Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition that affects the hand and wrist and occurs when the median nerve is compressed at the wrist. This can result in sensations of numbness, tingling, pain and clumsiness of the hand. Carpal tunnel syndrome is related to highly repetitive flexion and extension actions of the wrist. People with CTS often experience difficulty in performing simple tasks such as unscrewing a bottle top or fastening a button.

The carpal tunnel is located at the wrist just below the wrist crease, the floor of the tunnel is formed by the carpal bones and the roof of the tunnel is formed by the transverse carpal ligament. The structures that pass through the carpal tunnel are the median nerve; the four tendons of the flexor digitorum superficialis; the four tendons of the flexor digitorum profundus and the tendon of the flexor pollicis longus. The problem arises when the median nerve is compressed as it passes through the carpal tunnel. This can generally occur in one of two ways: the actual size of the tunnel itself decreases or the size of the contents passing through the tunnel increases. Generally the problem is due to one or the other cause, seldom do they occur together. Some causes of CTS are idiopathic or unknown.

The size of the contents passing through the tunnel can be increased by:

• Repetitive actions of the wrist, primarily flexion and extension that can lead to edema followed by chronic fibrosis and thickening of the tendons.
• Thickening of the retinaculum due to scar tissue from repeated trauma.
• Systemic conditions that result in edema and fluid retention or connective tissue. degeneration, such as diabetes, Hypothyroidism, rheumatoid arthritis and pregnancy.

The decreased canal space can be caused by:

• Bony callus development after a fracture of a carpal bone or the distal radius.
• Space occupying lesions such as ganglia, lipomas or cysts.
• Bony changes that occur with rheumatoid arthritis.

Acute causes include:

• Secondary to a trauma, such as a fracture or dislocation of the carpal bones of the wrist.
• Infection.
• Acute exacerbation of rheumatoid arthritis.
• New activity requiring repetitive wrist actions.
• Hematoma, which can occasionally occur in people with hemophilia or those on anticoagulants.

Contributing factors:

• It appears that a vitamin B6 deficiency can be present in those with CTS although it is unclear whether or not this deficiency is an actual cause.
• It may be a family trait.
• While work related CTS affects men and women equally, women can also be affected pre-menstrually, during pregnancy and menopause.Massage can focus on reducing local edema and increasing muscle tone in the forearm as well as addressing adhesions and trigger points that contribute to the condition.
• When CTS only occurs in one wrist it is usually in the dominant hand, however it is often found in both wrists. Another distinguishing feature of CTS is pain during the night, often waking the person up. There is usually local pain that occurs with wrist action. In later stages the pain can be present not only locally in the wrist and hand but also in the forearm, elbow and occasionally in the shoulder. The person will often shake, massage or exercise the hand for relief of symptoms, sometimes placing the hand under cool or warm running water helps. Swelling may be present.

Early diagnosis and treatment are important to avoid permanent damage of the median nerve. A physical examination of the hands, arms, shoulders, and neck can help determine if the person’s complaints are related to daily activities or to an underlying disorder and can rule out other painful conditions that mimic carpal tunnel syndrome. Diagnosis of carpal tunnel syndrome is confirmed by performing certain tests to detect damage to the median nerve.

Tinel’s test – The physician taps the median nerve at the wrist. A tingling response in one or more fingers indicates damage to the median nerve.
Phalen’s test – The patient puts the backs of the hands together and bends the wrists for one minute. Tingling of the fingers indicates damage to the median nerve.
Electromyography – Electrodes are placed on the forearm and electrical current is passed through the patient. Measurements on how fast and how well the median nerve transmits messages to muscles indicate if there is damage to this nerve.

In cases where the symptoms of carpal tunnel syndrome are mild or likely to be temporary, the treatment protocol generally includes, rest, anti-inflammatory drugs, analgesics and possibly splint to immobilize the wrist. In cases where the symptoms are severe surgery may be required.

So where do the essential oils come in? Many of the essential oils have anti-inflammatory, analgesic and diuretic properties so once we know what we are dealing with we can create a unique custom blend to address the specific problem.

Essential oils with anti-inflammatory properties include aniseed, benzoin, cardamom, chamomile German, chamomile Roman, clary sage, coriander, fennel, frankincense, geranium, ginger, helichrysum, lemongrass, marjoram, myrrh, orange, patchouli, peppermint, petitgrain and sandalwood.

Essential oils with analgesic properties include angelica, aniseed, bergamot, black pepper, cajuput, chamomile German, chamomile Roman, clove, coriander, eucalyptus, fennel, fir, frankincense, geranium, ginger, helichrysum, juniper, lavandin, lavender, lemongrass, marjoram, nutmeg, peppermint, rosemary, thyme and yarrow.

Essential oils with diuretic properties include angelica, aniseed, caraway, cardamom, carrot, cedarwood, cypress, eucalyptus, fennel, geranium, grapefruit, helichrysum, juniper, lavandin, lavender, lemon, marjoram, rosemary, sandalwood and black spruce.

The oils can be applied in a gentle massage or when there is a lot of inflammation in a cool or cold compress.

Blends for Carpal Tunnel Syndrome