what is carpal tunnel syndrome?

“In general, Carpal Tunnel Syndrome develops when the tissue around the Median Nerve of the hand swell and press on the nerve.  Early in the disorder, the process is reversible.  Over time, however, the insulation on the nerves may wear away, and permanent nerve damage may develop.  It is critical to begin treating early phases of Carpal Tunnel Syndrome before the damage progresses.  A conservative approach to CTS…… is the first step in treating this disorder.”  The University of Maryland Medical Center’s Carpal Tunnel Syndrome webpage.

“Carpal Tunnel Syndrome is a very common condition, caused by ‘The Pill’, pregnancy, Rheumatological, or Endocrine disorders; and involves compression of the Median Nerve in the Carpal Tunnel”   The Carpal Tunnel Anatomy video below from England’s University of Warwick.

Carpal Tunnel Syndrome.  It’s one of THOSE PROBLEMS that has become increasingly common in our stress-filled society.  The main symptoms are pain, numbness, and tingling.  Due to a wide array of factors, the tunnel (seen in purple above) becomes crowded due to swelling and INFLAMMATION.  As the swelling increases, the Median Nerve becomes irritated, causing the symptoms, and if left untreated, weakness.  The real shocker about this problem is what experts now think causes it.  According to an August 2013 issue of Medical News Today (What Is Carpal Tunnel Syndrome? What Causes Carpal Tunnel Syndrome?), this problem, according to brand new research from Harvard Medical School, is not nearly as associated with chronic overuse or computer use as we have been led to believe.  In fact, there are those who believe it is an AUTOIMMUNE DISEASE similar to Raynaud’s Phenomena.  And if you look at the list below, you will see that Carpal Tunnel Syndrome is intimately associated with several such (Autoimmune) diseases.

• DIABETES:  We are a nation of SUGAR ADDICTS.  Just remember that you do not have to have FULL BLOWN DIABETES in order to have Sugar Dysregulation.  Also remember that problems with the regulation of blood sugar are a foundational point for virtually all diseases (HERE).

• HYPOTHYROIDISM & DIMINISHED PITUITARY FUNCTION:  HERE is the link on thyroid issues.  In case you were not aware, the vast majority of America’s thyroid problems (Hashimoto’s and Graves) are AUTOIMMUNE.  Be aware that the quote at the top mentioned ENDOCRINE PROBLEMS in general, which would encompass the first three bullet points on this list.

• OBESITY: Unfortunately, when you count those who are SKINNY FAT, almost 80% of our nation’s adult population is either overweight or OBESE.

• RHEUMATOID OR DEGENERATIVE ARTHRITIS:  HERE are several links pertaining to various kinds of Arthritis (RA is Autoimmune).

• TENDON PROBLEMS:  I actually wrote an entire post about THIS FACTOR.

• PREVIOUS TREATMENT FOR BREAST CANCER:  This one was interesting.   And while I could POSTULATE AS TO THE RELATIONSHIP, I am not really sure.

• PREVIOUS WRIST INJURY:  This could be almost anything, including fractures, sprains and strains, or possibly TENDINOSIS.

• USING VIBRATING HAND-TOOLS REGULARLY:  This actually sounds more like a risk factor for Raynaud’s Disease (aka “Jackhammerer’s Syndrome”) than it does for Carpal Tunnel Syndrome.

• WORK-RELATED STRESS:  Although this is sort of a catch-all; as amazing as it sounds, neither repetitive work with the hands nor computer work made the list.

What does this list tell me?  It tells me that the same factor that is heavily involved in nearly all sickness and disease seems to be at work in Carpal Tunnel Syndrome as well.  What would that factor be?  Can anyone say INFLAMMATION?  Here’s the problem though.  Unless you begin to understand what actually causes Inflammation, you will end up being treated by physicians intent on prescribing you non-steroidal anti-inflammatory drugs (NSAIDS) or even worse; corticosteroids.  And when those don’t work — and frequently they do not — it’s on to Carpal Tunnel Syndrome Release Surgery.

Is surgery an effective / cost-effective option for CTS?  Depends on who you talk to.  I am here to tell you, however, that for many of you, there’s a better way to deal with this and many other INFLAMMATORY HEALTH PROBLEMS than simply taking another drug.  Since Carpal Tunnel Syndrome is not necessarily what you thought it was, it might make sense that it needs to be dealt with in ways that you might not necessarily have thought of or even heard of.  In other words, you may need to step outside the box.

According to most sources (see quote from the top of the page), Carpal Tunnel Syndrome can typically be effectively dealt with in a conservative manner —- if it is caught early enough.  The questions now become, what constitutes “conservative treatment” and when is “early enough“?  Let me first tell you what it is not considered conservative.  Despite the medical community’s inference that virtually anything falls into the “conservative” category so long as it does not involve surgery; is not really the most accurate way of thinking about this issue.  Case in point; corticosteroids.

