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Carpal tunnel syndrome (CTS) is an injury caused by a pinched or entrapment of a nerve in the wrist. The injury may cause pain and numbness in the index and middle fingers and weakness of the thumb. The carpal tunnel receives its name from the eight bones in the wrist, called carpals, which form a “tunnel” through which the nerve leading to the hand extends.
Signs and Symptoms:
Signs and symptoms of CTS include:
• Nighttime painful tingling in one or both hands, frequently causing sleep disturbance
• Feeling of weakness in the fingers
• A sense that fingers are swollen even though little or no swelling is apparent
• Daytime tingling in the hands, followed by a decreased ability to squeeze things
• Loss of strength in the muscle at the base of the thumb, near the palm
• Pain shooting from the hand up the arm as far as the shoulder
What Causes It? :
The carpal tunnel is filled with tendons (bundles of collagen fibers that attach muscle to bone) that control finger movement. Tasks requiring highly repetitive and forceful movements of the wrist can cause swelling around the tendons, resulting in a pinched nerve and producing CTS.
Who’s Most At Risk? :
People working with small hand tools and those using a computer keyboard on a regular basis are especially at risk.
Women are more likely than men to develop CTS. It most commonly occurs in people ages 40 -60. CTS is associated with health conditions, such as Lyme disease, rubella, pregnancy, and menopause.

What to Expect at our Office:
We will perform a physical examination and some simple tests to determine if there is a loss of sensation or some weakness in your thumb or fingers. We may also recommend more sophisticated diagnostic procedures ranging from a nerve conduction study to electromyography (EMG), X-rays, or magnetic resonance imaging (MRI) may be used to reveal the cause and the nature of the injury.

Treatment Options:
We may put your wrist in a splint, brace, ice, or tape to keep your wrist from bending, and to minimize or prevent pressure on the nerve. You may need to wear the splint full-time for 3 – 4 weeks, then at night only. These supports are applied as an aid to the adjustment.

You can help prevent CTS or alleviate symptoms by making some simple changes in your work and leisure habits, such as:
• Stretch or flex your arms and fingers before beginning work and at frequent intervals.
• Alternate tasks to reduce the amount of repetitive movements.
• Modify or change daily activities that put pressure on your wrists.
• Modify your work environment. Have an adjustable keyboard table and chair, and a wrist rest.

Nutrition and Supplements
Following these nutritional tips may help reduce symptoms:
• Eliminate all suspected food allergens, including dairy (milk, cheese, eggs and ice cream), wheat (gluten), soy, corn, preservatives, and chemical food additives.
• Eat foods high in B-vitamins and iron, such as whole grains (if no allergy), dark leafy greens (such as spinach and kale), and sea vegetables.
• Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes), and vegetables (such as squash and bell pepper).
• Avoid refined foods, such as white breads, pastas, and sugar.
• Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy) or beans for protein.
• Use healthy oils in foods, such as olive oil or vegetable oil.
• Reduce or eliminate trans fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid coffee and other stimulants, alcohol, and tobacco.
• As you can see all these are a good idea regardless of your condition.

You may address nutritional deficiencies with the following supplements:
• A multivitamin daily, containing the antioxidant vitamins A, C, E, D, the B-complex vitamins and trace minerals such as magnesium, calcium, zinc, and selenium.
• Omega-3 fatty acids, such as fish oil, to help decrease inflammation. Fish oils may increase bleeding in sensitive individuals, such as those taking blood thinning mediations (including aspirin).
• B-complex vitamin
• Vitamin C
• Alpha-lipoic acid for antioxidant support.
• Methylsulfonylmethane (MSM),  to help decrease inflammation.
• Again these will not repair but, add in the normalization of the tissue.

CTS is commonly treated in my office. The methods we use to treat CTS include adjustment of the wrist, elbow, and cervical spine, and wrist supports.
Massage may help prevent or relieve symptoms

Prognosis/Possible Complications:
Most people’s symptoms clear up within a few months of treatment. If left untreated, CTS in advanced stages can become quite serious, involving a loss of sensation, muscle deterioration, and permanent loss of function.