Carpal Tunnel Syndrome: Symptoms, Causes, Risk Factors, Healing Cycle & Treatment
What Is the Carpal Tunnel?
The carpal tunnel is a narrow canal-like space located at the junction of the wrist and the palm of your hand. It is bounded by wrist bones on the undersurface and by the transverse carpal ligament that covers and binds them. Through this tunnel pass the median nerve and tendons of the flexor muscles of the hand that act to bend the fingers. (1)
What Is Carpal Tunnel Syndrome?
The median nerve lies in a very restricted space in the carpal tunnel. Compression of the median nerve in this region leads to Carpal Tunnel Syndrome. It is the most common neuropathy of the upper limb that is caused by the entrapment of a nerve. (2) Pressure on the nerve causes disruption of neuronal signals down to the muscles that it supplies.
Carpal Tunnel Syndrome Symptoms:
The symptoms produced by compression of the median nerve in the carpal tunnel commonly include:
- ● Tingling, numbness, burning, and pain are early symptoms of the syndrome and most commonly occur in the thumb, index finger, middle finger, and part of the ring finger. (2) The pain may radiate upwards along the arm of the affected side.
- ● Weakened ability to grip causes objects to drop.
- ● Clumsiness of the hands and decreased coordination in performing activities that require fine motor skills.
- ● Wasting of the muscles that make up the thenar eminence. (3)
Carpal Tunnel Syndrome Risk Factors:
Risk factors that are commonly associated with the development of carpal tunnel syndrome include the following:
- History of wrist fracture.
- Degenerative bone diseases such as osteoarthritis or autoimmune conditions such as rheumatoid arthritis. (4)
- Obesity and increased body mass index. (5)
- Hormonal changes such as menopause.
- Imbalance of thyroid hormones.
- Repetitive hand activities such as typing, using the mobile phone, or such devices for a prolonged time.
- Hereditary predisposition.
How To Treat Carpal Tunnel Syndrome?
In order to effectively treat carpal tunnel syndrome, we need to understand what is really happening at the level of the tissues.
Carpal Tunnel Syndrome Pathogenesis – Healing Cycle:
The appropriate response of our body to any form of injury constitutes the following steps:
1. Inflammation: This is the earliest response to injury of body tissue. The damaged tissue causes the release of cellular signals that invite the immune cells to the site of injury. (6) These immune cells release inflammatory cytokines that are responsible for the generation of pain, redness, swelling, and an increase in temperature at the site of damage.
2. Proliferation: In an attempt to restore the lost or damaged tissue, the cells of the extracellular matrix produce collagen and other glycoproteins. This causes the build-up of fibrous scar tissue that binds the wounded tissue together. This stage of proliferation causes the formation of muscle spasms, trigger points, fascia restrictions, and fibrosis. (7)
3. Remodeling: This is the final phase of normal wound healing in which the body gets rid of the excessive scar tissue formed during the prior phases. The end result of this whole process is a tissue that resembles its original self, that was before the injury. (8)
Whether due to excessive movement or any of the other predisposing factors, small tears occur in the transverse carpal ligament that forms the roof of the carpal tunnel. Persistence of the injurious stimulus results in a continuous injury that causes inflammation at the wrist joint. As a result, excessive scar tissue keeps forming but never gets around to being removed. This causes compression of the median nerve in the carpal tunnel, thereby restricting the nerve supply and function of the different muscles that it supplies. (9)
What Not To Do:
There are several treatment modalities that may sound promising but do not cause any improvement in the long term. These include:
● Heat and Ice: The application of heat and Ice pads to the inflamed wrist joint causes easing of pain but the effect is only temporary as it doesn’t promote healing in any form.
● ESTIM: Electrical stimulation therapy may improve conduction through the median for the time being. However, soon after, the condition recurs because the causative factors have not been removed. (10)
● Foam roller and massage: These are common methods of pain relief that may, in fact, aggravate the injury by further compressing the inflamed tissue.
● Stretching and Exercise: Although these practices are very important, it is vital that they are employed at the right time, once the inflammatory phase is over. Stretching or exercising the wrist joint too early will increase the degree of injury and worsen the symptoms of carpal tunnel syndrome. (11)
How To Treat Your Carpal Tunnel Syndrome?
To make sure that our treatment approaches are effective, we need to target the phases of injury individually.
During the inflammatory phase:
● Make sure you rest the joint well in order to allow it to heal. (12)
● MagnaHeal tool decreases inflammation by applying a magnetic field force that penetrated up to 3 inches deep in the tissue.
● An anti-inflammatory diet includes the use of ginger, turmeric, etc, and cutting down of refined sugars and carbohydrates.
● Restoration of nutrients and vitamin deficiency is essential for healing. You can use the askASTR website. The website offers a set of questions that you can answer and have your nutritional requirements evaluated for free. It has a database that brings the expertise of at least 9 professionals.
During the proliferation phase:
In this phase, excessive scar tissue forms and fibrosis occurs which further restricts the pathway of the median nerve in the carpal tunnel. These restrictions need to be released in order to allow complete healing and prevent relapses in the future.
● The A3 and A5 tools have been designed specifically to help release scar tissue and trigger points that are entrapping the median nerve at the wrist joint.
● The A1 and A5 tools can help release the adhesions that have formed between the superficial and deeper layers of fascia due to chronic injury.
By specifically targeting the causative factors of the condition, you can effectively treat carpal tunnel syndrome, even at home!
2. Wipperman J, Goerl K. Carpal Tunnel Syndrome: Diagnosis and Management. Am Fam Physician [Internet]. 2016 Dec 15 [cited 2021 Sep 24];94(12). Available from: https://pubmed.ncbi.nlm.nih.gov/28075090/
3. Genova A, Dix O, Saefan A, Thakur M, Hassan A. Carpal Tunnel Syndrome: A Review of Literature. Cureus [Internet]. 2020 Mar [cited 2021 Sep 24];12(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164699/
5. Geoghegan JM, Clark DI, Bainbridge LC, Smith C, Hubbard R. Risk factors in carpal tunnel syndrome. J Hand Surg Br [Internet]. 2004 Aug [cited 2021 Sep 24];29(4). Available from: https://pubmed.ncbi.nlm.nih.gov/15234492/
8. Stephens P, Thomas DW. The cellular proliferative phase of the wound repair process. J Wound Care [Internet]. 2002 Jul [cited 2021 Sep 24];11(7). Available from: https://pubmed.ncbi.nlm.nih.gov/12192844/
9. Serhan CN. Resolution phase of inflammation: novel endogenous anti-inflammatory and proresolving lipid mediators and pathways. Annu Rev Immunol [Internet]. 2007 [cited 2021 Sep 24];25. Available from: https://pubmed.ncbi.nlm.nih.gov/17090225/
10. Werner RA, Andary M. Carpal tunnel syndrome: pathophysiology and clinical neurophysiology. Clin Neurophysiol [Internet]. 2002 Sep [cited 2021 Sep 24];113(9). Available from: https://pubmed.ncbi.nlm.nih.gov/12169318/
Carpal Tunnel Syndrome Home Treatment
ASTR Exceptionally Different
Reviews collected from various websites