Tuesday, 17 September 2019

Combating carpal tunnel syndrome


Combating carpal tunnel syndrome image
I've been suffering from tingling, numbness and pain that comes and goes in my right hand. My doctor told me it's carpal tunnel syndrome, probably caused by years of using my computer mouse at work and long hours spent scrolling on my smartphone. I've already taken steps to improve my posture at work, including changing my mouse, and cut down on the amount of time I'm on my phone, but can you suggest anything else that can help? I don't want to go down the drug route.
J.T., via email
Carpal tunnel syndrome is a condition caused by pressure on the median nerve, which runs through a U-shaped space in the wrist called the 'carpal tunnel.' As well as the symptoms you describe, it can also lead to weak muscles in the hand, difficulty gripping and even a permanent loss of feeling in some fingers.

While repetitive computer use is commonly thought to be a cause of carpal tunnel syndrome, scientific studies on this have reported contradictory results. Still, a recent review of the evidence found that frequent computer or mouse use can nearly double the risk of developing the condition.1 Repeatedly tapping, scrolling and swiping on your smartphone or tablet can also lead to carpal tunnel problems, it seems.2

If these sorts of repetitive movements are the cause of your carpal tunnel syndrome, improving your posture and reducing your phone use should help (also remember to give your hands and wrists a break every 15-20 minutes). But make sure you rule out other possible causes such as diabetes, arthritis and thyroid disease.3

Here are some other steps you can take to beat the condition.
Myofascial release
This holistic hands-on therapy, which uses manual pressure and stretching to release physical restrictions in the body, could help carpal tunnel syndrome. Instead of manipulating muscles, myofascial release works on the fascia—the web of elastin and collagen fibers that surrounds and separates muscles and other internal organs—which can scar or harden as a result of trauma, inflammation or prolonged poor posture.

In a study of four patients with carpal tunnel syndrome, all saw an improvement in both their symptoms and magnetic resonance imaging (MRI) scans after myofascial release treatment.4
To find a myofascial release practitioner near you visit

www.myofascialtherapy.org, or see below for how to do it yourself.
DIY myofascial release
According to Amanda Oswald, a leading myofascial release therapist in the UK and author of Living Pain Free: Healing Chronic Pain with Myofascial Release, most diagnosed cases of carpal tunnel syndrome have nothing to do with the carpal tunnel. The symptoms are caused by restrictions in the fascia further upstream, particularly in the neck, chest and armpit, she says. Her approach is 'fascial stretching,' focusing on the neck and arms, to release tension in these areas, and it's something you can easily do yourself at home.

Here's a simple exercise to try. Hold each stretch for at least 1½ to 2 minutes—the time it takes for fascia to start to release.

• Standing or sitting, slowly take your head to the side, bringing your ear toward your shoulder.
• Allow your arms to hang by your sides and keep your arms and shoulders loose.
• Gently move deeper into the stretch, waiting when you feel barriers and slowly breathing into them to allow deeper release.
• Imagine your opposite arm elongating and stretching away from your neck to create a three-dimensional fascial stretch in a pattern from your fingers to your arm, neck and head.
Tips
Beginners: Practice this in front of a mirror to ensure you don't raise your shoulders up as you stretch.
Advanced: To deepen the stretch, place your hand on the side of your head, but do not force it; only use the pressure of your hand as a counterweight.
For more fascial stretches for carpal tunnel syndrome, see Amanda's book Living Pain Free (Lotus Publishing, 2017; available on Amazon)
Osteopathy
This manipulative treatment has proven success in treating carpal tunnel syndrome, especially the 'opponens roll' maneuver.5 Used together with self-stretching exercises, it resulted in less restricted wrist movement and improved nerve conduction in one study.6

To find an osteopath near you visit www.academyofosteopathy.org in the US or www.osteopathy.org.uk in the UK.
Traditional Chinese medicine (TCM)
TCM techniques including acupuncture and cupping can be effective for carpal tunnel syndrome. In one randomized controlled trial, acupuncture was just as effective as steroid treatment, and it was also better at reducing sleep disturbance and improving nerve conduction than the drugs and came with minimal side-effects.7

In a trial of cupping therapy, whereby heated glass cups are applied to the skin to create suction and encourage energy flow in the body, the cupping group experienced a significant reduction in pain and other symptoms compared to the control group.8
Yoga
A yoga-based therapy was more effective at easing carpal tunnel syndrome and improving grip strength than wrist splints or no treatment in one study. The participants practiced 11 yoga postures that worked the joints of the upper body, along with relaxation, twice a week for two months.9
Check out WDDTY's August 2017 issue for some excellent hand and upper body exercises provided by our resident yoga expert Charlotte Watts, or find a yoga class or therapist near you.
Vitamin B6
Carpal tunnel syndrome has been linked to low levels of vitamin B6,10 so supplementing with the vitamin might help. In fact, several trials have found B6 to alleviate symptoms, even in people who are not deficient in the vitamin.11
Suggested dosage: 100 to 300 mg/day for up to three months; 50 to 100 mg/day after that.


References

References
1 J Neurol Sci, 2015; 349: 15-9
2 Muscle Nerve, 2017; 56: 873-80
3 J Gen Intern Med, 1999; 14: 310-4
4 J Am Osteopath Assoc, 1993; 93: 1273-8
5 Phys Med Rehabil Clin N Am, 2014; 25: 249-64
6 J Am Osteopath Assoc, 1994; 94: 647
7 Clin J Pain, 2009; 25: 327-33
8 J Pain, 2009; 10: 601-8
9 JAMA, 1998; 280: 1601-3
10 Nutr Rev, 2004; 62: 96-104
11 Adv Pharm Bull, 2013; 3: 283-8; J Am Coll Nutr, 1993; 12: 73-6

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