Carpal tunnel syndrome and Repetitive strain injury

What is carpal tunnel syndrome?

What is repetitive strain injury?

Symptoms of carpal tunnel syndrome

Causes of carpal tunnel syndrome

Prevention / remedies / cures / treatment for CTS and RSI

References

What is carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is a condition in which the median nerve in the wrist is compressed or otherwise compromised. The carpal tunnel or carpal canal is a fibro-osseous passageway in the wrist. Tendons and nerves pass through it. If any of the tendons swell or degenerate, they put pressure on the nerve, causing the symptoms described below.

CTS is more common in women than men. It can occur at any age but is most common in the early 40's. The risk of getting it sometime in one's life is about 10%.

Repetitive use of the hand or arm are often blamed for the onset of CTS. However, many doctors and researchers say the cause is idiopathic (unclear) because these people are not necessarily doing an unusually excessive level of work or movement.

CTS symptoms usually begin gradually, without a specific injury. At first, symptoms come and go. Should the CTS worsen, symptoms occur more frequently or may persist for longer periods.

What is repetitive strain injury?

Repetitive strain injury (RSI) is an injury to part of the musculoskeletal or nervous system caused by excessive repetitive use, vibration, compression or long periods of a body part held in a fixed position.

RSI is more common among people who do repetitive activities like hairdressing, decorating, typing or working on an assembly line, playing sports with lots of repetitive movement, who have a poor posture when sitting or standing, or who use hand-held power tools excessively.

Hard and repetitive work does not always cause RSI. Many people do the same work for years with no problem.

Carpal tunnel syndrome and RSI share many causes and symptoms. CTS is caused by pressure on the median nerve in the wrist specifically. On the other hand, RSI can affect nerves, muscles and tendons in the arms, legs and other parts of the body. RSI most commonly affects the shoulders, elbows, forearms and wrists, as well as the hands and fingers.

After ceasing the repetitive strain RSI often gets better without further treatment. However, the remedies suggested below will help speed up your recovery and make you more resilient to RSI.

RSI often has symptoms of muscle cramps or swelling, in addition to the symptoms listed below.

The risk of RSI increases with age.

Symptoms of carpal tunnel syndrome

• Pain, primarily in the thumb, index, middle and ring fingers.
• Symptoms are often worse at night, and may be severe enough to wake one up.
• Tingling, shock-like sensation or pins-and-needles in the fingers, hand or up the arm towards the shoulder.
• Numbness.
• Muscular weakness in the fingers, hand or arm. It may make it difficult to perform fine movements such as tying a shoe lace, buttoning clothes or typing. This can cause dropping things, from the weakness, numbness or loss of proprioception (awareness of where your hand is oriented in space).
• Burning sensation on the skin.
• Carpal tunnel syndrome is usually felt in only one arm at a time.

Causes of carpal tunnel syndrome

• Carpal tunnel syndrome has a nerve component, in which the nervous system is compromised due to a deficiency of B vitamins, particularly vitamins B1 (thiamine) and B6 (pyridoxine). Vitamin B12 may also be deficient. (1, 2)
• The above deficiency is also related to depression and psychological issues. CTS often occurs in those who are stressed and dissatisfied. It is likely that stress hormones are involved in compromise of nerves.
• Work-related factors such as vibration, wrist extension or flexion, hand force, and repetition increase the risk of developing CTS.
• Rheumatoid arthritis.

Prevention / remedies / cures / treatment for CTS and RSI

• Ensure you have vitamin B1 (thiamine) sufficiency, and B6 (pyridoxine) sufficiency. The best food source of vitamin B1 is unfortified nutritional yeast. Other food sources include grass-fed meat, fish and brewer's yeast.
• Eliminate all added sugar, refined carbohydrates, sweet foods, sweet fruit, dried fruit and fruit juice. Sugar inhibits vitamin B sufficiency. See the Grow Youthful diet.
• DMSO.
• At night, try not to sleep with the wrists bent, otherwise symptoms may awaken you from sleep.
• During the day, symptoms often occur when holding something or repeating a movement with the wrist bent forward or backward for a prolonged period. Examples can include holding a phone, driving or reading a book. Many patients find that doing a different movement, taking a break, or shaking their hands provides relief.
• Castor oil.
• Vitamin D.
• Minimise stress, change psychology and attitude through psychological counselling or meditation.
• Inclined Bed Therapy (IBT). IBT costs nothing, has no side effects except good ones, and is sometimes miraculously effective. Why wouldn't you try it?

References

1. Song XS, Huang ZJ, Song XJ. Thiamine suppresses thermal hyperalgesia, inhibits hyperexcitability, and lessens alterations of sodium currents in injured, dorsal root ganglion neurons in rats. Anesthesiology. 2009 Feb;110(2):387-400. doi: 10.1097/ALN.0b013e3181942f1e. PMID: 19194165.

2. Mazevet D, Vassilev K, Perrigot M. Neuropathies par carence en thiamine sans intoxication alcoolique: deux cas de troubles vesicosphincteriens [Neuropathy with non-alcoholic thiamine deficiency: two cases of bladder disorders]. Ann Readapt Med Phys. 2005 Feb;48(1):43-7. French. doi: 10.1016/j.annrmp.2004.06.054. PMID: 15664684.