TREATMENT FOR CARPAL TUNNEL SYNDROME
CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome is a common condition that causes pain, numbness and tingling in the hand and arm. This condition occurs when one of the major nerves in the hand, called the median nerve, is squeezed or compressed as it travels through the wrist. In most patients, carpal tunnel syndrome gets worse over time, so early diagnosis and treatment is considered important.
In early stages, symptoms can often be relieved with simple measures like wearing a wrist splint or avoiding certain activities. If pressure on the median nerve continues, it can lead to nerve damage and worsening symptoms. To prevent permanent damage, surgery to take pressure off the median nerve may be recommended for some patients.
Causes
Most cases of carpal tunnel syndrome caused by a combination of factors. Studies show that women and older people are more likely to develop the condition. Other risk factors for carpal tunnel syndrome include:
- Heredity : This is likely an important factor. The carpal tunnel may be smaller in some people or there might be anatomic differences that change the amount of space for the nerve and these traits could run in families
- Repetitive usage of hands : Repeating the same hand and wrist motions or activities over a prolonged period of time may aggravate the tendons in the wrist, causing swelling that puts pressure on the nerve
- Hand and wrist position : Doing activities that involve extreme flexion or extension of the hand and wrist for a prolonged period of time could increase pressure on the nerve
- Pregnancy : Hormonal changes during pregnancy can cause swelling
- Health conditions : Diabetes, rheumatoid arthritis and thyroid gland imbalance are conditions that are associated with carpal tunnel syndrome
SYMPTOMS
Symptoms of carpal tunnel syndrome may include:
- Numbness, tingling, burning and pain, primarily in the thumb and index, middle, and ring fingers
- Occasional shock-like sensations that radiate to the thumb and index, middle, and ring fingers
- Pain or tingling that may travel up the forearm toward the shoulder
- Weakness and clumsiness in the hand, this may make it difficult to perform fine movements such as buttoning your clothesDropping things due to weakness, numbness or a loss of proprioception (awareness of where your hand is in space)
- Dropping things due to weakness, numbness or a loss of proprioception (awareness of where your hand is in space)
In most cases, the symptoms of carpal tunnel syndrome begin gradually without a specific injury. Many patients find that their symptoms come and go at first. However, as the condition worsens, symptoms may occur more frequently or may persist for longer periods of time. Night-time symptoms are very common. Because many people sleep with their wrists bent, symptoms may awaken you from sleep. During the day, symptoms often occur when holding something for a prolonged period of time with the wrist bent forward or backward, such as when using a phone, driving or reading a book.
Some patients find that moving or shaking their hands helps relieve their symptoms.
Risk factors
A number of factors have been associated with carpal tunnel syndrome. Although they may not directly cause carpal tunnel syndrome, they may increase the risk of irritation or damage to the median nerve. These include:
- Anatomic factors. A wrist fracture or dislocation, or arthritis that deforms the small bones in the wrist, can alter the space within the carpal tunnel and put pressure on the median nerve.
People who have smaller carpal tunnels may be more likely to have carpal tunnel syndrome. - Sex. Carpal tunnel syndrome is generally more common in women. This may be because the carpal tunnel area is relatively smaller in women than in men.
Women who have carpal tunnel syndrome may also have smaller carpal tunnels than women who don't have the condition. - Nerve-damaging conditions. Some chronic illnesses, such as diabetes, increase your risk of nerve damage, including damage to your median nerve.
- Inflammatory conditions. Rheumatoid arthritis and other conditions that have an inflammatory component can affect the lining around the tendons in your wrist and put pressure on your median nerve.
- Medications. Some studies have shown a link between carpal tunnel syndrome and the use of anastrozole (Arimidex), a drug used to treat breast cancer.
- Obesity. Being obese is a risk factor for carpal tunnel syndrome.
- Body fluid changes. Fluid retention may increase the pressure within your carpal tunnel, irritating the median nerve. This is common during pregnancy and menopause. Carpal tunnel syndrome associated with pregnancy generally gets better on its own after pregnancy
- Other medical conditions. Certain conditions, such as menopause, thyroid disorders, kidney failure and lymphedema, may increase your chances of carpal tunnel syndrome.
- Workplace factors. Working with vibrating tools or on an assembly line that requires prolonged or repetitive flexing of the wrist may create harmful pressure on the median nerve or worsen existing nerve damage, especially if the work is done in a cold environment.
