Last month, we covered what Carpal Tunnel Syndrome (CTS) is, its symptoms, causes, who is at risk, and how it’s diagnosed. This month, we’ll center our focus on CTS treatment.
How is CTS treated? For the best success, treatment should begin as early as possible. Unfortunately, most people wait a long time before they get to the point where the symptoms interfere with daily activity enough to prompt them to make an appointment. Once the cause or causes of CTS are determined, treatment can address ALL the presenting contributing conditions. The FIRST course of care should be NON-SURGICAL, though this is not always practiced – so be aware! Non-surgical care includes the following:
- Manipulation: This usually includes adjusting the small bones of the hand, the wrist, the forearm, elbow, shoulder, and/or the neck.
- Soft-tissue therapy: This includes loosening up the overly tight forearm muscles the median nerve runs through (on the palm side of the forearm).
- Modalities: Such as electrical stimulation and/or laser/light therapy can be very beneficial in reducing swelling or inflammation. In chronic CTS, ultrasound may be helpful as well.
- Nutritional: Nutrients such as vitamin B6 have been shown in studies to be effective in some cases. Also, anti-inflammatory herbs (ginger, turmeric, bioflavinoids) and / or digestive enzymes (bromelain, papain, and others) taken between meals are quite effective.
2. Anti-Inflammatory: The first important distinction is that ice can be very effective depending on how long the CTS has been present. In particular, ice cupping or rubbing ice directly on the skin over the carpal tunnel is the most effective way to use ice as an anti-inflammatory agent. When doing so, you will experience four stages of cooling: Cold, Burning, Achy, Numb or “C-BAN.” It’s important to remember this as you are REALLY going to want to quit in the burning/achy stages when it feels uncomfortable. Once the skin over the wrist / carpal tunnel gets numb (which takes about four to five minutes) QUIT as the next “stage” of cooling is FROST BITE! Most medical practitioners promote the use of NSAIDs (non-steroidal anti-inflammatory drugs) like naproxen, aspirin, or ibuprofen. However, these carry negative side effects including gastritis (burning in the stomach that can lead to ulcers), or liver and/or kidney damage. Try the nutritional anti-inflammatory approaches FIRST as they are extremely helpful without the negative side effect potential!
3. Diet: An ant-inflammatory diet, like the Paleo-diet or gluten free diet, serves as a great tool in reducing the inflammatory markers in the body. Though only 7-10% of the population has celiac disease (gluten intolerance), it’s been estimated that over 80% of us are gluten “sensitive.” Reducing systemic inflammation can make a BIG DIFFERENCE in the management of many conditions including CTS!
4. Mechanical: Wrist “cock-up” splints can also be REALLY HELPFUL, especially for nighttime use. The reason for this is because when our wrist is bent forwards or backwards, which frequently occurs when sleeping, the pressure inside the carpal tunnel increases, and over time (minutes to hours), the increased pressure in the tunnel exerts compression on the median nerve which then creates numbness into the thumb, index, third and half of the fourth finger, which can wake you up out of a sound sleep. Keeping the wrist straight at night prevents you from curling your wrist under your jaw while sleeping.
5. Ergonomic Modifications: Changing your workstation (computer station, line position, machine controls, pace or rate of repetitive movements, and more) is VERY effective.
NOTE: ALL of the above can be managed through the services offered by your doctor of chiropractic!