosis
• Cervical disc syndrome or brachial plexus lesion

TREATMENT STRATEGY FOR CARPAL TUNNEL SYNDROME

• Identify / address underlying cause
• Protect joint from further injury
• Reduce pain, swelling and inflammation
• Reduce fluid retention
• Promote tissue repair

Dietary guidelines for Carpal Tunnel Syndrome

• Eliminate all suspected food allergens, including dairy, wheat, corn, soy, additives and preservatives
• Minimise pro-inflammatory foods: sugar, refined carbohydrates, trans fats, excessive red meat, saturated fats, omega-6 fatty acids, caffeine and alcohol
• Emphasise anti-inflammatory foods: in cold-water oily fish, berries, nuts and seeds, turmeric, ginger, green tea, olive oil
• Emphasise antioxidant-rich foods to promote tissue repair: berries, green tea, turmeric, fruits and vegetables
• Include foods rich in B-vitamins and iron: whole grains, nuts and seeds, dark green leafy vegetables
• Moderate alcohol and caffeine intake
• Avoid excessive protein intake
• Weight loss diet if indicated: essential part of the treatment strategy in overweight and obese patients

Supplements that may assist with Carpal Tunnel Syndrome

• Reduce pain, swelling and inflammation
• Vitamin C and bioflavonoids
• Omega-3 fatty acids
• Bromelain
• Curcumin
• Ginger:
• B6
• B-complex and zinc

Herbal Medicine treatment that supports Carpal tunnel syndrome

• Anti-inflammatory – turmeric, ginger, boswellia
• Reduce pain – St John‘s wort, Jamaica dogwood, prickly ash
• Reduce fluid retention – butcher‘s broom, horse chestnut
• Promote tissue repair – gotu kola, green tea
• Topical application – arnica, St John‘s wort

Lifestyle / Physical measures

• Splinting wrist in slight dorsiflexion – full time for 3-4 weeks then slowly reduce to nighttime only
• Contrast hydrotherapy (alternating hot and cold applications) brings nutrients to the site and diffuses metabolic waste from inflammation – immerse the wrists fully
• Acupuncture is a recommended treatment for carpal tunnel syndrome
• Chiropractic / physio treatment may be useful
• Massage may help with prevention as well as symptomatically, especially with topical application of rosemary and/or St John‘s wort
• Avoid repetitive motion for long periods of time
• Weight reduction if necessary

Functional Medicine Treatment of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a condition predominantly caused by repetitive actions of the hand and wrist with underlying inflammation being a major driving factor.  Systemic inflammation can greatly contribute to the onset and progression of carpel tunnel.  In addition to managing symptoms and implementing physical manipulation and a functional medicine treatment approach addresses systemic inflammation in the body. 

Systemic inflammation is often greatly contributed to by a poor functioning gut along with imbalances in detoxification and other biochemical pathways.  Optimising and testing the gut is essential in identifying inflammation pathways that are overactive. 

At our Perth clinic of Advanced Functional Medicine we have been referred many patients that haven’t responded to physio and chiropractic interventions as well as has been expected.  Reducing inflammation in the body has been shown to assist with carpal tunnel

If you are suffering from Carpel Tunnel Syndrome or other inflammatory conditions we would love to hear from you, how did you treat your carpel tunnel, was inflammation a major contributing factor in your case, what interventions worked best for you?  Please write a comment below.

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