What is carpal tunnel syndrome?

Although the carpal tunnel might sound like some rugged tunnel in the Swiss Alps, these little tunnels are actually located on the palm side of your wrists. The carpal tunnel is a small passageway in the middle of the palm side of your wrist that allows the median nerve to pass through – a small canal surrounded by bones of the wrist and the transverse carpal ligament.

The median nerve extends down your arm, originating in the nerves that come out of your cervical spine at your neck, traveling to your armpit, down to the elbow crease, and through the carpal tunnel and into your hand. It branches out and supplies nerves to all but your pinky finger.

The median nerve also shares the carpal tunnel with nine tendons that help you move your hand and fingers – so it gets a little crowded – therefore, it’s vulnerable to compression. 

Why do I feel electricity in my hands? Do I have carpal tunnel syndrome?

The median nerve is both a motor and a sensory nerve – in other words it’s necessary for movement, as well as sensations of pain, touch, and temperature. When it’s being compressed it can cause carpal tunnel syndrome (CTS). But what does carpal tunnel feel like? A common sign is feeling something akin to electric shock in your hands or fingers. What causes electric shock feeling in fingers? Although there are several things that can cause you to feel like you have electricity pulsating through your hand, carpal tunnel syndrome is at the top of the list. And while it’s important to see a health-care professional to get a firm diagnosis, besides electric shock-like feelings, there are other classic symptoms that can provide clues:

How to tell if you have carpal tunnel – symptoms you could be experiencing:

  • Needle-like pain in the fingertips
  • Tingling in wrist, hand, and fingers
  • Swelling and numbness in hands 
  • Wrist numbness
  • Weakness in hand with a tendency to drop things
  • Burning or tingling isolated to the thumb, index finger, and middle finger; the inner side of the ring finger might also be affected

Although CTS usually occurs in both hands, it normally manifests in the dominant hand first. During early stages of carpal tunnel, the symptoms often develop at night during sleep and are most pronounced on waking. This is because we all tend to bend our wrists forward when we sleep. Eventually, the symptoms can emerge at any time of the day. If you have CTS, you might find yourself shaking your hand to relieve the symptoms. As the syndrome progresses, there can be a loss of sensation in the hand, along with muscle or nerve atrophy (wasting) that causes weakness in the hand. 

Risk factors for carpal tunnel syndrome

It is estimated that 3-6 percent of U.S. adults have carpal tunnel syndrome. It is more common in women and the incidence is considerably higher during pregnancy; 20-45 percent of pregnant women experience CTS, caused by hormone changes and edema. 

Median nerve compression can be caused by inflammation of the surrounding connective tissue, swelling/edema, hormone changes, localized stress or injury, or a lesion, such as a ganglionic cyst putting pressure on the median nerve.

Certain repetitive motions increase the risk, including occupations that require use of vibrational tools or those that require forceful movements. Such occupational hazards can result in swelling and inflammation. Repetitive tensing of the hand and wrist, such as occurs during computer mouse use, can also contribute to CTS, although it is unclear to what extent.

Health conditions that increase CTS risk include obesity, types 1 and 2 diabetes, alcohol abuse, rheumatoid arthritis, hypothyroidism, and kidney disease – although most cases are not related to an underlying chronic condition.

How do you know if it’s carpal tunnel syndrome? 

The answer to this question comes down, in part, to knowing the answer to the question, “What does carpal tunnel feel like?” Although symptoms of CTS were discussed above, there are at least two conditions that are often misdiagnosed as carpal tunnel syndrome. 

One condition is tendonitis – inflammation of the tendons of the wrist. While both CTS and tendonitis can cause pain, tendonitis does not cause numbness or tingling and does not typically resolve when you stop the offending activity. And because tendonitis does not follow the course of a nerve, it can affect any part of the hand, wrist, or fingers. 

Simple arthritis of the wrist, hand, or fingers can also be mistaken for CTS because it can cause pain and swelling. However, arthritis will not cause numbness or tingling unless the swelling is in the wrist and it impinges on the median nerve – essentially causing carpal tunnel. 

Wrist pain can also be caused by a sprain of the ligaments and is usually caused by trauma, such as an attempt to break a fall. 

Numbness, tingling, and pain in the hand can also be caused by neuropathy associated with diabetes, certain chemotherapy medications, alcoholism, and other causes. In that case, the underlying condition is typically easily identified and unless the condition results in impingement or damage to the median nerve, it is not carpal tunnel syndrome.

In addition to knowing “What does carpal tunnel feel like?” there are simple tests you can do – or your health-care professional can perform – that can provide some insight. 

One test is called Tinel’s sign and is performed by tapping in the center of the palm side of the wrist. If CTS is present, then sensations of tingling and numbness will occur.

Phalen’s test involves pressing the backs of your hands together (inverted prayer) for 30-60 seconds to see if this causes CTS symptoms.

If there is still question, then further diagnostics might include an ultrasound and a nerve conduction test.

What can I do to alleviate carpal tunnel syndrome symptoms?

At-home. Simple, at-home approaches include avoiding offending activities that aggravate the symptoms, taking more frequent breaks from the activity, wearing fingerless gloves to keep the wrist warm if you work in a cold environment, and icing the wrist when there is swelling. If the symptoms occur when using a specific device, like a computer keyboard or a mouse, then you can look for ergonomically correct versions – those that best allow the hands and wrists to remain in a neutral position.

