What Is Carpal Tunnel Syndrome?
Carpal tunnel syndrome refers to the compression of the median nerve as it passes into the hand. This nerve is located on the palm side of your hand, which is also known as the carpal tunnel. The median nerve is meant to provide sensation to your thumb, index finger, middle finger, and parts of the ring finger. It also supplies the impulse to the muscle going into the thumb. This compression can occur in one or both hands as a result of swelling in the wrist, leading to numbness, weakness, and tingling on the side of your hand near the thumb.
Pain in the carpal tunnel is a result of excess pressure in the wrist and on the median nerve, usually from swelling. The swelling is most commonly caused by an underlying condition and obstructed blood flow. This can be in relation to diabetes, thyroid dysfunction, fluid retention, high blood pressure, autoimmune disorders (like rheumatoid arthritis), and trauma or fracture to the wrist.
When the wrist is overextended repeatedly, it can worsen the compression as the repetitive motion contributes to swelling and compression of the median nerve. Common causes of this include:
- Poor wrist positioning during use of a mouse or keyboard
- Prolonged exposure to vibrations from power tools or other tools
- Repeated movements that extend the wrist like playing the piano or typing
Women are more likely to be diagnosed with carpal tunnel syndrome, and it is usually found in people between the ages of 30 to 60. However, those with the conditions mentioned above are at higher risk. Other factors like smoking, high salt intake, a high BMI, and certain occupations are also risk factors.
The first sign of carpal tunnel syndrome is often the feeling of a hand “falling asleep” frequently and dropping objects. You may also notice numbness, tingling, and pain in the thumb and first three fingers, pain and burning that travels up the arm, wrist pain that interferes with sleep, and weakness in the hand muscles.
Inflammation and Carpal Tunnel Syndrome
The central cause of carpal tunnel pain is inflammation, which is a natural process in the body meant to defend against injury and infection. However, chronic inflammation is linked to conditions like heart disease, diabetes, and cancer.
Diets that are high in processed foods can also lead to increased levels of pro-inflammatory proteins known as cytokines. One cytokine that has been linked to carpal tunnel pain is tumor necrosis factor alpha (TNFa), which has been shown to increase with diets rich in highly processed foods.
Other foods can also impact inflammation levels in the body, so it is important to manage this through dietary changes.
Foods to Avoid
Refined Starches and Sugars
- Sugary breakfast cereals
- White brad
- White flour
- Regular pasta
- White rice
- Ice cream
- Cake
- Muffins
- Cookies
- Candy
Foods High in Saturated Fat and Trans Fat
Examples include:
- Beef and pork
- Processed lunch meats, like bologna
- Margarine
- Microwave popcorn
- Pie and cake
- Icing or frosting
Fried Foods
Food that has been fried is usually high in both trans fat and sodium content. This may include fast foods like French fries, fried chicken, and tacos.
Salty Foods
Salt is a main cause of water retention, which can worsen swelling and pressure on the median nerve. Lots of processed and packaged foods contain high levels of sodium. You can also avoid adding table salt to meals.
Alcohol
Heavy intake of alcoholic beverages can raise inflammation levels in the body. In fact, a study in 2018 found that long-term and excessive use of alcohol can increase the overall risk of developing carpal tunnel syndrome.
Foods to Alleviate Symptoms
In contrast, some foods have properties that reduce inflammation and can potentially reduce carpal tunnel symptoms.
Foods Containing Omega-3 Fatty Acids
In addition to being neuroprotective, omega-3 fatty acids have anti-inflammatory properties and have been shown to reduce numbness and pain linked to carpal tunnel syndrome. Omega-3 fatty acids are found in fish oil and cold-water fatty fish, such as salmon, tuna, herring, mackerel, and sardines. Some conditions, like pregnancy, may dictate a moderate intake of these, so it is best to consult with a doctor before using supplements or adding them to your diet.
Antioxidants
Antioxidants are molecules in the body that fight free radicals, which are compounds that can cause harm when they reach certain levels. Free radicals are linked to illnesses like diabetes, heart disease, and cancer, which can increase the risk of carpal tunnel syndrome. Foods high in antioxidants can reduce inflammation as well. Examples of these foods include:
- Berries, especially blueberries, strawberries, and goji berries
- Spinach and other dark, leafy greens
- Citrus fruits like oranges and lemons
- Red bell peppers and other colorful vegetables
- Herbs and spices like parsley and turmeric
- Walnuts, pistachios, and other nuts
- Fatty fish, such as salmon
Vitamin B6
Foods that contain high levels of B6 include:
- Salmon
- Pork
- Poultry (turkey, chicken, and duck)
- Bananas
- Soybeans
- Wheat germ
- Spinach
- Chickpeas
- Potatoes
Vitamin B12
- Clams
- Liver
- Salmon
- Tuna
- Eggs
- Trout
Turmeric
Turmeric is a spice that contains curcumin, which is known to have antioxidant, anti-inflammatory, and neuroprotective effects for peripheral nerves. Many people who use turmeric have seen benefits with regards to reducing inflammation associated with carpal tunnel syndrome, as well as other conditions like arthritis.
