One of the most frustrating and common conditions of hand pain is carpal tunnel syndrome. When patients have a lifestyle, hobby, or occupation that requires them to use their hands, there is a higher likelihood they will experience carpal tunnel syndrome, which can complicate the accomplishment of what would be routine tasks.
Despite carpal tunnel syndrome being common, most patients do not understand the condition and dismiss it as a cramp. But when the pain is persistent and precludes the use of one’s hands, it is likely to be carpal tunnel syndrome, and it is certainly more serious than a muscle cramp or spasm.
Understanding the true nature of carpal tunnel syndrome is essential for patients to seek proper diagnosis, treatment, and management strategies. In the following sections, we will explore the anatomy and development of carpal tunnel syndrome, its symptoms, risk factors, and conventional treatment approaches.
Additionally, we will discuss a breakthrough treatment option involving high-dose platelet-rich plasma (PRP) therapy and its potential benefits in managing carpal tunnel syndrome.
In this article, we will explore the innovative therapy option of PRP for carpal tunnel, which may provide the relief you have been seeking. We aim to equip you with valuable insights and knowledge to identify and alleviate the painful symptoms of this painful condition.
To begin, let’s delve into the definition of carpal tunnel syndrome and discuss the process of how it can develop.
Defining Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) develops gradually over a long period of time. For example, imagine someone who spends hours each day typing on a keyboard with improper wrist positioning. The repetitive hand and wrist movements, combined with sustained poor hand posture, can cause strain and irritation on the tendons in the wrist.
Over time, this repetitive strain leads to swelling and inflammation within the carpal tunnel, which in turn increases pressure on the median nerve. As the pressure on the nerve persists, it can result in the characteristic uncomfortable symptoms of CTS, including pain, numbness, and tingling.
It is essential to emphasize that carpal tunnel syndrome is a nerve condition rather than a muscular complication. While muscle strain can contribute to the development of CTS, the primary cause lies in the compression and irritation of the median nerve as it travels through the carpal tunnel.
For example, during their comprehensive literature review, Dr. Genova and Dix conducted an in-depth analysis of the nature and pathogenesis of CTS and determined that “[c]arpal tunnel syndrome (CTS) is a common medical condition that remains one of the most frequently reported forms of median nerve compression.
CTS occurs when the median nerve is squeezed or compressed as it travels through the wrist. The syndrome is characterized by pain in the hand, numbness, and tingling in the distribution of the median nerve” (2020).
The distinction is vital as some individuals mistakenly categorize CTS as a problem related to muscles. Clarifying this point helps patients grasp the true nature of the condition and its impact on the median nerve. By recognizing CTS as a nerve-related syndrome, patients can gain a better understanding of the appropriate treatment approaches and management strategies required to effectively address the underlying nerve compression and alleviate the associated symptoms.
Having established a comprehensive understanding of the development and pathophysiology of CTS, we will now explore the distinctive indicators and symptoms that characterize this condition in the following section.
Symptoms Of Carpal Tunnel Syndrome
CTS presents a range of symptoms that can significantly impact an individual’s daily life and activities. The most common signs of CTS include pain, numbness, tingling, and a “pins and needles” sensation in the hand and fingers, particularly in the thumb, index, middle, and ring fingers.
These symptoms may start gradually and primarily affect the hand’s palm side, but they can progress over time.
As CTS progresses, individuals may experience weakness in the affected hand, making it challenging to perform routine tasks that require fine motor skills, such as buttoning clothes, gripping objects, or holding utensils.
The loss of grip strength and dexterity can hinder the ability to perform work-related duties or engage in hobbies and recreational activities, causing frustration and limitations in daily functioning.
Moreover, the symptoms of CTS often worsen at night, leading to sleep disturbances and disrupted rest. Many individuals report awakening with a feeling of numbness or pain in their hands or having the need to shake or move their hands to relieve discomfort. The constant disruption of sleep can lead to fatigue, daytime drowsiness, and decreased productivity.
The impact of CTS symptoms extends beyond physical limitations. Chronic pain and discomfort may result in emotional distress, anxiety, and depression. The inability to participate fully in activities that were once enjoyable can contribute to feelings of isolation and reduced quality of life.
It is essential to recognize and address the symptoms of CTS promptly to minimize their impact on daily life. Seeking medical attention, receiving an accurate diagnosis, and exploring appropriate treatment options can help alleviate symptoms, restore hand functionality, and improve overall well-being.