Splinting the wrist can also be effective. A splint for CTS looks like a fingerless glove and keeps the wrist straight or slightly bent back. Some people use them just at night, a practice that can alleviate symptoms on waking, as well as providing continued benefit during the day. Splints should not be worn constantly because they not only interfere with daily activities, but they can also weaken muscles in the long term.

Practitioner guided. Other approaches to alleviating symptoms depend on what is causing CTS. If there is an underlying cause, such as inflammation, then that should be addressed. A conventional practitioner might start out with a steroid injection (such as cortisone), and while this can alleviate the inflammation temporarily, the symptoms can return within weeks. Although NSAIDS like ibuprofen can help alleviate pain in the short term, they have not been shown to provide lasting benefit for CTS.

When all else fails, surgery can be performed. This involves cutting the transverse carpal ligament – the one putting pressure on the median nerve. This is either done via laparoscopy or conventional open surgery.

Nutritional support

Research and clinical experience also show that certain vitamins, botanicals, and other nutrients can help ease symptoms. 

Vitamin B6. Pyridoxine (vitamin B6) is an essential co-factor in the synthesis of several neurotransmitters (chemicals that stimulate nerve function) and has long been used for nutritional support of individuals with carpal tunnel syndrome.* Some older research found lower levels of vitamin B6 in individuals with CTS compared to those who did not have CTS,1 although recent research has not confirmed this.

In a 2007 review2 of 14 studies, eight showed benefit, while the other six studies were either inconclusive or showed no benefit.3  Although many older studies relied on subjective symptom reports, a more recent study looked at both symptoms and nerve function tests. In this study, 20 individuals with CTS were randomly selected to take 120 mg of vitamin B6 daily for three months along with splinting, while 19 others received only splinting. At the end of three months, the participants taking B6 showed symptom improvement in all areas,* while the splint-only group showed improvement only in the ability to open a jar and handle a phone. Nerve conduction tests were better in the B6 group also.*4

Based on the evidence and lack of toxicity, vitamin B6 can be considered as adjunct nutritional support for individuals who have CTS.* Thorne provides biologically active vitamin B6 (pyridoxal 5’ phosphate) as a stand-alone supplement or combined in a B complex with a special emphasis on B6. And if you’re an athlete suffering from carpal tunnel syndrome, this formula – Thorne’s B-Complex #6 – is NSF Certified for Sport®.

Curcumin/alpha-lipoic acid. Additional support might be provided by nutrients and botanicals like curcumin, which supports a balanced inflammatory response, or alpha-lipoic acid, which provides antioxidant support.*

A study found a combination of curcumin phytosome, alpha-lipoic acid, and B vitamins provided benefit to individuals with CTS who were awaiting surgery.*5  Patients (180; 60 in each of three groups) were given a supplement twice daily for three months prior to and three months following surgery, three months prior to surgery only, or nothing before or after surgery. The supplement consisted of 500 mg curcumin phytosome, 300 mg alpha-lipoic acid, and small amounts (1-4.5 mg) of vitamins B1, B2, B5, and B6. Participants in the group who took the supplement before and after surgery had significantly fewer nighttime symptoms and positive Phalen’s tests (inverted prayer) compared to the other two groups.* The bottom line: it appears that, when evaluated 40 days and three months after surgery, individuals still taking the supplement experienced faster recovery.* 

Thorne’s Curcumin Phytosome contains 500 mg per capsule, while Thorne’s Alpha-Lipoic Acid provides 300 mg per capsule.

The takeaway

Evidence confirms nutritional support can benefit individuals who have carpal tunnel syndrome – particularly as an adjunct to splint use and other conservative treatments or as a means to support healing after surgery.*

References

  1. Ellis JM, Kishi T, Azuma J, Folkers K. Vitamin B6 deficiency in patients with a clinical syndrome including the carpal tunnel defect. Biochemical and clinical response to therapy with pyridoxine. Res Commun Chem Pathol Pharmacol 1976;13(4):743-757. 
  2. Aufiero E, Stitik TP, Foye PM, Chen B. Pyridoxine hydrochloride treatment of carpal tunnel syndrome: a review. Nutr Rev 2004;62(3):96-104. doi: 10.1111/j.1753-4887.2004.tb00030.x. 
  3. Ryan-Harshman M, Aldoori W. Carpal tunnel syndrome and vitamin B6. Can Fam Physician 2007;53(7):1161-1162. 
  4. Talebi M, Andalib S, Bakhti S, et al. Effect of vitamin B6 on clinical symptoms and electrodiagnostic results of patients with carpal tunnel syndrome. Adv Pharm Bull 2013;3(2):283-288. doi: 10.5681/apb.2013.046. 
  5. Pajardi G, Bortot P, Ponti V, Novelli C. Clinical usefulness of oral supplementation with alpha-lipoic acid, curcumin phytosome, and B-group vitamins in patients with carpal tunnel syndrome undergoing surgical treatment. Evid Based Complement Alternat Med 2014;2014:891310. doi: 10.1155/2014/89131