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Health Protocols

Carpal Tunnel Syndrome


Carpal tunnel syndrome (CTS) is a relatively common disorder characterized by pain, tingling, numbness, or changes in sensation in the hands, wrists, or fingers. CTS results from irritation or compression of the median nerve, which travels from the wrist into the hand through a canal called the carpal tunnel (Marshall 2007). A significant portion of the population will be affected by CTS at some point in time, with estimates of lifetime prevalence ranging from 3-20% (LeBlanc 2011; Pajardi 2014; Haase 2007; Atroshi 1999; Ashworth 2013a; Raman 2012; Ghasemi-Rad 2014; Pandey 2013).

A variety of factors have been associated with the onset of CTS, including trauma, pregnancy, oral contraceptives, diabetes, hypothyroidism, rheumatoid arthritis, and occupational factors such as repetitive motion or use of vibrating tools. Some cases are considered idiopathic, meaning their cause is unknown (Pajardi 2014; Lewanska 2013; Alfonso 2010; Giersiepen 2011; Thomsen 2008; Eleftheriou 2012; Andersen 2011; Balci 2007; Ferry 2000). CTS is reported to be three times more common in females than males, with a reported prevalence of 3.7% among the US adult population (Ashworth 2013b).

Several treatment options are available for CTS. Corticosteroids, typically injected into the carpal tunnel, are often used in the conservative treatment of CTS; however, they may simply mask the symptoms and allow continued deterioration of the median nerve (Huisstede, Hoogvleit 2010; Marshall 2007; O’Connor 2003; Wallace 2000). Surgical release of the transverse carpal ligament is a common method of relieving moderate to severe CTS, with over 500 000 procedures performed annually in the United States (Jain 2014; A.D.A.M. 2013).

Physical medicine approaches include splints, stretching exercises, massage, ultrasound, acupuncture, and low-level laser therapy (Huisstede, Hoogvliet 2010; Huisstede, Randsdrop 2010; Fusakul 2014; Branco 1999; Baker 2012; Khosrawi 2012; Elliot 2013). Several integrative interventions such as B vitamins (especially B6), alpha-lipoic acid, omega-3 fatty acids, curcumin, and the enzyme serratiopeptidase may also be helpful in easing symptoms (Di Geronimo 2009; Pajardi 2014, Ko 2010; Ellis 1982; Panagariya 1999).

In this protocol you will learn about the causes of CTS and how this condition is conventionally diagnosed and treated. You will also discover some emerging therapies such as sonographically guided percutaneous needle release that may be effective in the management of CTS symptoms. A number of natural approaches that target some of the pathological mechanisms underlying CTS will be reviewed as well.