Risk Factors And Causes Of Carpal Tunnel Syndrome
CTS is influenced by various risk factors that increase the likelihood of the condition developing. Along with understanding CTS as a nerve condition and not a muscular condition, patients should also have a thorough understanding of the risk factors for CTS that could apply to them.
Dr. Genova and Dix continue to review the condition of CTS and explain that the “[r]isk factors for CTS include obesity, monotonous wrist activity, pregnancy, genetic heredity, and rheumatoid inflammation.”
Certain individual factors, including age, sex, hormonal changes, and diabetes mellitus, which can lead to peripheral neuropathy, are associated with increased susceptibility to CTS. Women, in particular, are more prone to developing this condition.
Therefore, individuals who possess these risk factors should be especially vigilant in implementing preventive measures and seeking early intervention to manage and reduce the impact of CTS.
This can include practicing proper ergonomics, maintaining good posture, taking regular breaks, using ergonomic equipment, implementing stretching exercises, and seeking medical advice for early intervention and management.
Furthermore, obesity is recognized as a significant factor in nerve-damaging conditions, such as diabetic peripheral neuropathy. To reduce the risks of developing CTS and other related disorders, individuals can take steps to control their weight.
Extensive research has focused on understanding these risk factors and the specific causes associated with CTS, particularly in relation to repetitive hand movements and work-related activities. Let’s go on to explore these in greater detail.
Work-Related Carpal Tunnel Syndrome
Patients who experience CTS may have developed the condition from work/hobby repetition–including something as innocuous as typing on a keyboard. Work-related carpal tunnel syndrome has significant implications for occupational health and carries an associated economic burden.
Dr. Genova and Dix’s literature review has clearly categorized CTS as a work-related musculoskeletal disorder, highlighting its relevance in today’s world by explaining that “[m]ost western nations indicate a rise in the number of work-related musculoskeletal disorders (WMSDs).
This is associated with increased strain and repetitive movements by individuals. Europe, in 1998, for instance, reported more than 60% of upper limb musculoskeletal disorders recognized as work-related . . . CTS incidences.
The prevalence levels may also vary across the different occupations and industries, with industries such as the fish processing industries reporting the occurrence of CTS in their workers estimated at 73%. These views on the occurrence rates of CTS illustrate the weight of the challenge, making it a significant area of concern, which would require effective strategies for management”. It may not surprise patients to learn that CTS is more prevalent in those who engage in activities requiring prolonged and forceful use of the hand and wrist, as well as exposure to hand-arm vibration, such as assembly line work and manual labor. Still, these monotonous and repetitive motions can irritate the hand’s median nerve and pose a significant risk for developing CTS over time.
Relationship Between Carpal Tunnel Syndrome And Repetitive Hand Movement
If the hand’s median nerve is continually irritated due to repetitive activities, the pain associated with CTS can intensify over time.
This prolonged irritation can lead to swelling, inflammation, and increased pressure, which ultimately worsens nerve compression and escalates the severity of pain associated with CTS.
Dr. Tonga and Bahadir explain why increased pain could lead to drastic decisions made by patients in regard to their treatment and go on to specify the importance of first addressing weight management and B12 deficiency before considering surgery.
The doctors found that throughout their experiences, “CTS severity not only increases patient’s discomfort but also makes them lean toward surgery. Controlling CTS severity may help keep symptoms manageable with conservative means.
In this regard, as BMI and vitamin B12 deficiency increase the CTS grade, patients with CTS should keep their weights under control and carefully choose their diets to prevent vitamin B12 deficiency” (2022).
Like most doctors, Tonga and Bahadir seek to mitigate the conditions of their patients and intend to keep surgical intervention as a last resort. But, when weight maintenance and B12 supplementation are not enough, patients may be looking for an alternative that works and is safe.
Recognizing the impact of CTS severity on patients’ decision-making, along with the potential influence of factors such as weight and B12 deficiency, as well as the weighty decision surrounding surgical intervention, highlights the importance of exploring accurate diagnostic methods for CTS. Let’s go on to discuss how CTS is diagnosed in the next section.
Diagnosing Carpal Tunnel Syndrome
To ensure accurate diagnosis and appropriate treatment of CTS, healthcare professionals may utilize a number of diagnostic approaches. The evaluation typically consists of the following:
- Medical history: The doctor reviews the patient’s symptoms, risk factors, and relevant medical conditions to understand the context and potential causes of CTS.