However, the scientific evidence is conflicting and these factors haven't been established as direct causes of carpal tunnel syndrome.
Several studies have evaluated whether there is an association between computer use and carpal tunnel syndrome. Some evidence suggests that it is mouse use, and not the use of a keyboard, that may be the problem. However, there has not been enough quality and consistent evidence to support extensive computer use as a risk factor for carpal tunnel syndrome, although it may cause a different form of hand pain.
COMPLICATIONS
If you have carpal tunnel syndrome and don't treat it, the symptoms can last a long time and get worse. They could also go away and then come back. When you get a diagnosis early, the condition is easier to treat. You can avoid permanent muscle damage and keep your hand working the way it should.
PREVENTION
There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on your hands and wrists with these methods:
- Reduce your force and relax your grip. If your work involves a cash register or keyboard, for instance, hit the keys softly. For prolonged handwriting, use a big pen with an oversized, soft grip adapter and free-flowing ink.
- Take short, frequent breaks. Gently stretch and bend hands and wrists periodically. Alternate tasks when possible. This is especially important if you use equipment that vibrates or that requires you to exert a great amount of force. Even a few minutes each hour can make a difference.
- Watch your form. Avoid bending your wrist all the way up or down. A relaxed middle position is best. Keep your keyboard at elbow height or slightly lower.
- Improve your posture. Incorrect posture rolls shoulders forward, shortening your neck and shoulder muscles and compressing nerves in your neck. This can affect your wrists, fingers and hands, and can cause neck pain.
- Change your computer mouse. Make sure that your computer mouse is comfortable and doesn't strain your wrist.
- Keep your hands warm. You're more likely to develop hand pain and stiffness if you work in a cold environment. If you can't control the temperature at work, put on fingerless gloves that keep your hands and wrists warm.
DIAGNOSIS
- Physical Examination During the evaluation, your doctor will talk to you about your general health and medical history and will ask about your symptoms. They would carefully examine your hand and wrist to perform a number of physical tests as follows,
- They might bend and hold your wrists in a flexed position to test for numbness or tingling in your hands
- Test sensitivity in your fingertips and hands by lightly touching them with a special instrument when your eyes are closed
- Check for weakness in the muscles around the base of your thumb
- Look for atrophy in the muscles around the base of your thumb. In severe cases, these muscles may become visibly smaller
- Tests :
- Electrophysiological tests : These tests will help your doctor measure how well your median nerve is working and help determine whether there is too much pressure on the nerve. The tests will also help your doctor to understand whether you have another nerve condition, such as neuropathy or other sites of nerve compression that might be contributing to your symptoms. Electrophysiological tests may include:
- Nerve conduction studies : These tests measure the signals travelling in the nerves of your hand and arm which could detect when a nerve is not conducting its signal effectively. Nerve conduction studies can help your doctor to diagnose how severe your problem is and help to guide treatment
- Electromyogram (EMG) : An EMG measures the electrical activity in muscles. EMG results can show whether you have any nerve or muscle damage
- Ultrasound : An ultrasound uses high-frequency sound waves to help create pictures of bone and tissue. Your doctor may recommend an ultrasound of your wrist to evaluate the median nerve for signs of compression
- X-rays : X-rays provide images of dense structures, such as bone. If you have limited wrist motion or wrist pain, your doctor may order x-rays to exclude other causes for your symptoms, such as arthritis, ligament injury or a fracture
- Magnetic resonance imaging (MRI) scans : These studies provide better images of the body's soft tissues. Your doctor may order an MRI to help determine other causes for your symptoms or to look for abnormal tissues that could be impacting the median nerve. An MRI can also help your doctor determine if there are problems with the nerve itself, such as scarring from an injury or tumor
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TREATMENT
Although it is a gradual process, for most people carpal tunnel syndrome will worsen over time without some form of treatment. For this reason, it is important to be evaluated and diagnosed by your doctor. In the early stages, it may be possible to slow or stop the progression of the disease.
