Integrative medicine treatments relieve carpal tunnel syndrome

By Linda Childers

Carpal tunnel syndrome (CTS), a condition that causes pain, tingling, and numbness, in the hand and arm, is on the rise, as more patients spend time using smartphones and other electronic devices.

A study published in The Journal of Family Medicine and Primary Care found that four or more hours per day of smartphone use was associated with the development of CTS. In addition, the study found those who held their smartphone with both hands, had a 7.8 percent higher risk of developing CTS than those who only used one hand.

The American College of Rheumatology reported that CTS is the most common nerve disorder experienced today, affecting 4-10 million Americans. Middle-aged and older individuals are more likely to develop CTS and women are three times more likely than men to be diagnosed with CTS. The good news is the condition is typically very treatable.

While physicians may prescribe traditional treatments for CTS such as pain medications, steroid injections, and even surgery to relieve pressure on the nerve, several integrative medicine treatments, including chiropractic care and acupuncture, provide safe, effective, non-medicinal approaches to treating CTS.

Ashley Prince, DC, of Prince Health and Wellness in the Woodlands, Texas, said diagnosing carpal tunnel syndrome can be difficult if clinicians only look at symptoms. In her clinic, Prince uses full spine imaging, such as X-rays, to determine if there is nerve entrapment in a patient’s neck. If there is no entrapment in the neck causing nerve pain going down the arm, she X-rays the elbow and the wrist. 

“If the nerve entrapment is coming from the neck, cervical manipulation will be performed. If the entrapment is in the elbow or wrist, extremity adjustments, an instrument called an Arthrostim will be used,” Prince said. “This provides gentle pressure to the affected area and reduces symptoms by taking pressure off the affected nerve.”

Kevin Lees, DC, manager of auditing and quality at The Joint Chiropractic, said chiropractic therapies can relieve CTS-related pain, including cryotherapy, soft tissue mobilization techniques such as median nerve glides, joint manipulation to wrists, elbows, and cervical spines, and exercise.

“Chiropractors view the body holistically and seek to treat the cause of CTS by helping to remove the nerve compression through mobilization or adjustments, “Lees said. “We can also help patients stretch and strengthen these muscles to avoid recurrence.”

Emphasizing good ergonomics while using devices is also key in preventing CTS, according to Lees. He encourages patients to stretch and flex their hands and wrists often when taking breaks from repetitive tasks like typing, which helps take stress off the arms and wrist.

Treatment for CTS can last weeks or months, depending on the severity of the condition, how quickly treatment begins, and the type of treatment used, he said.

“Fluid retention, osteoarthritis, ligament laxity and obesity, which slows down how fast the nerves travel to the hand, can all play a role in carpal tunnel syndrome,” Lees said. “Symptoms may take time to appear, signaling that the problem has already been occurring for a while.”

Lees said practitioners should work to determine the underlying cause to address each patient’s CTS.

“While some treatment is aimed at resolving symptoms, if the cause of CTS isn’t addressed, symptoms will most likely return,” he said. “Following up treatment with exercises and stretches to help change the biomechanics is very important.”

Addressing CTS through acupuncture

Acupuncture has also been shown to be an effective treatment strategy for CTS patients, according to Sabrina Havens, DACM, of Onda Blu Acupuncture in Great Neck, New York. Havens typically uses a combination of acupuncture and massage therapy techniques.

“I do this not just to treat CTS, but also to assess the muscles in the forearm, shoulder, and neck,” she said. “Often, there can be multiple areas affected although their primary pain is in the wrist.”

According to Havens, while some clients typically see a difference after one session, it typically takes six acupuncture treatments to see significant results.

A study published in Alternative Therapy Health Medicine found those with CTS who had acupuncture treatments for four weeks noticed improvements in pain, numbness, tingling, and muscle weakness.

“Results are dependent on the severity of condition and other complicating factors, such as a client’s job that doesn’t allow adequate rest,” Havens said. “I take a gentle approach when I begin treating a client with CTS, for example, I often start with needling alone and add electric stimulation based on the patient’s comfort level.”

Havens also encourages practitioners to work with or refer out to physical therapists for appropriate therapeutic exercises. She has found acupuncture coupled with good physical therapy can provide clients with the longest lasting relief. Physical therapists, occupational therapists, and certified hand therapists can teach patients hand and wrist exercises to do at home to prevent and relieve discomfort caused by CTS.

A study published in the Journal of the American Medical Association found that a yoga-based regimen was also effective in relieving symptoms of CTS. After practicing 11 yoga postures, including dandasana, namaste, and garudasana, designed for strengthening, stretching, and balancing, twice weekly for eight weeks, participants reported significant improvements in pain and grip strength. Researchers noted that since CTS occurs primarily due to improper alignment, yoga can counteract the repetitive movements that led to the development of CTS.

“For many of us, screen time is part of our lives,” Havens said, “and we can’t escape the strain on our wrists, but we can take breaks and perform wrist exercises to strengthen and increase circulation.”