Carpel tunnel syndrome or as the name suggests is a condition of where a nerve of hand. Median nerve gets compressed as it passed through the wrist. Median nerve compression is also known as the Carpal tunnel syndrome. Compression of Median nerve causes numbness and tingling sensation in the distribution of the median nerve in the hand. The nerve gets compressed under a muscle known as Flexor Retiniculum.1, 2
This condition is also an example of stenosing tenovaginitis. The only difference is that the cause is not only thickening of the flexor retinaculum but also some other pathology such as rheumatoid arthritis involving the synovial sheaths of the flexor tendons or dislocation of lunate bone which compresses on the contents of this Osseo-fibrous canal, mainly the median nerve, also exits.3
The majority of the patients are women between the ages of 40-60 years.1 and3
The commonest cause is rheumatoid arthritis or many times a non specific synovitis.
- Compression of the canal be trauma (long term or immediate) for example in persons constantly using the hand in one position, e.g. hair dressers, gardeners, people working on computers etc.
- Joint dislocation2
- Chronic granulomas2
- Fluid build-up during pregnancy2
- Swelling of the lining of the flexor tendons 2
Sign and Symptoms1, 3
- The main complaint of the patient is some sort of difficulty in flexing fingers with pain and neurological deficits of the median nerve, e.g. paraesthesia or numbness or in coordination or weakness of the muscles innervated by median nerve.3
- Numbness and Tingling sensation in hands is the most common presentation. Most patients are not able to realize that paraesthesia is only in the median territory and say the whole hand tingles. Patients also sometimes present it as burning sensation.1
- A more diffuse symmetrical peripheral neuropathy can occur and is usually limited to symptoms and signs of mild ‘glove and stocking’ sensory loss. Where person feels loss or decreased sensation in hand where they wear gloves.
- The symptoms usually appear at night (2-4 am) and may wake the person from sleep. Patients usually shake the hand to get relief. 1
The main symptom is acroparaesthesia at night occurring in the distribution of the median nerve but may spread up to involve the arm.
Occasionally the pain may shoot upwards and may mislead the clinician. On examination there will be some sensory change and motor impairment of the nerve (median nerve) concerned. In late cases there may be wasting of the thenareminence. When the patient is asked to flex the wrist there will be exacerbation of the symptoms particularly paraesthesia within 1 minute and the symptoms will disappear as soon as the wrist is straightened. This is known as the
‘Wrist flexion Test’ (Pha/en’s sign). Electrical nerve conduction study will elicit a delay in motor conduction of themedian nerve at the wrist.3
- On examination sensory loss is in the median nerve territory involving only the fingers. The abductor policies power which is a muscle is weak.1
- Wasting, if it occurs, is in the outer half of the thinner eminence but 80-90% of cases have no physical signs at all and the diagnosis is made only on history and wasting.1
- Pain and tingling may be elicited by sustained flexion of the wrist for a minute or tapping the wrist over the median nerve. Pain is often relieved by elevating the arm and shaking the wrist to assist venous return.1
Physiotherapy and exercises have a very important role to play in case of Median nerve compression or carpel tunnel syndrome. As right exercise can decompress the area gradually and symptoms wane off. In some patients decompression of the carpal tunnel or transposition of the ulnar nerve may be necessary. In these electro physiological investigation is advisable pre-operatively in order to confirm the diagnosis and site of compression.
Carpal tunnel syndrome and ulnar nerve palsy may remit if patients are advised to avoid activities involving repetitive wrist movement or pressure on the elbows.
Foods that causeinflammation may make carpal tunnel syndrome worse. There is limited scope of diet but can be helpful to some extent. Avoid high starch food and high containing food help reduce the inflammations.
Scope of Homeopathy
Homeopathic management includes giving drugs/remedies based on symptomatic presentation as per each case. Therefore, every next patient of Carpal tunnel syndrome will receive a different remedy based on his/her presentation. Homeopathic remedies if given rightly, not only reduces intensity of symptoms but also slow down progression of disease.
It is advisable to contact a registered homeopathic practitioner and seek homeopathic treatment in person consultation.
Do not self medicate.
Carpel tunnel syndrome Medicines5
reliable anti-inflammatory, antispasmodic, and analgesic for all manner of neuromuscular complaints.
Joints red, swollen, hot, with stitches and tearing; worse on least movement. Every spot is painful on pressure. Constant motion of left arm and leg (Helleb). Aggravated by motion and better by rest is the key symptom of bryonia.
Causticum, is helpful when there is excessive loss of muscle strength in the hands. People complain of a tearing pain and numbness in the hands. The wrist may also feel contracted in cases where Causticum will offer effective treatment.
Upper and lower cervical vertebrae sore to touch, often reflex from uterine irritation; dull pain in region of lower dorsal and upper lumbar vertebrae; weight and pain in lumbar and sacral region, sometimes extend all around body.
Hypericum is among the best Homeopathic medicines for carpal tunnel syndrome in cases where the characteristic symptom is a tingling sensation or numbness in the thumb and fingers. Burning sensation in the fingers.
Burning and twining in spinal column with numbness of feet, hands and other parts of body; crimpy pains in hands; sudden jerking of the limbs on dropping off to sleep, muscles of back become rigid; aesthenopia.
Plumbum Met is an excellent choice among Homeopathic medicines for carpal tunnel syndrome in its advanced stage. It is prescribed when the finger muscles have started to atrophy or degenerate. A marked weakness in hands and fingers appears. The person suffering this condition is unable to lift anything with his hand due to weakness. A tingling sensation and numbness in the hands and fingers is also noticed in such severe cases where Plumbum Met would be the most suited Homeopathic medicines for carpal tunnel syndrome.
Hot, painful swelling of joints. Pains tearing in tendons, ligaments, and fasciae. Rheumatic pains spread over a large surface at nape of neck, loins, and extremities; better motion (Agaric). Soreness of condyles of bones. Limbs stiff paralyzed. The cold fresh air is not tolerated; it makes the skin painful. Pain along ulnar nerve. Tearing down thighs.
ailments from over straining or inflammation of the wrist tendons leads to carpal tunnel syndrome. Contraction of fingers. Pain and stiffness in wrists and hands. Ganglia (Benzoic ac). Tendons sore.
- API, Textbook of Medicine, 1444p.
- Ralston S.H., Penman I.D., Strachan M.W.J., Hobson R.P. Davidson’s, Principles and Practice of Medicine. 23rdrev.ed. Edinburgh; Churchill Livingstone/Elsevier; 2018. 1417p.
- Dr. Das S. A manual on Clinical Surgery. 13threv.ed. Kolkata: Dr. S. Das; 2018. 648p.
- Kasper D.L., Fauci A.S., Hauser S.L., Longo D.L., Jameson J.L., Loscalzo J. Harrison’s Manual of Medicine. 19th rev. ed.United States: McGraw Hill; 2016. 1222p.
- Boericke W. Pocket Manual of Homoeopathic Materia Medica. San Francisco: Boericke & Runyon; 1901, 572p.