- Nonsurgical Treatment : If diagnosed and treated early, the symptoms of carpal tunnel syndrome can often be relieved without surgery. If your diagnosis is uncertain or if your symptoms are mild, your doctor will recommend nonsurgical treatment first. Nonsurgical treatments may include:
- Bracing or splinting : Wearing a brace or splint at night will keep you from bending your wrist while you sleep. Keeping your wrist in a straight or neutral position reduces pressure on the nerve in the carpal tunnel. It may also help to wear a splint during the day when doing activities that aggravate your symptoms
- Nonsteroidal anti-inflammatory drugs (NSAIDs) : Medications such as ibuprofen and naproxen can help relieve pain and inflammation
- Activity changes : Symptoms often occur when your hand and wrist are in the same position for too long, particularly when your wrist is flexed or extended. If your job or recreational activities aggravate your symptoms, changing or modifying these activities can help slow or stop progression of the disease
- Nerve gliding exercises : Some patients may benefit from exercises that help the median nerve move more freely within the confines of the carpal tunnel. Specific exercises may be recommended by your doctor or therapist
- Steroid injections : Corticosteroid or cortisone, is a powerful anti-inflammatory agent that can be injected into the carpal tunnel. Although these injections often relieve painful symptoms and help to calm a flare up of symptoms, their effect is sometimes only temporary. A cortisone injection may also be used by your doctor to help diagnose your carpal tunnel syndrome
- Surgical Treatment : If nonsurgical treatment does not relieve your symptoms after a period of time, your doctor may recommend surgery. The decision whether to have surgery is based on the severity of your symptoms, how much pain and numbness you are having in your hand. In long-standing cases with constant numbness of your thumb muscles, surgery may be recommended to prevent irreversible damage
Effectiveness of Acupuncture treatment
Acupuncture often a successful go-to therapy for carpal tunnel syndrome. Research shows that it has positively been helpful for several people. Acupuncture is suggested to be better than certain medications. It is an ancient Chinese physiotherapy that has become a well-liked and well-researched method for managing this pain. The researchers have noted that acupuncture helped reduce symptoms by “remapping” the brain.Studies and research have shown the effectiveness of acupuncture to relieve pain caused by the carpal tunnel syndrome. It also relieves pain while waiting for surgical intervention and can occasionally make surgery unnecessary.
Mechanism of Acupuncture
Acupuncture is a traditional therapy that supports the thought of energetics within the body.They added that it also provided some healing effects at the source of the pain in the patients’ wrists.
- Treatment consists of inserting needles at various pressure points on the body and through the skin. Needles aren't meant to cause pain, harm or discomfort
- A professional acupuncturist would target energy (or “qi” in Chinese medicine) points for treatment. These also are termed as meridians, with some being of special benefit to painful nerves and muscles within the joints
- By stimulating these points, parts of the systema nervosum also are stimulated to alleviate pain. Acupuncture also can provide pain relief from other similar neuromuscular issues that there might not be too many pain remedy options
- One of the benefits of acupuncture is it’s so minimally invasive and has such a low-risk profile. The signals the brain receives after an acupuncture needle is stuck into the skin may in essence “remap” the brain so it modifies pain signals from the wrist
- Reduces pain and inflammation : Acupuncture increases blood flow to the affected area. Blood brings healing properties such as platelets and red blood cells which lead to faster recovery. When these are increased during blood flow, it pulls out toxins and fluid buildup which in turn decreases inflammation. When there is less inflammation and swelling, there is less pain
- Releases neurotransmitters : There are hormones that send messages regulating the on/off mechanisms of varied nerve endings. Acupuncture releases endorphins and serotonin as natural pain medication. The natural pain killers that are triggered by acupuncture could be stronger than morphine. You get natural pain relief and reduction of inflammation without the harsh unwanted side effects of medicationTriggers electromagnetic impulses in the body: These impulses can help speed the body’s way of handling pain, including the discharge of endorphins. Acupuncture reduces trigger points in the muscles around the knee. When muscles or nerves get tight, they tend to get sore, achy and result in decreased movement in an area. Acupuncture releases these trigger points without the need of injecting
- medication . This makes for a natural approach to relieve affected muscles or nerves in the painful joints and trigger points
BEST CURE FOR CARPAL TUNNEL SYNDROME
Looking for a best solution to treat carpal tunnel syndrome, here’s why you should reach out to the expert Acupuncturist. A. Shaji Bharath from Dr.Bharath’s Acu Heal. He is currently treating patients for a wide range of conditions. As a certified acupuncture practitioner with 15 years of experience, with vast knowledge on orthopaedics and having worked with several Orthopedists, Acupuncturist. A. Shaji Bharath has seen Acupuncture doing wonders on people suffering from carpal tunnel syndrome. The effectiveness rate increases several times just with one course of Acupuncture and it can help alleviate the symptoms, reduce pain and helps patients get back to their normal routine at the earliest, by evaluating their condition and offering appropriate treatment. Most people swear by acupuncture, citing it as a ‘miracle’ in improving their quality of life, that focuses on joint or nerve syndromes and conditions of your body's musculoskeletal system, which allows you to move, work and be active. Dial: +91 9884746916 or Visit: drbharathsacuheal.com for more details on treating carpal tunnel syndrome using Acupuncture.
