Introduction Risk factors Diagnosis Conventional treatment

Causes Symptoms Prevention Homoeopathic treatment

Carpal Tunnel Syndrome is basically is a set of symptoms that occur when a particular nerve (Median nerve) gets compressed at the wrist. This condition is grouped under 'Entrapment Neuropathies' since the nerve gets 'trapped' in a tunnel-like space of the wrist which is called 'Carpal Tunnel'. The Median nerve is responsible for sensations on the palmer aspect of the thumb and fingers as well as movements of some of the small muscles of the hand. Due to pressure of the surrounding vessels and tendons on the median nerve, it starts producing abnormal sensations and pain in the areas that are supplied by it.

As mentioned earlier, the primary cause of Carpal Tunnel Syndrome is the compression of the Median nerve at the wrist. The increased pressure on the nerve may be due to any one the following reasons:

• Congenitally smaller Carpal Tunnel
• Trauma/ injury to the wrist resulting in swelling of the wrist tissues
• Overactivity of the pituitary gland
• Hypothyroidism
• Rheumatoid arthritis
• Mechanical problems in the wrist joint
• Stress
• Constant and repeated use of vibrating hand tools
• Fluid retention (during pregnancy, menopause, etc)
• Cyst or tumour development within the Carpal Tunnel

• Gender: Female to male ratio for development of this condition is 3:1. This may be due to a smaller canal in females as compared to males.
• More likely to develop in the dominant hand
• Diabetes and other metabolic disorders that affect nerves in general
• People in occupations that involve assembling such as manufacturing, sewing, finishing, cleaning meat/poultry, fish packing, etc
• Jobs that involve typing a large volume of data for long hours

Some of the common symptoms of Tension headaches are as follows:

• Gradual onset in most cases with involvement of palmer aspect thumb, index and middle fingers
• Burning sensation, tingling, numbness, discomfort in above mentioned areas
• There may be a sensation as if fingers are swollen even though there is no perceptible swelling on examination
• Symptoms usually appear during night time in the initial stages
• Sharp shooting pains in the forearm
• Grip power may be reduced
• There may be wasting of muscles in the affected region in the advanced stages
• Some patients may be unable to tell difference between warmth and cool sensations (using the affected fingers)

Early diagnosis is essential for prompt treatment of this condition which can otherwise progress significantly. Clinical signs and symptoms are mostly indicative of the diagnosis. Certain tests (blood investigations, X-rays, etc.) may be done to rule out other conditions with similar features like Carpal Tunnel syndrome.

To confirm the diagnosis, Electrodiagnostic tests such as those mentioned below may be done:

• Nerve Conduction studies
• Electromyography
• Ultrasound imaging

• Avoid repetitive activities that may worsen symptoms
• Give adequate rest to the wrist: Use splints if required
• Take frequent breaks at work, perform stretching exercises
• When working with vibrating equipment, wear gel-padded gloves
• Avoid gripping very hard when writing, driving or using tools
• Keep your keyboard at the height of your elbow or slightly lower than that
• Stiffness and pain may worsen with a colder atmosphere so you can adjust the room temperature or wear fingerless gloves

• In case the patient has any underlying condition such as diabetes, arthritis, etc. the treatment of the same is advocated first.
• Drugs such as Non-steroidal anti-inflammatory drugs (NSAIDs) are often used for pain relief
• Steroids are generally injected locally in cases of severe pain
• Vitamin B6 supplements are also prescribed
• Diuretics (drugs that treat water retention) may be useful in some cases
• Surgery: Carpal Tunnel Release is the surgery of choice in cases where medical treatment gives no relief.

Homeopathy has good scope in the treatment of Carpal Tunnel syndrome. The medicines can effectively control the discomfort, tingling, numbness, pain associated with this condition.

It must be kept in mind that targeting the cause during treatment is very essential, for e.g., if the condition has occurred due to generalised water retention in the body (from any cause), the underlying condition also has to be treated else the tissue swelling in the wrist will not subside.

In cases where an inhererently narrow Carpal tunnel is the cause of the pain, Homeopathy can offer pain relief but will not increase the size of the canal; however, treatment may delay or avoid the need for surgery in such cases.