Carpal Tunnel syndrome non-surgical treatment
Do you think you are suffering from carpal tunnel syndrome?
Treat your carpal tunnel syndrome yourself
Exercises for nerve sliding
Perform stretching exercises and nerve sliding with the arm and wrist:
i. Extend your elbow, then place your wrist in a full extension position, also extending your fingers. Keep the elbow straight and raise your hand and fingers toward the sky.
ii. Then place your wrist in flexion while keeping your elbow extended. Keep your elbow straight and lower your hand toward the ground.
iii. Then alternate the wrist positions from full extension to full flexion. Repeat these movements alternately when symptoms occur. The movements must be made slowly, counting about 3 seconds in moving from a position of utmost flexion to utmost extension, and vice versa. Perform 5 to 10 repetitions of each movement.
iv. Then perform the same maneuvers while holding the elbow in flexion. The elbow is thus folded at right angles, ie at 90 °, and the wrist is folded backwards and held in this position.
v. The elbow is then held in the same flexion position and the wrist is brought forward as if to reproduce the image of the head of a duck.
vi. These exercises of stretching and nerve sliding aim to stretch and lengthen the nerve and thus to contribute to the reduction of the pressure on the nerve.
vii. Stretching poses, such as those practiced in yoga, consist in relaxing and lengthening the transverse ligament of the carpus that forms the roof of the carpal tunnel, as well as the ligaments that connect the bones forming the floor of the canal. The aim is to make the channel less rigid and thus reduce the pressure locally. These exercises are effective for the some advanced forms of compression of the median nerve at the wrist.
Significant weight loss may in some cases relieve the symptoms of carpal tunnel syndrome.
Smoking is a risk factor or at least an aggravating factor in carpal tunnel syndrome, which affects the supply of oxygen to the median nerve. It is strongly recommended that you quit smoking in the presence of symptoms of nerve compression.
Control of diabetes and hypothyroidism
The diseases most commonly associated with carpal tunnel syndrome are diabetes and hypothyroidism. Research has shown that approximately 20% of people with diabetes and 17% of people affected by hypothyroidism would be affected by carpal tunnel syndrome during their lifetime.
Movements to avoid
i. Activities that may increase your risk of suffering from carpal tunnel syndrome are often related to repetitive activities, such as knitting or needlework.
ii. Extreme positions such as folded or extended wrist (especially when combined with effort), frequent bending and/or wrist twisting may be harmful.
iii. The use of vibrating tools such as a sander or a grinder or jack hammer is a risk factor. The use of a walking stick, wheelchair or crutches may increase the risk of developing carpal tunnel syndrome.
Obtain a sleep orthosis for the wrist. This should place the wrist in a neutral position. It can be purchased in pharmacies, orthotists or specialized occupational therapists. The latter allows the nerve to rest in the canal, and thus to avoid the accentuation of ductal pressure during movements of flexion and extension of the wrist. The neutral position is preferable to the extension. The orthosis can be made to measure (molded thermoplastic orthosis) or as a prefabricated model. The orthosis should be worn at night for up to four to six weeks. Then stop wearing the orthosis and observe whether or not the symptoms recur or increase in intensity. If this is the case, continuing to wear the orthosis is not recommended without consulting a doctor, as this means that the compression is severe and scalable. It is then important to consult a hand surgeon.
i. Cortisone injections into the carpal tunnel, when properly performed by a specialist, are not very painful and can temporarily improve symptoms. On the other hand, it is not advisable to repeat them because they can mask the symptoms of nerve compression which persists and thus, which are silently aggravated. There is then a danger of irreversible lesions appearing.
ii. Risks associated with cortisone injection include mechanical injury to the median nerve and other problems, such as weakening of the tissue and especially atrophy of the skin. A skin discoloration area, called depigmentation, or even scarred tissue can be irreversible. A risk of infection also exists because cortisone diminishes the localized ability to defensed against infections. Cortisone injection does not cause weight gain.
iii. A cortisone injection into the carpal tunnel may be useful when the diagnosis is not entirely certain. If the symptoms improve after this injection, the diagnosis is confirmed and a permanent treatment will be suggested. If no improvement is noted, even temporary, then another diagnosis must be found.
iv. Cortisone is a powerful anti-inflammatory drug that, when injected into the canal, will deflate the flexor tendons that bend your fingers and are in the canal. The pressure in the canal, and thus on the median nerve, will then decrease. Neurological symptoms can then improve.
v. This effect is unfortunately temporary, so relief usually lasts a few weeks to a few months. Avoid repeating it to avoid permanent and irreversible damage.