Carpal Tunnel Syndrome

3-6%

of the US adult population is living with carpal tunnel syndrome, that's 4-10 million Americans.

90%

CTS accounts for 90% of all entrapment neuropathies (compressed nerve disorders).

40-60

Carpal tunnel syndrome can occur at any age but is most common ages 40 to 60.

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a common condition that is characterized by pressure to one of the major nerves in the hand, called the median nerve. The median nerve enters the hand through the carpal tunnel, also called the carpal canal, which is a narrow passageway that goes from the wrist to the hand. 

As a result of this pinched nerve, carpal tunnel syndrome can result in numbness, tingling, and weakness in the wrist and hand.

Who is affected?

Anyone can be diagnosed with carpal tunnel syndrome. People generally show symptoms of the condition between ages 40 and 70, and your chances of getting carpal tunnel syndrome increase as you get older. [1] [2] Women are twice as likely to be affected by the condition as men. [1]

There isn’t a single cause of carpal tunnel syndrome, but there are a number of factors that might make you more at risk of developing the condition. Some of these factors include wrist fractures, obesity, and other conditions such as diabetes and rheumatoid arthritis. [3]

What happens in your body?

  • Frequent numbness or tingling in the fingers or hand, especially in the thumb, index, and middle fingers
    • This symptom often first appears at night, and may wake you up from sleep. As the condition progresses, this sensation may occur during the day, while you’re doing manual (hand-related) tasks such as driving or talking on the phone.
  • Hand weakness that can lead to dropping objects or difficulty performing other manual tasks

Some people with carpal tunnel syndrome may feel more electric shock-like sensations in their hands, while others may feel as if their fingers feel swollen. All of these symptoms are a result of the pinched median nerve.

How do I know if I have carpal tunnel syndrome?

It is important to get an accurate diagnosis as quickly as possible to make sure that the condition does not worsen. The best way to do this is by visiting your doctor and, if possible, getting a referral to a specialized care provider. One doctor that specifically treats carpal tunnel syndrome is a neurologist.

Some ways that your doctor can assess whether you have the condition is through inquiring about your symptoms, and conducting a physical examination or medical tests (such an X-ray, electromyography, or nerve conduction study).

How is it treated?

There is no known cure for Carpal Tunnel Syndrome, but integrative interventions have shown to reduce pain and discomfort and improve quality of life by slowing the condition’s progression and easing the severity of symptoms. [5] [6]

Integrative interventions offer a holistic approach to treatment. Instead of just conventional medicine, integrative treatments combine conventional medicine with nutritional tools, mind-body medicine, and manual medicine for a holistic approach to treating carpal tunnel syndrome.

For those new to integrative medicine, learn more here

Conventional Medicine

Many people with carpal tunnel syndrome find that certain medications work for them and others do not. So, in order to find an effective conventional treatment, people with carpal tunnel syndrome often work with their doctors to determine which medication works best with their body and needs. 

With the right medication, it is possible to manage symptoms and prevent the rapid worsening of the condition. Before starting to take any medication, be sure to ask your doctor about possible side effects. And if you notice any of the side effects once you start your treatment, let your doctor know as soon as possible.

Examples of conventional treatments:

  • Non-steroidal anti-inflammatory drugs (common name: ibuprofen), or NSAIDs, are commonly used treatments for pain resulting from carpal tunnel syndrome. [3] [7]

  • Glucocorticoids (also known as corticosteroids) are steroid drugs that can be taken by mouth or injection, and are meant to start working immediately to reduce pain and inflammation caused by carpal tunnel syndrome. Corticosteroid injections are considered to be more effective than the oral drug in treating the condition. [3] [7]

  • Doctors recommend surgery if other treatments are not effective. Endoscopy surgery involves your doctor using a telescope-like device with a tiny camera attached to it to view the carpal tunnel and cut the ligament that is pressing on the median nerve. Open surgery has the same goal of relieving pressure on the median nerve, but does not use a tiny camera, also called an endoscope. [3] [7]

Mind-Body Medicine

Research shows that gentle, low-intensity mind-body treatments can help carpal tunnel patients with mobility, mood, decreased pain, and more. There are a wide variety of mind-body treatments for carpal tunnel syndrome, ranging from deep breathing to aqua-therapy.

When living with chronic pain, engaging in regular movement and exercise may feel difficult and unnecessary. But doing so can actually improve your symptoms. 