- Physical examination: The doctor examines the hands, wrists, and arms, looking for signs of swelling, tenderness, or weakness. They may also check for abnormalities in the range of motion and assess muscle strength.
- Nerve conduction study: This test measures the speed at which electrical signals travel through the median nerve. Electrodes are placed on specific points along the nerve pathway, and small electrical impulses are applied to evaluate how well the nerve conducts these signals.
- Electromyogram (EMG): This test assesses the electrical activity of muscles and helps determine if there is nerve damage. Thin, needle-like electrodes are inserted into specific muscles to record their response to nerve stimulation.
- Ultrasound imaging: In some cases, ultrasound imaging may be used to assess the structures within the wrist and identify any abnormalities. It allows visualization of the median nerve, tendons, and surrounding tissues, helping to confirm the diagnosis and rule out other conditions.
It is crucial to consult with a healthcare professional for an accurate diagnosis, as other conditions can exhibit symptoms similar to carpal tunnel syndrome.
A comprehensive evaluation, incorporating medical history, physical examination, and relevant diagnostic tests, enables healthcare providers to formulate an appropriate treatment plan tailored to the individual’s specific needs.
Once a diagnosis of carpal tunnel syndrome (CTS) is made, it is crucial to seek and obtain a personalized management plan that takes into account your specific needs and lifestyle preferences.
How Conventional Medicine Approaches Carpal Tunnel Syndrome
Conventional medical treatments for CTS aim to relieve symptoms, reduce inflammation, and alleviate pressure on the median nerve. The specific treatment options prescribed by healthcare professionals may vary depending on the severity of the condition and individual patient factors. Here are some common examples of conventional treatments for CTS:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications such as ibuprofen or naproxen are often recommended to reduce inflammation and alleviate pain associated with CTS.
Wrist Splints/Braces: Wearing a wrist splint or brace can help stabilize the wrist in a neutral position, relieving pressure on the median nerve and reducing symptoms. Splints are typically worn during activities that aggravate symptoms or at night.
Corticosteroid Injections: Injections of corticosteroids into the carpal tunnel can provide temporary relief by reducing inflammation and swelling around the median nerve. Repeat doses are often required overtime.
Physical Therapy: Therapeutic exercises and techniques can improve wrist strength, flexibility, and posture, reducing symptoms and preventing further injury. Physical therapists may also employ techniques like ultrasound or laser therapy to promote healing.
Occupational Changes/Ergonomic Modifications: Making modifications to workstations or job tasks, such as using ergonomic keyboards or adjusting desk height, can help reduce strain on the wrists and minimize symptom exacerbation.
Lifestyle Modifications: Simple lifestyle changes like taking regular breaks from repetitive hand activities, practicing proper hand and wrist posture, and avoiding activities that aggravate symptoms can provide relief and prevent CTS progression.
In cases where conservative treatments do not provide sufficient relief, surgical intervention may be considered. This surgery typically involves releasing the pressure on the median nerve by cutting the transverse carpal ligament, a procedure known as carpal tunnel release.
However, it is important to note that surgery is typically reserved for severe or persistent cases of CTS that do not respond to more conservative measures. Individuals diagnosed with carpal tunnel syndrome (CTS) should seek professional medical advice to determine the most suitable treatment approach based on their specific symptoms and circumstances.
While conservative treatments such as braces, physical therapy, and ergonomic changes may not always provide sufficient relief, relying on medications and steroid injections may not be preferred due to personal lifestyle choices.
In the upcoming sections, we will explore the effectiveness of platelet-rich plasma (PRP) therapy for CTS and why it is favored as an innovative alternative for those who have not responded to conventional treatments and wish to avoid surgery.
Why Consider High-Dose PRP As A Treatment For Carpal Tunnel Syndrome?
One treatment that is safe and proven to be effective is high-dose platelet-rich plasma. In a small study examining the efficacy of PRP when applied to CTS, doctors Güven and Özçakar determined that “[p]latelet-rich plasma (PRP) treatment has the potential to become a part of the nonsurgical approach in carpal tunnel syndrome (CTS) as a regenerative method.
PRP therapies aim to enhance the self-healing ability of [the] human body by exposing the injured tissue to a high concentration of autologous growth factors. Nerve tissues also seem to benefit from the regenerative effects of PRP concentrates” (2019).
