Treatment methods for carpal tunnel syndrome: The carpal tunnel is a canal in the wrist area that is limited by bone and connective tissue. It is located on the inside of the wrist and carpus, covered by a strong connective tissue band called the carpal ligament (retinaculum flexorum). Tendons and the median nerve run through this tunnel, which is responsible for the sensitivity and mobility of the ball of the thumb and certain areas of the hand.
When the tissue in the carpal tunnel swells, the median nerve can come under pressure and cause carpal tunnel syndrome. These symptoms often go away on their own, but can also last longer. There are various treatment options to provide relief.
Graphic: Representation of the carpal tunnel and the nerves of the hand – The carpal tunnel and the nerves of the hand
Symptoms occur when the tissue in the carpal tunnel swells, increasing the pressure on the median nerve.
The following symptoms may occur with carpal tunnel syndrome:
Sensory disturbances: Parts of the hand feel numb or tingling (pins and needles). This typically affects the thumb, index, middle and ring fingers (marked darker in the graphic). A first characteristic sign is when one hand falls asleep at night.
Finger pain: Occasionally, pain occurs throughout the hand or radiating pain down the arm.
These symptoms usually occur at night or in the morning. They often affect both hands, but not necessarily at the same time. Symptoms often improve when the hand is shaken.
It is often not known exactly why the tissue swells. Excessive and incorrect strain could play a role, such as heavy pressure on the wrist, excessive extension or flexion of the wrist, and one-sided activities associated with strong vibrations, such as working with a jackhammer.
For many sufferers, symptoms worsen under such stress. Whether these stresses can actually cause carpal tunnel syndrome remains unclear. It is often assumed that working on a computer increases the risk of carpal tunnel syndrome. However, previous studies suggest that the influence of computer work is rather small.
Certain diseases can promote the development of carpal tunnel syndrome, such as rheumatism, diabetes mellitus, injuries in the wrist area and repeated inflammation of the tendon sheaths. The risk is also slightly increased during pregnancy, as more fluid accumulates in the tissue during this time.
Sudden onset of severe symptoms is rare. Such “acute carpal tunnel syndrome” is usually caused by inflammation, injury or bleeding in the wrist.
Carpal tunnel syndrome usually occurs in people between the ages of 40 and 70. It is extremely rare in children. Women become ill more often than men. People who do physical work are also more frequently affected. It is estimated that 3 out of 1000 people develop carpal tunnel syndrome each year.
Some people have only mild symptoms that come and go for years. It is estimated that these symptoms disappear within six months in about a third of those affected, even without treatment. Others suffer from permanent problems. As the disease progresses, the hand may become permanently numb. In the later stages, muscle atrophy in the ball of the thumb can occur. As strength and feeling decrease, it may become difficult to grip a cup properly, for example.
First, the doctor asks about the symptoms and examines the hand and wrist. Special tests are carried out to check the mobility and sensitivity of the hand and fingers and to determine whether there are any sensory disturbances or abnormal sensations.
Electrophysiological tests such as electroneurography may be necessary to determine whether carpal tunnel syndrome is the cause of the symptoms. These tests measure how well nerves can conduct electrical impulses and whether nerve function is impaired. The results of these tests are considered together with the symptoms, physical examination, living conditions and medical history.
It is also important to rule out other causes of the disease. For example, changes in the cervical spine can affect the nerve roots. Other diseases of the nervous system such as polyneuropathies can cause similar symptoms.
1. Mild to moderate symptoms of carpal tunnel syndrome can usually be treated initially with a splint. This is worn at night and prevents the wrist from bending. It is also recommended
2. Avoid stress that is believed to be related to the symptoms.
3. Cortisone injections into the carpal tunnel can provide temporary relief, but have no lasting effect in the long term.
4. If carpal tunnel syndrome persists, surgery may be considered. This involves severing the carpal ligament, which stretches across the carpal bones. This relieves the pressure on the median nerve. Surgery can permanently relieve symptoms, but is not always advisable. As a rule, a different treatment is chosen at the beginning of the disease. Prompt surgery is usually only necessary in the rare case of acute carpal tunnel syndrome.
5. There is evidence that extracorporeal shock wave therapy (ESWT) can alleviate the symptoms somewhat. In this therapy, a device emits sound waves at high pressure from the outside through the skin. The costs for this treatment are usually not covered by statutory health insurance.
6. Occasionally other treatments are recommended, such as acupuncture, ultrasound therapy, laser therapy or magnetic field therapy. However, there is no clear evidence that they can help with carpal tunnel syndrome.
7. Many people take painkillers to relieve the symptoms, especially non-steroidal anti-inflammatory drugs (NSAIDs), which are available over the counter in pharmacies. Sometimes it is also recommended to take vitamin B6 supplements as they are said to strengthen the nerves. However, previous studies suggest that neither NSAIDs nor vitamin B6 can adequately relieve pain.
8. curpal® offers an innovative and gentle alternative to the conventional treatment of carpal tunnel syndrome. It allows patients to relieve their symptoms and improve their quality of life without having to undergo surgery. You can find more information about curpal® and its application on the official website: https://www.curpal.de/produkt/curpal/
Sources:
1. Focus.online – https://unternehmen.focus.de/karpaltunnelsyndrom-symptome.html
2. Ärzteblatt.de – https://www.aerzteblatt.de/archiv/188575/Karpaltunnelsyndrom-Manuelle-Therapie-ist-ueber-ein-Jahr-so-wirksam-wie-OP
Carpal tunnel syndrome (CTS) is a condition characterized by symptoms such as tingling, numbness, and other unpleasant sensations in the wrist area. Those affected often complain of symptoms that occur especially at night. The causes of carpal tunnel syndrome can be varied, from diabetes to advanced age.
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