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Carpal Tunnel Syndrome - Remedies and Treatment Strategies

Pain, General | July 20, 2014 | Author: The Super Pharmacist

general, Pain

Carpal Tunnel Syndrome - Remedies and Treatment Strategies

The carpal tunnel is an anatomical structure located at the end of the wrist. It is an 'arch' formed by the carpal bones leading from the wrist into the palm in the general direction of the thumb. The function of the carpal tunnel is to allow tendons and the medial nerve to pass into the hand, which provides motor ability and sensation to this structure. The median nerve controls sensation in the thumb, first two fingers, and also the proximal (i.e. closest to the palm) portion of the third finger. In addition, the medial nerve serves the muscles located at the base of the thumb. This controls its range of motion away from the fingers and palm.

Carpal tunnel syndrome is a condition in which the arch is compressed or otherwise becomes smaller. If this results in mechanical impingement to the medial nerve, it may result in pain and motor problems in the hand. It may also result in a loss of sensation in the fingers mentioned above.

Compression of the carpal tunnel may be associated with accumulation of the material normally present in the structure for the purposes of lubrication and protection, known as synovium. It may also be associated with swelling in other soft tissue. Other symptoms of carpal tunnel syndrome may include tingling and extreme numbness in the affected area. This condition is often chronic and can cause considerable reductions in the life quality of those affected. 

Causes of Carpal Tunnel Syndrome

Causes of Carpal Tunnel SyndromeThe causes of carpal tunnel syndrome are often controversial. Many cases are idiopathic, or appearing with no apparent explanation or underlying cause, such as a related condition (see below).

Carpal tunnel syndrome is also often associated with repetitive strain, i.e. with occupations that involve a high volume of hand motions, such as typing or other manual labour. This association is often dismissed, but research has shown a consistent link with service industry, healthcare or office work and self-reports of carpal tunnel syndrome worldwide.

The incidence of carpal tunnel syndrome is also associated with a range of conditions that may increase the risk of carpal tunnel and/or medial nerve compression or soft tissue swelling in general.

These conditions include:

  • Pregnancy
  • Cancer (i.e. certain tumors may be present in the carpal region, thus pressing on the medial nerve)
  • Diabetes
  • Osteoarthritis
  • Rheumatoid arthritis
  • Gout
  • Hypothyroidism
  • Obesity
  • Hypertension
  • Acromegaly

Diagnosis of Carpal Tunnel Syndrome

Diagnosis of carpal tunnel syndrome is initiated by patient reports to a doctor, who may then recommend procedures to verify the presence of the condition. These reports usually involve numbness intense enough to wake the patient from sleep, which is a classic first sign of carpal tunnel syndrome. The better-regarded diagnostic tests include:

  • Nerve conductance tests and/or electromyography
  • Qualtitative sensory testing
  • Magnetic resonance imaging (MRI)
  • Ultrasonography
  • X-ray and/or computed tomography

Treatments and Remedies for Carpal Tunnel Syndrome

There are many treatment strategies available for carpal tunnel syndrome, which mainly focus on reducing swelling or allowing the free movement of the medial nerve. These include:


This may involve the use of splints, which are specifically-designed devices worn on the wrist, similar in appearance to braces or casts.

SplintingThe purpose of splinting is to maintain the wrist in a position that reduces carpal tunnel compression (i.e. it may reduce wrist bending or flexing) thus alleviating pressure on the medial nerve.

In some cases, the splint is worn only at night to prevent wrist postures that contribute to carpal tunnel syndrome. Although treatment is more effective if applied full-time.

Splinting may be a more acceptable treatment for patients who do not wish to undergo surgery However, some research indicates that this treatment is only effective in the short term.


This is a pharmacological option that acts by inhibiting pain and inflammation when injected into the affected area. In the case of carpal tunnel syndrome, corticosteroid injection may also contribute to decompression in the carpal arch. An alternative to injected steroids are oral steroids, which have been found to be effective in the treatment of carpal tunnel syndrome. Steroid therapy carries some risks, including side-effects such as weight gain, mood swings and gastrointestinal damage.

Steroid therapy has been found to be most effective in short-term treatment of carpal tunnel syndrome.

Local Anasethetics

Procaine is a local anaesthetic medication that may be administered in combination with corticosteroids, to provide additional pain relief. Recent research has indicated that procaine alone is equally effective, however. A trial of a heated patch releasing other local anaesthetics (tetracaine and lidocaine) in 15 patients resulted in significant pain reduction over 14 days.

Local anaesthetics may provide a viable alternative to steroid therapy for carpal tunnel syndrome.


Carpal Tunnel SyndromeThis is an alternative therapy derived from traditional Chinese medicine.

The modern form of acupuncture  is regarded as effective in treating a variety of pain conditions. 

A trial of acupuncture in carpal tunnel patients found that this treatment produced significant improvements in symptoms, and was equal in effect to steroid (prednisolone) therapy.


This may be an undesirable option for many patients, but often results in long-term improvement in the symptoms of carpal tunnel syndrome. These procedures typically involve the bisection of the transverse carpal ligament, which lies roughly above the medial nerve (if the hand is placed palm upwards).

This alleviates compression on the nerve, resulting in a significant reduction of pain and/or numbness.

There are two basic types of carpal tunnel surgery:

  • Open-wrist
  • Endoscopic

These are regarded as equal in efficacy, although endoscopic surgery may be associated with quicker recovery times. There is also little difference between the two types in terms of complications or risks, which may include scarring, reduction in grip strength and 'pillar pain', a type of pain felt in the upper surface of the hand. Surgery is recommended for moderate to severe cases of carpal tunnel syndrome.  Australia's best online pharmacy


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