BEST ACUPUNCTURE DOCTOR NEAR ME
To choose the Best doctor for Acupuncture, it's important that the Acupuncturist should have a decade of experience and treated at least 1000 to 2000 patients.
You can also search for the Best Acupuncture Doctor near me or ask your primary care physician to refer an experienced Acupuncturist nearby. Once you find the Best Acupuncture Doctor in Chennai, you may go through their google reviews first and then fix an appointment with the doctor only when you are satisfied with the reviews.
The Best Acupuncture Doctor should address your concerns and help you feel more comfortable before your first session. Acupuncture usually takes numerous sessions or several weeks to get a complete cure in any ailment but within 3 or 4 sessions the patients will experience positive differences.
BEST ACUPUNCTURE CLINIC NEAR ME
There are numerous clinics popping up and it is sometimes skeptical to choose the best or even the safe one. To address such concerns, you can look into the following points to choose the best acupuncture clinic for treating carpal tunnel syndrome. Acupuncture is also offered in hospital, pain clinics and by healthcare organizations but it is ideal to visit the best Acupuncture Clinic. If you are not sure, it would be a good idea to contact your local doctor to see if they would be prepared to refer to the best rated acupuncture clinics.Acupuncture is offered in ttop rated acupuncture clinics near me because conventional treatment has failed or produces unacceptable side effects. Most of the best acupuncture clinics will spell out very clearly what type of acupuncture they practice and how professional they are - at present anyone can set themselves up as an acupuncturist but reputable
practitioners will belong to an organization. So while you are filtering the best clinics for acupuncture that treats carpal tunnel syndrome, you can look out for these factors.Treatment without surgery and drugs for carpal tunnel syndrome is possible through acupuncture and it gives the best result.
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THE BOTTOM LINE
Dial +91 9884746916 or Visit: drbharathsacuheal.com, if you have signs and symptoms of carpal tunnel syndrome that interfere with your normal activities and sleep patterns. Permanent nerve and muscle damage can occur without treatment.
SCIENTIFIC REFERENCES
- Sears ED, Swiatek PR, Hou H, Chung KC. Utilization of Preoperative Electrodiagnostic Studies for Carpal Tunnel Syndrome: An Analysis of National Practice Patterns. J Hand Surg Am. 2016 Jun;41(6):665-672.e1.
- Mooar PA, Doherty WJ, Murray JN, Pezold R, Sevarino KS. Management of Carpal Tunnel Syndrome. J Am Acad Orthop Surg. 2018 Mar 15;26(6):e128-e130.
- Eroğlu A, Sarı E, Topuz AK, Şimşek H, Pusat S. Recurrent carpal tunnel syndrome : Evaluation and treatment of the possible causes. World J Clin Cases. 2018 Sep 26;6(10):365-372.
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FAQ:
What are the services provided for Carpal Tunnel Syndrome by Dr. Bharath’s Acu Heal?
At Bharath's Acu Heal, Carpal Tunnel Syndrome is treated with Acupuncture and the treatment will be given based on the disease’s chronicity and acuteness. In the first few sessions, there will be a positive change in the symptoms and after several sessions, there will be a 90% to 100% chance that the patient will get cured of Carpal Tunnel Syndrome. Simultaneously the patient will be advised on a diet and exercise regime which includes an induced sound sleep that plays a vital role in reversing the disease.
What are the benefits of acupuncture for Carpal Tunnel Syndrome?
This is a drugless therapy and there are no side effects. After completing the course of treatment any form of medication can be stopped and the symptoms will get completely reversed.
How many sessions do you need for Carpal tunnel syndrome?
It takes around 20 to 30 sessions in a period of 2 to 3 months.