Carpal Tunnel Syndrome  

What is it?

Carpal tunnel syndrome (CTS) is caused when the median nerve in the wrist is compressed.

The carpal tunnel is a narrow, rigid passageway composed of ligaments and the carpal bones (wrist bones) at the base of the hand. The carpal tunnel houses the median nerve and associated tendons that move the fingers and wrist.

The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to small muscles in the hand that allow the fingers and thumb to move.

The median nerve originates from the brachial plexus which is formed from the gathering of nerve roots emanating from nerve roots C5, C6, C7, C8, & T1. The median nerve is the only nerve that passes through the carpal tunnel.

Carpal tunnel syndrome occurs when thickening from irritated tendons or other wrist swelling narrows the tunnel that results in compression of the median nerve. The result is numbness and tingling in the hands, primarily the thumb, index and/or long fingers or the presence of an electric-like shock in your hands. Pain, weakness, or numbness in the hand and wrist and may radiating up the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which peripheral nerves are compressed or traumatized.

Treatment of Carpal Tunnel Syndrome: Acupuncture is a safe and effective treatment option for CTS.

A common reasons that people seek acupuncture is for repetitive stress injuries, including carpal tunnel syndrome. Acupuncture is effective at treating carpal tunnel syndrome; possibly eliminating the need for surgery or the prolonged use of anti-inflammatory drugs or corticosteroids.

Published in the May 2009 issue of the Clinical Journal of Pain, a randomized, controlled study that was conducted to investigate the efficacy of acupuncture compared with steroid treatment in patients with mild-to-moderate carpal tunnel syndrome the outcomes were measured by both nerve conduction studies and symptom assessment surveys.

Seventy-seven patients were randomly divided into 2 groups. One group received eight acupuncture treatments over four weeks, and the other group received oral doses of prednisone, daily, for four weeks. The results showed that acupuncture was just as effective as the corticosteroid for pain, numbness, tingling and weakness. For the symptoms of nighttime awakening and motor function, the acupuncture group had better results.

The researchers concluded that acupuncture is a safe and effective treatment option for CTS for those who experience side effects to oral steroids or for those who do not opt for early surgery. Source: The Clinical Journal of Pain. 25(4):327-333, May 2009. doi: 10.1097/AJP.0b013e318190511c

Standard practice (western medicine) initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. This is also a good recommendation during acupuncture therapy, it is necessary to give the wrist a chance to heal and if there are repetitive stressors placed on the wrist healing will not be as effective. Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may ease pain. Cool (ice) packs and prednisone (taken by mouth) or lidocaine (injected directly into the wrist) can relieve swelling and pressure on the median nerve and provide immediate, temporary relief.

A recent study concluded that a number of nonsurgical interventions, including use of wrist splints at night, decrease symptoms from CTS in the short term. However, there was not enough information to comment on the midterm and long-term effectiveness of these nonsurgical interventions. Another study concluded that people with a recent diagnosis of CTS were most likely to benefit from the use of wrist splints at night.

Reference:

NINDS Carpal Tunnel Syndrome Information Page

Median nerve

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

Laptop & Computer Safety: Avoiding Carpal Tunnel

Acupuncture in treatment of carpal tunnel syndrome: A randomized controlled trial study

Acupuncture in patients with carpal tunnel syndrome: A randomized controlled trial.

Wrist pain is any pain or discomfort in the wrist from New York Times.

Splints Work for Carpal Tunnel Syndrome, Study Shows