If you wake up with numbness or a "pins and needles" sensation in your hands, your body is sending you a message.
Carpal tunnel syndrome (CTS) is the most common neuropathy that we treat, making up 90% of all neuropathy cases in the United States. This condition occurs when the median nerve is compressed as it passes through the carpal tunnel, leading to entrapment (getting squished). The initial signs of CTS include pain, numbness, and paresthesias within the median nerve distribution. As CTS is a progressive condition in most patients, it can result in permanent loss of sensation and function in the hand if it is not adequately identified and treated.
Who gets Carpal Tunnel Syndrome?
Individuals at higher risk for developing CTS include those with occupations or hobbies that involve repetitive hand motions, wrist position extremes, or vibration. Women are more likely than men to develop the condition, and certain health issues such as diabetes or rheumatoid arthritis can increase risk.
Wheelchair athletes, rock climbers and cyclists are at increased risk of developing carpal tunnel syndrome due to the demands of their sport
Chefs, waiters, bartenders, dishwashers, and food processing or food preparation workers often work in fast-paced conditions where their hands and wrists are being strained in a way that can aggravate carpal tunnel syndrome symptoms.
What can we do about it?
Treatment typically is conservative to begin with and includes physical therapy, wearing a night splint and potentially steroid injections. However, ultimately the steroid injections are just as effective as night splinting alone, so it may not be worth the quick fix.
Approximately 70% to 90% of mild-to-moderate CTS cases positively respond to conservative management. Nevertheless, many patients may progress to the point where surgical intervention becomes necessary. Patients with CTS that are secondary to diabetes or a wrist fracture often have a less favorable prognosis and may need surgery.
Radial Shockwave Therapy has been shown to be more effective then steroid injections and conventional physical therapy alone. If you are interested in all the details, this study has some really good data! Since the results of this study showed that shockwave therapy combined with conventional physiotherapy improved the clinical measurements significantly more than conventional physiotherapy alone, it seems that shockwave can activate a stronger analgesic and anti-inflammation mechanism compared to conventional physiotherapy.
Shockwave therapies clinical effect on peripheral nerves has recently gotten more attention. Several studies have attempted to use shockwave therapy as an alternative treatment for peripheral neuropathy, in additional to CTS. The exact mechanism behind the effect of shockwave therapy on peripheral neuropathy is currently unknown. However, studies have reported that shockwave therapy has an anti-inflammatory effect in musculoskeletal disorders by stimulating the production of nitric oxide.
While this may sound overly complex, we love learning about all the current research and sharing it with you. Here's the bottom line: combining shockwave therapy, night splints and postural strengthening can prevent surgical intervention for CTS.
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