Dr. Friedman’s Health Blog

Carpal Tunnel Syndrome: Getting a Grip on the Latest Treatments

By: Dr. David Friedman

Having discomfort in your hand and wrist? Weak, numb or tingling fingers? You may be experiencing carpal tunnel syndrome (CTS.) Carpal tunnel syndrome is caused when the median nerve, which runs from your forearm through your wrist into your hand, gets compressed. The most common cause of this pinching is repetitive use of the hands and arms (i.e. typing at a computer, punching cash register keys, texting, using tools, knitting, etc.) According to the U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), CTS causes the highest number of days lost among all work related injuries. The ailment has become the nation’s most common and costly occupational health problem, affecting hundreds of thousands of American workers, and costing more than $20 billion a year in workers compensation.

DIAGNOSIS

If you are waking up with numbness in one or two hands and feel the need to shake it to get relief, you probably have CTS. There are some objective tests your doctor can perform to confirm a diagnosis. First, he will hold your hands in certain positions to see if this causes your symptoms to increase. Next, he may do an orthopedic procedure called Tinel’s test. This is performed by lightly tapping (percussing) over the nerve to elicit a sensation of tingling or “pins and needles” in the distribution of the nerve. Or, there’s a more definitive test called a “nerve conduction study” where probes are placed on your arm and electrical impulses are tested individually to see if the impulses are blocked.

TREATMENT OPTIONS

Once you have received the diagnoses of CTS, there are several treatment options. The worst thing you can do is use those common five words, “Maybe it will go away.” Ignoring the early signs of CTS can eventually lead to a permanent disabling condition later.

 CHIROPRACTIC 

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In my office, CTS is hands-down (pun intended) one of my favorite ailments to treat. The treatment is a gentle realignment of the bones in the wrist which brings relief, often immediately! During my exam, I do pre- and post-grip strength tests, and the results after treatment are phenomenal! I have seen patients, who had no strength at all in their hands, able to open a pickle jar after just one treatment. Sometimes, I’ll recommend patients wear a wrist splint. This keeps the wrist and fingers in neutral positions, which can reduce the pain. I will review ways that the hands can be used without aggravating the condition. Apart from typing, texting, knitting and hammering, there can be other activities that will make you more prone to getting CTS. For example, pushing things with the wrist in an extended position, like doing pushups or giving somebody a high five, creates inflammation inside the carpal tunnel. If you have signs of CTS, use your fist to close doors. When pushing yourself up from a chair, use your fist instead of the extended hand. That one tip alone will help you more than you can imagine.  Keep in mind, not all Chiropractors treat CTS. It’s important to find someone that is certified in extremity adjusting and can accurately realign the osseous structures in the wrist.

NUTRITION AND DIET

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The next time you’re at the grocery store, reach for some fresh pineapples, because they contain an enzyme called bromelain, which helps to reduce inflammation in the wrist. In the summertime months, enjoy watermelons. They act as a diuretic, which can also reduce inflammation which helps relieve carpal tunnel syndrome. Also, I’ve seen great success by recommending Vitamin B6 (100 mg). Taken daily, some people see a reduction of symptoms in as little as three weeks. Lastly, stay away from food that contributes to inflammation like sugar, corn, red meat and dairy products. Eating these items is like pouring gasoline on a flame.

USE ICE/HEAT COMBO

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Because CTS can cause compression of the blood vessels in the wrist and hand, swelling is common. I’ve had many patients who had to stop wearing their wedding ring because it no longer fit. The best way to remedy this is to use an ice/heat combo soak. Simply soak your hand in a pan or bucket of ice water for 15 minutes, followed immediately by soaking that same hand in warm water for 15 minutes. The ice water compresses the blood vessels and removes inflammation and the warm water opens up the blood vessels and increases a fresh blood flow, which promotes healing. I like to call this an oil change of the wrist and hand; out with the old blood and in with the new. This procedure will also bring more Vitamin B6 to that area where it’s needed.

PAY ATTENTION TO HOW YOU SNOOZE

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CTS symptoms often come on at night and may wake you up. Some doctors believe this is because the fluid in the body is redistributed when you lie down, so more of it accumulates in the wrist. But another contributing factor may be your sleeping position: You may sleep with your wrist bent and/or tucked under your head or pillow, which can cause compression of the median nerve. So when you settle down for the night, allow your hand or wrist to lie flat on the mattress.

LOSE WEIGHT

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Excess weight can compress the median nerve in the wrist, so try to keep your weight within five to ten pounds of your ideal weight by eating a healthy diet and getting plenty of exercise. Avoid using hand weights. Instead, reach for those exercise bands and don’t forget your cardio.

AVOID SMOKING

Quit-SmokingIn addition to harming the heart and lungs, smoking constricts the small blood vessels of the hand and reduces blood flow, which can aggravate Carpal Tunnel Syndrome.

SURGERY

Carpal Tunnel Syndrome surgery is an option but should be the last resort. Even when a surgical procedure for CTS is successful, the results are often temporary. During surgery, the orthopedic will use a scalpel to cut through the three layers of skin, muscle fibers and ligaments. Once cut, all of these areas will start to heal with scar tissue. Because scar tissue is hard and rough, this can eventually lead to compression on the median nerve and bring back a return of the symptoms. This requires an additional surgery to remove the scar tissue that was caused by the previous surgery. It’s a vicious cycle. Always opt for conservative, natural options before considering surgery. By utilizing chiropractic, nutrition, dietary and lifestyle changes, your chances of success are very high. After you’ve exhausted conservative methods, then and only then should you consider invasive surgery for CTS.

CTS is a debilitating condition that can strip people of their ability to use their most valued asset, their hands. If you are suffering with symptoms of CTS, get a grip and take some proactive steps to get your life back! Caught early, the ailment can be 100% fixable! High five? No. Remember, if you’re suffering from CTS, it’s better to do a fist bump.

About the Author

Dr. David Friedman is a Clincial Nutritionist, Doctor of Naturopathy, Chiropractic Neurologist, Board Certified Alternative Medical Practitioner, and Board Certified in Integrative Medicine.  He's the author of the Food Sanity, how to eat in a world of fads and fiction.  Dr. Friedman is a syndicated television health expert and host of  To Your Good Health Radio, which has changed the face of talk radio by incorporating entertainment, shock value and solutions to everyday health and wellness issues.

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