Carpal tunnel syndrome is a common issue found in the the hand and wrist, and can be very painful. The syndrome manifests itself through the nerves that lead to the fingers and the hand being pinched by a narrowing of the carpal tunnel. This leads to pain, especially at night. While the most common treatment is still surgery, proper nutrition with a focus on micronutrients such as Magnesium and B-Vitamins can also provide relief.
Age, hard physical labor, diabetes, and pregnancy are the most common triggers of carpal tunnel syndrome, affecting women three times as often as men.
How does carpal tunnel syndrome develop?
Carpal tunnel syndrome is a significant narrowing of the median nerve in the area of the wrist. Increasing age and heavy physical work with mechanical overstraining of the wrist are the main risk factors, especially for women, who are affected about three times as often as men.
Carpal tunnel syndrome often occurs in metabolic disorders such as diabetes mellitus (up to 15% of diabetics are affected) or in dialysis patients. Hormonal changes such as pregnancy or thyroid diseases can also trigger the disease. Chronic inflammatory diseases such as rheumatism and tendovaginitis as well as fractures in the wrist area can also lead to a narrowing of the carpal tunnel.
What symptoms should I watch out for?
Typical symptoms of carpal tunnel syndrome include nightly pain in the hand area radiating into the forearm, which is exacerbated when trying to fall asleep. Additionally, tingling or discomfort, especially in the first three fingers (thumb, index and middle fingers) can occur. Over time, these issues can get worse and manifest themselves during the day. Due to impaired motor function, especially affecting the thumb, carpal tunnel syndrome leads to clumsiness during work requiring fine motor skills. Further, one may experience a weak grasp and, over time, muscle atrophy in the thumb. Patients often wake up at night and have to shake out the affected hand and hold it under cold water to relieve the symptoms.
In the carpal tunnel, all flexor tendons of the fingers as well as the hand nerve, the so-called median nerve, run from the forearm to the palm of the hand. The median nerve is a complex nerve, controlling muscle movements in the thumb area (motor function) and other tasks. This nerve also provides the feeling of touch to all fingers except half the ring finger and the pinkie. The carpal tunnel encased by carpal bones and supplemented by a tight band to form the “tunnel”. In the case of tissue swelling in the tunnel, this leads to pressure and damage to the median nerve with the occurrence of typical symptoms.
How is carpal tunnel syndrome detected?
In most cases, the diagnosis of carpal tunnel syndrome can be made by interviewing the patient (anamnesis) and clinical examination. A precise neurological examination with measurement of the nerve conduction speed of the median nerve, which is significantly slower in the event of illness, is important to ensure the diagnosis. The motor transfer time and sensitive nerve conduction speed are measured.
If the findings are unclear, further examinations, especially of the cervical spine, are necessary to exclude other diseases as the cause of the issues. As timely diagnosis and treatment can prevent permanent damage (sensory disorders, muscle loss), a doctor should be consulted as early as possible.
Treatment of carpal tunnel syndrome
In the early stages of the disease and in mild forms of the disease, night-time wearing of a splint and the administration of anti-inflammatory and decongestant drugs can be tried. If this treatment does not soon lead to an improvement, the operation should not be delayed in order to prevent permanent damage to the nerves. The operation can be performed under regional or local anaesthesia. The tight connective tissue band (retinaculum) that closes off the carpal tunnel is completely cut and the median nerve is exposed via a small skin incision. Often the nerve is already clearly flattened due to the constant pressure.
Magnesium, vitamin B6, alpha-lipoic acid and omega-3 fatty acids can alleviate symptoms
What role does the right diet play?
In addition to surgical treatment, it often makes sense to take supportive action through nutrition. Magnesium, B vitamins, omega-3 fatty acids and alpha-lipoic acid are of particular importance here.
Magnesium, with its effect on the nervous and muscle system, can help to release muscle tension in the wrist and avoid additional pressure on the pain region. The group of B vitamins, especially B6, with their positive neurological effects are particularly effective at preventing nerve degeneration and relieving pain in nerve tissue. Finally, the special antioxidant, blood circulation, and anti-inflammatory properties of omega-3 fatty acids, pine bark extract pycnogenol and alpha-lipoic acid can also contribute to a preventive and accompanying treatment.
Rarely, additional procedures such as the removal of the nerve sheath or thickened tendon sheaths are necessary. It is particularly important that the nerve is completely freed. Endoscopic surgical techniques, so-called buttonhole techniques, have not been able to establish themselves over traditional surgical methods due to the higher risk and lack of advantages. After the operation, the hand is protected with functional physical therapy through targeted exercises without immobilization.
With timely surgery, the nerve pain is usually eliminated, freeing the patient from chronic discomfort.