Before starting a physical exercise regimen, consult with your doctor about what might be the best activities for you and your body.

Examples of mind-body medicine:

  • Tai chi is a Chinese practice of slow, low-intensity movements that researchers have found can improve mobility, functionality, and psychological health in patients with chronic conditions.

  • Yoga comes in many different styles, often engaging both the body and the mind through controlled breathing and stretching. A study conducted at the University of Pennsylvania  suggests a yoga-based regimen was more effective than wrist splinting or no treatment in relieving some symptoms and signs of carpal tunnel syndrome.

  • Gentle exercise programs guided by instructors who understand your condition can help you both lose weight and manage your symptoms. Weight loss has shown to relieve pressure on your joints and curb pain-causing inflammation.

  • Relaxation therapies like deep breathing techniques, meditation, and biofeedback can help patients ease anxiety and better manage chronic pain.  UCLA researchers suggest that mind-body treatments like these can disrupt inflammatory pathways in the body and are anti-inflammatory.

Manual Medicine

Manual treatments are administered by certified therapists, using physical pressure and stimulation on the body to reduce carpal tunnel syndrome symptoms. Treatments can vary in intensity and incorporate other elements such as heat and aromatherapy to enhance relief.

Examples of manual medicine:

  • A widely-adopted Chinese treatment administered by certified acupuncturists who insert very thin needles at strategic points on the body to support overall wellness. Researchers showed that acupuncture is effective in treating chronic pain generally. Another group of researchers have shown that it can specifically alleviate symptoms of Carpal Tunnel Syndrome.

  • Licensed massage therapists use different techniques, like shiatsu, hot stone, and Swedish massage, to provide temporary pain relief. Studies suggest that massage therapy is particularly helpful for muscle pain, and that it can also help reduce anxiety.

  • Hand therapy is a form of rehabilitation that utilizes different types of treatments to restore functional use of the hands. Researchers at Oregon Health & Science University have demonstrated the use of different hand therapies and the possible benefits in helping restore function.

Nutritional Tools

Nutrition plays a crucial role in your overall health, and is a tool you can use to combat joint damage, reduce inflammation, and manage other carpal tunnel syndrome symptoms. 

Just like with conventional, mind-body, and manual medicines, there is not one ideal treatment for every carpal tunnel syndrome patient. When selecting nutritional tools to treat your condition, it is best to consult with your doctor or work with a dietitian, naturopath, or nutritionist to find out the best diet for you.

Examples of nutritional tools:

  • Anti-inflammatory diets

    • Anti-inflammatory diets include nutrient-dense foods that contain antioxidants and intend to reduce inflammation in the body. A popular anti-inflammatory diet is the Mediterranean diet which has been shown to reduce signs of inflammation.

  • Plant-based diets

    • Vegetarian and vegan diets have shown to promote gut health, which may have an anti-inflammatory impact.

  • Elimination diet

    • While some foods can help reduce symptoms, other foods may trigger them. An elimination diet, which is an eating plan that eliminates certain foods or food groups believed to be causing negative bodily reactions, can help you figure out which foods are triggering those symptoms and bring you closer to your ideal diet.

  • Fish

    • Research suggests that eating fish may reduce joint inflammation for those with rheumatoid arthritis and may help with symptoms of carpal tunnel.

    • Recommendation: Eat three to four ounces of fish (salmon, tuna, sardines, anchovies, or other cold-water fish) twice a week.

  • Fruits and vegetables

    • Fruits and vegetables have antioxidants, which support your immune system and may fight inflammation.

    • Recommendation: Eat one and a half to two cups of fruit (like blueberries, blackberries, cherries, and strawberries) and two to three cups of vegetables (like spinach, kale, and broccoli) per meal.

  • Nuts

    • Nuts are rich in healthy fat, protein, and fiber, and help fight inflammation.

    • Recommendation: Eat one and a half ounces–about a handful–of nuts (like walnuts, pine nuts, pistachios, and almonds) per day.

  • Beans

    • Beans (like red, pinto, navy, and black beans) are rich in fiber and protein, and are full of both antioxidants and anti-inflammatory properties.

    • Recommendation: Eat at least one cup of beans per week.

  • Olive oil

    • This heart-healthy ingredient contains healthy fat, antioxidants, and oleocanthal, an anti-inflammatory compound.