The doctors explain their methods for determining PRP efficacy and explain that their purpose is “to investigate the possible beneficial effects of PRP injection in CTS. A total of 40 hands of 30 patients were included (20 hands per group) with mild to moderate idiopathic CTS.
Patients with mild to moderate CTS were placed into either control or PRP groups. Activity modification and night-only wrist splints were suggested in both groups.
Additionally, in the PRP group, a single perineural PRP injection into the carpal tunnel was applied under ultrasound guidance. Sensibility tests, Boston carpal tunnel questionnaire (BCTQ), and electrophysiological and ultrasonographical findings were measured initially and after four weeks.
Groups were similar regarding demographics. BCTQ scores and ultrasonographical values were improved in both groups. Delta analyses revealed that the difference in BCTQ scores improved better in the PRP group. Electrophysiological values improved in the PRP group.
Our study demonstrated that a single, perineural PRP injection into the carpal tunnel provided further improvements in CTS”.
Study after study has concluded that PRP for carpal tunnel syndrome, if anything, supplements and improves pain management capability compared to other treatment options.
PRP And Nerve Regeneration
With nerve damage, the process of treatment is more complicated. However, the healing capability of our body works in much the same way. The application of high-dose platelet-rich plasma to CTS-affected areas is an assistance to the body’s natural healing process.
Based on a comprehensive evaluation of studies conducted in 2017, doctors Sanchez and his associates concluded that there were six pieces of evidence supporting the effectiveness of high-dose platelet-rich plasma (PRP) treatment in promoting nerve regeneration.
“1) neuroprotection and prevention of neuronal apoptosis,
2) stimulation of vascular regeneration,
3) promotion of axonal regeneration,
4) regulation of inflammatory response in the microenvironment,
5) alleviation of nerve collateral muscle atrophy, and
6) improvement of human nervous system parameters” (2017).
With the benefits of this natural application of healing platelets in mind, patients struggling with CTS pain and irritation are more and more likely to seek this type of treatment every day they have to live with the condition.
Common Patient Concerns About Platelet-Rich Plasma
We’ve all witnessed the human body’s incredible capability to heal injuries. A scraped back will bleed, scab, and scar in a number of days, and a broken bone will reset itself in a matter of weeks. These healing processes work through the cells in our body, activating and targeting the affected areas.
High-dose platelet-rich plasma has the potential to heal and regrow damaged tissue around the median nerve and is often favored among those patients who have suffered from carpal tunnel syndrome.
After hearing the results of these above studies, many might be jumping at the chance to treat their CTS with high-dose platelet-rich plasma, some might be more apprehensive due to their lack of understanding of what high-dose platelet-rich plasma is in the first place.
Let’s address some of the common reservations and basic concerns individuals may have regarding PRP Therapy:
Risks and Safety: Platelet-rich plasma treatment is considered safe since it utilizes the patient’s own blood components, reducing the risk of adverse reactions or complications. As with any medical procedure, there is a small risk of infection or allergic reaction.
However, these risks can be minimized by choosing a reputable healthcare provider with experience in administering PRP therapy.
Recovery Time: The recovery time following a high-dose PRP treatment for CTS is significantly shorter compared to surgical intervention. However, it can vary depending on the individual and the severity of their condition.
Side Effects: PRP treatment for CTS is generally well-tolerated, with rare temporary side effects at the injection site, such as pain, swelling, redness, or bruising. These typically resolve within a few days. Serious complications like infection or nerve damage are rare. At Orthagenex, we use specialized imaging to precisely guide PRP therapy, minimizing any potential risks.
By addressing these concerns, patients can make informed decisions about whether high-dose platelet-rich plasma treatment is the right option for their carpal tunnel syndrome. To gain further insight, it is helpful to compare PRP treatment to the more conventionally used cortisone injections.
Comparing PRP Treatment To Cortisone Injections
In a similar, albeit more extensive, study on the efficacy of high dose platelet rich plasma in comparison to corticosteroid injections, doctors Senna, Shaat, and Ali found that “[c]arpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper extremity.
Treatments for CTS alternate from conservative strategies to surgical decompression of the median nerve. Few studies have applied platelet-rich plasma (PRP) for treating idiopathic CTS, with acceptable success rates.” (2019).
In great detail, the doctors continue to explain the process of their study and explain that it was “. . . a randomized controlled trial in a cohort of Egyptian patients [who] suffered from mild to moderate CTS. They were randomly divided into two groups. Group 1: patients received ultrasound-guided PRP injection, and group 2 patients received ultrasound-guided corticosteroid injection.
