TECH PAINS: Carpal Tunnel Syndrome

Tim H. Tanaka, Ph.D.

(Originally published in Eye for the Future Magazine, 1997)

Carpal Tunnel Syndrome (CTS) sounds darker than it is, and can be treated with acupuncture. CTS, irritation of the median nerve resulting from inflammation and swelling of soft tissue within that particular part of the wrist called “carpal tunnel”, often develops following prolonged repeated movements of the wrist in an unchanging manner.

Jackie is a bright 42 year-old project manager for a major advertising agency. Her job requires her to meet deadlines which means that she often has to work for extended periods of time at her computer terminal. Over the past three month, despite developing sporadic pain in her wrist, she continued to work in order to finish the project she was completely engulfed in. Two weeks ago, however, when she found herself almost incapable of using the keyboard or even holding a coffee mug, she came to me. Her problem, sadly, was no surprise to me. I explained CTS to her in the same way that I had explained to countless other patients. “Join the group”, I said. “you’ve now discovered a flip side to the technology – pain!

Symptoms and Risk Factors of CTS

One of the common symptom of CTS is a tingling and/or numbness in thumb, index, middle, and a part of the ring finger. Another symptom is wrist pain, which may suddenly shoot up through the forearm to the elbow (or severe sleep disorders). Specific risk factors in CTS include (any and all) repetitive wrist motions, the use of force, awkward postures, heavy lifting, or any combination of these factors.

In recent years, the technological revolution that has brought computers into almost every office and household has spawned an epidemic of hand, arm, and shoulder injuries that result from high speed typing, thousands of repeated keystrokes, and dragging the computer mouse.

In addition to the risk factors mentioned above, certain groups of people are known to be more vulnerable to developing CTS, such as menopausal or pregnant women and people with rheumatoid arthritis, obesity, and diabetes.

What does treatment of CTS involve?

Conventional treatment for carpal tunnel syndrome will depend on the severity of the symptoms and the nature of the underlying condition that cause the symptoms. Anti-inflammatory drugs and wrist splints may be prescribed to manage the symptoms, and in certain cases a corticosteroid may injected into the local area. In the advanced stage, surgery might be recommended to release the pressure in the carpal tunnel to avoid permanent nerve damage.

However, there are other alternatives.

Acupuncture

Studies have found that acupuncture reduces edema (a swelling of soft tissue). Other scientific experiments have suggested that acupuncture can stimulate the production of cortisol, a hormone that reduces pain and inflammation. Since the median nerve impingement is often caused by soft tissue swelling and inflammation in the carpal tunnel, acupuncture is certainly a treatment option to consider, especially for the those in the early stages of CTS.

Acupuncture is also helpful for the relief of neck pain, shoulder stiffness, eye strain, and headache, which are symptoms commonly seen in people with CTS. A minimum of several treatments is usually required to achieve a cumulative, enduring effect.

Massage/ Shiatsu/ Reflexology

Massage and shiatsu therapies are useful for stimulating blood flow, reducing edema, and improving tissue health of the hands and arms. These therapies also promote general relaxation and stress reduction. Reflexology treatment to the hands is also beneficial for reducing localized muscle spasm and tension of the overused hands and wrist.

Surface Electromyographic (EMG) Biofeedback Therapy

EMG Biofeedback therapy is extremely useful for minimizing the unnecessary stress and strain of the muscles and joints while you are performing tasks. Surface electromyography monitors the activity of each muscle group through electrical potentials collected from several surface electrodes attached to certain key muscles. Through this mechanism, it can help identify both the overworked muscles and those muscles which are not performing properly during a particular job activity.

The person is guided through each simulated job task, and the most efficient and least stressful movements on his or her body are demonstrated. The session is conducted while observing the graphically monitored muscle activity on the computer screen.

Often, individually designed stretching and strengthening exercises are prescribed according to each EMG finding. Professional advice from an ergonomic standpoint may also be given which would include analysis of desk and chair height, of your computer monitor location, and placement of other equipment to minimize job-related physical stress.

You might wonder why the person sitting in the next to you performing the same task is not experiencing any of your symptoms. In many cases, the way you perform an occupational task (e.g., posture, angle of the hands etc.) is where the difference lies. Very simple ergonomic solutions to change the way you work often will reduce muscle and joint strain significantly.

Self Help

Take a break: You should take short breaks frequently, do breathing exercises, walk around the office, and stretch your body.

Ice: If you experience intense pain, apply ice or a cold compress on your wrist for 10 minutes and repeat as necessary with a minimum 30 minute interval between applications. Although cooling is an important at-home pain management strategy of CTS, prolonged exposure to cold wind is a hazard. Avoid any cold drafts at night, wear extra sweaters in the wintertime, and during the summer, never expose yourself to direct cool air from air conditioning.

Vitamin Supplement:
There are studies suggesting that a modest dose of Vitamin B6 is beneficial to those with CTS.
Jackie, like many other patients with CTS, had a limited number of options to choose from. As a single mother with three children she could ill afford to leave her job for a even short time. “The advertising business has been a graveyard for older people, no matter how talented they are. Once you have a job you try to hold on to it as long as you can”, she told me.

 

After a careful review of her medical history and a thorough physical examination, I suggested that Jackie receive acupuncture treatments over a seven-session period. I furthermore, advised a simple ergonomic solution to her workplace problems which involved no more than a rearrangement of furniture and a procedural change in her use of the computer mouse.

Over the many years I have been in practice, I can remember only one “patient” who posed a problem seemingly without a solution I could furnish. The “problem” according to the patient, my 8 year old nephew, is that “my wrist kills me after I’ve played video games for six hours”. After thinking it over for awhile, I finally found the solution. “Read a book, instead” I said.

Pacific Wellness Institute in Toronto are part of the vanguard in scientific acupuncture. The clinic’s director, Tim Tanaka, Ph.D. has ongoing research studies exploring which techniques are most effective and obtain the quickest results. He combines traditional techniques with his own research advancements and extensive clinical experience, to optimize your health and recovery.