    • Recommendation: Consume two to three tablespoons of extra virgin olive oil per day by using it in your cooking or salad dressings.

  • Onions

    • These simple, flavor-rich vegetables are packed with antioxidants and may help reduce inflammation, improve heart health, and help control cholesterol levels.

  • Fiber

    • Fiber is found in foods like beans, whole grain breads, and fresh vegetables. It makes you feel fuller for longer and boosts digestive health. It also may help reduce inflammation.

    • Recommendation: Incorporate a good mix of insoluble fiber (from vegetables, wheat, and seeds) and soluble fiber (from fruits and oats) in your diet or try fiber supplements.

  • Fish oils

    • Fish oils may reduce inflammation. Research has shown to dramatically reduce the symptoms of rheumatoid arthritis and it may also help alleviate symptoms of Carpal Tunnel Syndrome.

  • Gamma linolenic acid (GLA)

    • Gamma linolenic acid is mostly found in plant seed oils like borage seed, evening primrose, and blackcurrant seed oil. Researchers in Italy have found that it may be useful for controlling symptoms of Carpal Tunnel Syndrome especially if used in the early stages of the condition.    

  • Turmeric

    • Research shows that a key chemical compound (curcumin) in turmeric can relieve rheumatoid arthritis and its symptoms. This may suggest its efficacy in Carpal Tunnel Syndrome.    

    • Recommendation: Turmeric is a popular spice which you can add to any food or drink (like vegetables, rice, tea, or smoothies). Add it to your meals or take it in supplement form. Some supplements combine turmeric curcumin with black pepper for enhanced absorption and greater health benefits.

  • Vitamin D

    • Vitamin D supplements are good for bone health, and they can also help keep the immune system functioning properly. Some research shows the Vitamin D deficiency might be triggering Carpal Tunnel Syndrome. This suggests that it may help the treatment process if patients take vitamin D supplements alongside other therapies.

  • Antioxidants

    • Selenium supplements can help keep your immune system functioning properly and prevent cell damage (also known as oxidative stress).

    • Research shows other antioxidants that can help prevent cell damage and keep the body in a balanced state are vitamin A and vitamin C.

  • Probiotics

    • Chronic conditions and medications can have a negative impact on gut health. Studies show probiotic supplements may help improve gut health and even lead to lower levels of inflammation.

  • [1] Polykandriotis E, Premm W, Horch RE. Carpal tunnel syndrome in young adults--an ultrasonographic and neurophysiological study. Minim Invasive Neurosurg. 2007;50(6):328-334. doi:10.1055/s-2007-993163 
  • [2] Carpal Tunnel Syndrome: Risk Factors, Symptoms & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4005-carpal-tunnel-syndrome. Accessed July 27, 2020. 
  • [3] Carpal tunnel syndrome. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/carpal-tunnel-syndrome/symptoms-causes/syc-20355603. Published February 1, 2020. Accessed July 27, 2020. 
  • [4] Carpal Tunnel Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-Sheet. Accessed July 27, 2020. 
  • [5] Marian S. Garfinkel ED. Yoga-Based Intervention for Carpal Tunnel Syndrome. JAMA. https://jamanetwork.com/journals/jama/article-abstract/188150. Published November 11, 1998. Accessed July 27, 2020. 
  • [6] Wipperman J, Goerl K. Carpal Tunnel Syndrome: Diagnosis and Management. American Family Physician. https://www.aafp.org/afp/2016/1215/p993.html. Published December 15, 2016. Accessed July 27, 2020. 
  • [7] Taylor-Gjevre RM, Gjevre JA, Strueby L, Boyle CA, Nair B, Sibley JT. Treatments for carpal tunnel syndrome: who does what, when ... and why?. Can Fam Physician. 2007;53(7):1186-1190. 
  • [8] Ibrahim, I., Khan, W., Goddard, N., & Smitham, P. (2012). Carpal Tunnel Syndrome: A Review of the Recent Literature. The Open Orthopaedics Journal, 6(1), 69-76. doi:10.2174/1874325001206010069 
  • [9] LeBlanc, K., & Cestia, W. (2011, April 15). Carpal Tunnel Syndrome. Retrieved July 12, 2020, from https://www.aafp.org/afp/2011/0415/p952.html 
The information on this page is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek medical advice from your physician or health provider for your specific needs.