It is important to use turmeric along with black pepper, as the latter increases the bioavailability of curcumin and, therefore, the effectiveness. Turmeric is also available in tea forms.
Supplements
If you struggle to add some of these foods to your diet, you may be able to take the form of supplements. Vitamins B12 and B6, fish oil capsules, and turmeric are all commonly sold in supplement form and available at grocery stores.
Other supplements can add nutrients that are difficult to include in a diet. This includes capsaicin, a compound found in hot red peppers and shown to relieve pain, as well as alpha-lipoic acid, which has neuroprotective properties.
Other Non-Surgical Treatments for Carpal Tunnel
While foods and supplements are an important element of managing carpal tunnel pain, they usually will not resolve the issue entirely. Many people will choose to use other home remedies as a way to alleviate swelling and manage their pain.
Other ways to reduce symptoms at home include:
- Oral over the counter anti-inflammatory medication
- Topical steroidal creams
- Topical capsaicin creams
- Use of a wrist brace or splint
- Reduce repetitive motion activities that require flexing the wrist
- Sleeping in positions that do not bend your wrist
- Massage
When symptoms continue and cause issues with performing daily tasks or your job, you should seek a healthcare provider who specializes in carpal tunnel treatment. If you are able to be diagnosed early, they should be able to create a treatment plan that is less invasive than surgery.
Usually, they will begin with wrist splinting in order to hold the wrist still while you sleep, reducing nighttime pain, tingling, and numbness. This usually helps relieve symptoms during the day as well. For pain management, you may also be instructed to use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, to reduce both pain and inflammation.
When over the counter medication is not sufficient, your doctor may recommend corticosteroid injections into the carpal tunnel itself. This medication decreases inflammation and swelling, reducing pressure on the median nerve. Oral corticosteroids are not as effective as these injections when it comes to carpal tunnel syndrome.
If there is an underlying condition, like rheumatoid arthritis, associated with the symptoms, then management or treatment of that condition is also recommended.
Carpal Tunnel Surgery
If symptoms are severe and unmanaged or simply do not respond to the treatments mentioned above, surgery may be recommended. The goal of surgery will be to relieve pressure by cutting the ligament that is pressing on the median nerve.
In some cases, this is an open surgery, in which an incision is made in the palm of your hand over the carpal tunnel, allowing the ligament to be cut and the nerve to be free. Otherwise, it will be an endoscopic surgery, in which the surgeon uses a telescope-like device with a tiny camera attached to it in order to see inside the carpal tunnel. The surgeon then cuts the ligament through one or two tiny incisions in your hand or wrist. This is often a less painful option with a quicker recovery.
What Doctor Should I See for Carpal Tunnel?
Depending on the severity of your carpal tunnel treatment, a number of different specialists may be a part of your care plan.
Your first stop should be a physical therapist and chiropractor who can assist with most cases of carpal tunnel syndrome. An Atlanta physical therapist will work with you to create a therapy plan that can reduce pain and numbness, including providing exercises that can be performed at home. In addition to this, a chiropractor will be able to perform spinal adjustments as well as extremity adjustments in order to improve nervous system health and minimize pain, swelling, and inflammation.
Both these forms of treatment are highly effective at providing relief for carpal tunnel in addition to other health conditions. The goal of both specialties is to help the body realign back to its natural and healthy state, allowing the body to regain its natural strength and operate effectively. In a moderate case of carpal tunnel, this can be all that is needed to alleviate pain and help you return to daily activities.
If your case of carpal tunnel is more severe, you may be referred to work with an orthopedic surgeon who can perform the necessary procedures. Once the surgery is complete, you can then work with a physical therapist to regain strength and movement in your wrist as you return to activities you were previously unable to participate in. If you experience carpal tunnel in both wrists, the surgery will often be performed separately in order to maintain the use of one hand during recovery.
Hand Specialists in Atlanta
At AICA Orthopedics, we take the diagnosis and treatment of carpal tunnel syndrome seriously and strive to help you return to a pain-free lifestyle. After a discussion of your symptoms, we will work with you to determine lifestyle changes that you can make, including advising you on dietary measures that will help with your pain. If symptoms persist and additional treatment is needed, our staff includes physical therapists, chiropractors, pain management specialists, and orthopedic surgeons. Each member of your care team will work together to offer a seamless experience as we deliver your personalized, comprehensive treatment plan.
Contact AICA Orthopedics today to begin finding relief from wrist pain.
Sources
- Carpal Tunnel Syndrome: A Review of the Recent Literature
- Trans Fats
- Individual Risk Factors of Carpal Tunnel Syndrome