The outcome measures were assessed via the Visual Analog Scale, the Boston Carpal Tunnel Syndrome Questionnaire, electrophysiological findings in sensory and motor functions of the median nerve, and morphological changes of median nerve detected by ultrasound . . . PRP injection was superior to the local steroid injection in the improvement of clinical manifestations . . . this superiority was observed in third-month follow-up suggesting better outcomes in a long-term follow-up”.
In the end, doctors Güven and Özçakar concluded that “Platelet-Rich Plasma could be an effective treatment of mild to moderate idiopathic CTS and superior to corticosteroid in improving pain, function, and distal sensory latency of [the] median nerve.”
Additionally, PRP therapy has a more favorable safety profile. As PRP is derived from a patient’s own blood, there is a reduced risk of adverse reactions or complications associated with foreign substances. Corticosteroid injections, on the other hand, carry potential side effects such as tissue atrophy, skin discoloration, and transient elevation of blood glucose levels.
Furthermore, PRP therapy has the potential for long-term benefits. The study mentioned above indicated that the superiority of PRP over corticosteroid injections was observed in the third-month follow-up, suggesting sustained improvement and better outcomes over a longer period.
This long-lasting effect could be particularly advantageous for individuals with mild to moderate idiopathic CTS, providing sustained relief from symptoms and potentially reducing the need for the repeat interventions that cortisone injections typically require.
Now that we have gained a comprehensive understanding of CTS and the effectiveness of the treatment options available based on research studies let us shift our focus to how our professionals at Orthagenex have chosen to approach the management of the painful symptoms associated with CTS.
How Orthagenex Approaches Carpal Tunnel Syndrome
Orthagenex not only offers patients high-dose platelet-rich plasma as a treatment for CTS but consultation and educational tools to help them maintain and manage their condition with confidence.
In the simplest explanation, from a patient’s own blood, we can take platelets in a concentrated form.
When blood is taken from these patients and put in a centrifuge, it is spun around quickly to separate red blood cells from white blood cells as well as concentrate the number of platelets together.
These concentrated platelets, once extracted and applied, act as a treatment that can be used to target nerve-damaged and nerve-irritated areas. These damaged areas include the median nerve damaged through carpal tunnel syndrome– regardless of its current pathogenesis.
Sessions with Orthagenex see patients not only going through the treatment process to reduce pain and increase flexibility but ensure patients have the tools they need to manage their conditions on a daily basis.
At Orthagenex, we offer personalized consultations and educational tools to empower patients to manage their condition proactively. These sessions aim to provide patients with a deeper understanding of CTS, its triggers, and practical strategies to alleviate symptoms and enhance overall well-being.Through a combination of PRP therapy and ongoing support, Orthagenex strives to reduce pain, improve flexibility, and enhance the quality of life for individuals with CTS. By equipping patients with the necessary means and knowledge, they can actively participate in self-care and implement strategies to manage their condition on a daily basis.
Orthagenex’s approach emphasizes a whole-person and patient-centered approach to CTS management, focusing not only on the treatment itself but also on empowering individuals to take control of their health and achieve long-term relief.
Seek A Regenerative Treatment For Carpal Tunnel Syndrome
In conclusion, Orthagenex’s high-dose platelet-rich plasma (PRP) treatment for carpal tunnel syndrome offers a breakthrough regenerative approach to managing this debilitating condition. Research studies have demonstrated the efficacy of PRP in reducing pain, improving functionality, and promoting nerve regeneration.
Unlike traditional treatments, such as cortisone injections or surgery, PRP therapy harnesses the body’s own healing capabilities to target the damaged tissue and enhance the self-healing process. Furthermore, PRP treatment has been shown to have superior long-term outcomes compared to corticosteroid injections.
Orthagenex’s approach to carpal tunnel syndrome combines high-dose PRP therapy with comprehensive patient consultations and educational resources. This whole-person approach empowers patients to actively manage their condition and achieve long-lasting pain relief and improved hand function.
If you are struggling with carpal tunnel syndrome, consider exploring high-dose PRP treatment at Orthagenex. Consult with a healthcare professional to determine if PRP therapy is the right choice for you and take the first step towards regaining control over your hand pain and restoring your quality of life.
There’s a better way to treat carpal tunnel syndrome. Get started with a consultation today.