An April 2007 study (A Systematic Review of Conservative Treatment of Carpal Tunnel Syndrome) published in the medical journal Clinical Rehabilitation, looked at the evidence from over 30 randomized studies on Carpal Tunnel Syndrome.  Although they mentioned NSAIDS as showing “limited” efficacy in the treatment of CTS (something that is recommended by most physicians, and touted on sites like MayoClinic and WebMD), their big brother (CORTICOSTEROIDS — injected and / or oral) was the only form of treatment that made the “strong evidence” category.  Yes; I understand that steroids have the ability to at least temporarily relieve the symptoms of CTS.  The problem is, they also have a crazy array of common and frequently severe side effects.

While I’m all about helping people avoid surgery, one must be careful about trading tomorrow for today — which is exactly what you are likely doing with corticosteroid injections.  Although the short term effects of corticosteroids such as cortisone range from mood swings, swelling of the limbs and face, SEXUAL DYSFUNCTIONS, INDIGESTION, BLOOD SUGAR DYSREGULATION, WEIGHT GAIN, INSOMNIA, ACNE, ANXIETY / DEPRESSION, and a slew of others, they are not my biggest concern.  The real problem with corticosteroids (particularly when they are injected) is local degeneration.  While it was dealing with chronic back problems and not Carpal Tunnel Syndrome, a 2004 study published in the Spine Journal said, “no conclusive evidence exists to determine that spinal steroid injections give lasting improvement…“.  This is just as true with Carpal Tunnel Syndrome

WebMD’s “Carpal Tunnel Syndrome Health Center” carries an article called, Corticosteroids for Carpal Tunnel Syndrome.  Listen to what the authors have to say about this mode of treatment.  “Although they may relieve pain and inflammation, corticosteroids can also slow healing and weaken tendons and bones (osteopenia or OSTEOPOROSIS). Other side effects of corticosteroid injection include pain that gets worse after the injection, loss of strength and movement in the tendon, breakdown (degeneration), tearing, or rupture of the tendon, scarring of the tendon, or accidental injury to the median nerve in the wrist during injection.”   And even though the meta-analysis we looked at earlier essentially said that NSAIDS were a wash as far as their effectiveness in dealing with this Carpal Tunnel Syndrome, they were touted by WebMD as a preferred form of treatment —- probably because they are less dangerous than the steroids.

The bottom line is that corticosteroids, while undoubtedly providing some temporary relief of symptoms, are a terrible long term ‘solution’ to Carpal Tunnel Syndrome.  In fact, one of the studies I looked at actually talked about a side effect called Wallerian Degeneration.  This is where the nerve actually begins degenerating / deteriorating back up the arm (I know someone who had this happen).  When these so-called “conservative” treatment methods don’t work, surgery is the next option.  What exactly is Carpal Tunnel Release Surgery and what does it entail?

In Carpal Tunnel Release Surgery, an incision is made in the Transverse Carpal Ligament (aka the Flexor Retinaculum — see the pic at the top of this page) in order to “release” the bound ligament, and thus ‘release’ or take pressure off of the contents of the Carpal Tunnel.  Read between the lines as you listen to what a popular online encyclopedia had to say about the success rates of Carpal Tunnel Release Surgery.

Think for a moment about what the authors are really saying in light of what many of you already know.  If you have worked in an industry where Carpal Tunnel Release Surgery is common, you already know that recurrence of symptoms after the surgery are likewise common — despite the fact that according to the quote above, you are likely being told that your symptoms are no longer caused by Carpal Tunnel Syndrome.  This sort of reminds me of a doctor I once asked the question of why so many people come down with the worst case of flu ever, shortly after getting a FLU SHOT.  His answer was that technically speaking, they don’t come down with the Flu.  It is merely “Flu-like symptoms“.

Put all this in the computer, add it up, and it tells me that somewhere we are missing the boat with this problem we call Carpal Tunnel Syndrome.  Surely there must be a better way to deal with Carpal Tunnel Syndrome.  Often times there is.  How would I go about helping someone struggling with Carpal Tunnel Syndrome?  There are several steps that make sense in light of the most current peer-reviewed literature.

• CHANGE OF DIET AND LIFESTYLE:  Remember the list from the top of the page on the chief causes of Carpal Tunnel Syndrome?  Reviewing this list reveals that Carpal Tunnel Syndrome might be far more complex than we have been led to believe.

• CHIROPRACTIC ADJUSTMENTS:  The nerves that end up in your hand and wrist come from your neck.  Make sure to take a look at the NERVE CHART.

• TISSUE REMODELING:  This could be at either the WRIST or the NECK.  HERE is what I am talking about when I mention “Tissue Remodeling”.

• NUTRITIONAL SUPPLEMENTS:  This might be in the form of WHOLE FOOD B-Vitamins.  It might mean that you need to take some PGFO.   An obvious GUT PROBLEM (seen in most of the problems in the list at the top of the page) might mean that you need some PROBIOTICS or something else.

• COLD LASER THERAPY:  This is an amazing (relatively) new technology that promotes healing.  If you want to find out more about the way that COLD LASER THERAPY would work with Carpal Tunnel Syndrome, just click the link.

If you are interested in learning more about AVOIDING CARPAL TUNNEL SURGERY, just click the link and begin reading.