Carpal tunnel syndrome is the most common type of nerve compression, with a 10% lifetime risk for the general population, and an 84% risk for diabetics (1). While there is no single pinpointed cause, there are a number of treatment options. Of growing prevalence are regenerative therapies, including ozone, platelet rich plasma, stem cell, and pulsed electromagnetic field therapies - all of which are safe and incredibly effective natural therapies to treat pain and loss of function.
What is carpal tunnel syndrome? Is it just wrist pain?
The carpal tunnel is a narrow passageway between the anterior (palm-side) bones and tendons in the wrist and hand (1). Running through this space is the median nerve, which brings signals to and from the brain and spinal cord to many of the muscles in the forearm and hand (3). Carpal tunnel syndrome is consistent pressure on the median nerve that causes numbness, tingling, weakness, pain, and even loss of function in the hand, wrist, and/or arm (2, 4). Any of the fingers of the hand may be affected, though normally the pinky is not. Some people may feel an electric shock in their fingers, or a pain that travels from the wrist up to the arm that may even wake them up at night (2). Other symptoms may include dropping objects, feeling the need to “shake out” the hand or wrist, or feeling like the fingers are swollen even though there is no visible swelling (4).
What causes carpal tunnel syndrome?
While there is no set cause, there are a number of factors that can contribute to excessive pressure on the median nerve. These include (2, 4, 5):
Injury to the wrist or hand, including a fractured or dislocated wrist or arthritis
Being a woman puts you at higher risk of having smaller carpal tunnels, which can contribute to greater likelihood of compressed median nerves
Nerve-damaging conditions, such as diabetes
Inflammatory diseases like rheumatoid arthritis
Fluid retention may put pressure on the nerve, due to medication, pregnancy, menopause, etc.
Conditions like thyroid disorders, an overactive pituitary gland, kidney failure, or lymphedema
Workplace or lifestyle factors, such as working on an assembly line, using vibrating tools, sewing, finishing, meatpacking, cleaning, driving, or any other activities that involve prolonged or repetitive flexing, especially in a cold environment.
What can you do to prevent carpal tunnel syndrome, or keep it from getting worse?
Since the main cause(s) are not yet determined, there are no specific guidelines that may work for everyone. So, experts recommend trying a mixture of these tips and seeing what works for you. The most important thing to practice is to take short, frequent breaks during any activity that puts pressure on your hands or wrists (2, 5). Alternating activities, stretching the hands and wrists, and changing positions can also help. Reducing your overall force by typing more softly, writing with a pen with free-flowing ink, or using tools that don’t require as much pressure can all be helpful (2). Keep your hands warm when working, either by adjusting the temperature or by wearing gloves (2).
Posture and positioning is another key aspect to promote carpal tunnel health. Maintaining good posture with a neutral spine is not only good for your neck but prevents compressing nerves that affect your extremities (2, 5). Being aware of your wrist and hand positioning can also go a long way in helping prevent carpal tunnel. Avoid bending the wrists at a great angle, and aim for a neutral, relaxed position in which your wrists are either at the same height or slightly lower than your elbows (2). Consider an ergonomic workstation, which is designed to promote good posture and neutral positions that remove extra stress from joints, muscles, and nerves (5). Lastly, keeping good general health, including reducing risk factors such as obesity and diabetes, and managing the other contributing conditions mentioned above will also help prevent carpal tunnel syndrome.
What are treatment options for carpal tunnel syndrome?
Treatment options for carpal tunnel syndrome depend on the severity of the nerve compression. Your physician will first perform a few tests, including a physical examination of the hands, wrists, arms, shoulders, and neck to determine any swelling, tenderness, warmth, atrophy, or discoloration (2, 4). They may also have you perform a few exercises to test movement and reflexes (like holding your wrists at a certain angle for 60 seconds), or even recommend an x-ray or lab tests to determine any underlying conditions such as fractures, arthritis, or diabetes (2, 4).
Once the severity of the syndrome is assessed, treatment may begin. Common treatment options include wearing wrist splints at night, avoiding activities that make symptoms worse, introducing yoga, managing underlying conditions such as diabetes, arthritis, or obesity, and trying out chiropractic care or acupuncture (4). Conventional treatment options may also include painkillers, corticosteroid injections, or surgery to sever a ligament around the wrist in order to minimize pressure on the median nerve (4).
This is where regenerative therapies can come into play. Instead of painkillers, corticosteroids, and surgeries, all of which can have a number of harmful side effects, we at Temecula Center of Integrative Medicine prefer to focus on regenerative therapies (6, 7). These include ozone, platelet rich plasma, stem cell, and pulsed electromagnetic field therapies, all of which can treat carpal tunnel syndrome, reduce inflammation and pain, and promote the body’s natural healing processes.
Ozone therapy is an injection into a joint which increases red blood cell processes, resulting in an increase in oxygen to the nearby tissues (8). This kicks cells into gear to produce more energy and more enzymes that attack harmful free radicals and strengthen cell integrity (8). Ozone therapy can reduce inflammation, pain, and even activate the immune system (8, 9). In terms of carpal tunnel syndrome, ozone therapy has been found to reduce symptom severity, improve function and range of motion, and reduce pain, especially for those with mild and moderate carpal tunnel syndrome (9, 10).
Platelet Rich Plasma (PRP) Therapy
PRP therapy uses the patients’ blood that has gone through a centrifuge to separate out plasma (the liquid part of blood) and platelets, which are then injected into sites needing healing. It is often used to treat arthritis, post-surgical healing, and most types of tendon, ligament, muscle, and joint injuries (11). While PRP therapy is most often effective when done repeatedly, even one injection has been shown to greatly improve pain, function, and reduce overall median nerve pressure for those with carpal tunnel syndrome in multiple studies (6, 12). Further, PRP therapy was very well tolerated, with no side effects, infections, or complaints in these studies.
Pulsed Electromagnetic Field Therapy
PEMF therapy uses a pad, ring, or paddle to emit a resonating magnetic field over the area of the body that needs healing. All parts of the body have electrical currents, and when our cells have disrupted or reduced electric currents, the body cannot function properly or heal itself well. PEMF therapy boosts cellular metabolism and creates an energy boost in the affected cells, resulting in greater healing and function. Studies focusing on using PEMF have found that there was a significant decrease in pain alongside objective improvement in nerve conduction and hand and wrist function, especially when using PEMF regularly for at least one month (13, 14).
If you are considering regenerative therapies to treat carpal tunnel syndrome or other painful conditions, please reach out! We would love to schedule a consultation with you to get more information about you, hear about your health history and symptoms, and then partner together to create the best treatment plan for you. It is our joy to help our patients find greater health and healing than they thought possible!
Jonathan Vellinga, MD is an Internal Medicine practitioner with a broad interest in medicine. He graduated Summa cum laude from Weber State University in Clinical Laboratory Sciences and completed his medical degree from the Medical College of Wisconsin.
Upon graduation from medical school, he completed his Internal Medicine residency at the University of Michigan. Dr. Vellinga is board-certified with the American Board of Internal Medicine and a member of the Institute for Functional Medicine.
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