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| Carpal tunnel syndrome |
Think there’s no hope for recovering from carpal tunnel syndrome using natural strategies? Well, turns out there are a number of scientifically proven natural therapies that reduce pain and increase motion for carpal tunnel syndrome. These include certain herbs, supplements and foods according to the research.
Let’s look at the scientific evidence for these natural remedies for carpal tunnel syndrome (CTS).
What is carpal tunnel syndrome?
Carpal tunnel is caused by the entrapment and subsequent pressure on the median nerve along with accompanying tendons that wind through the carpal tunnel.
For this reason, some have suspected repetitive motion as a potential cause.
The carpal tunnel is a small hollow in the region of the wrist where a number of small bones also coexist.
Carpal tunnel syndrome is the result of the compression and entrapment of the median nerve as it runs through the carpal tunnel in the wrist and upper palm. It is typically symptomized with pain in the wrists and a significant reduction of hand, arm and wrist mobility. It also can produce numbness in the thumb, fingers, hand and wrist. Often this numbness and pain will occur during the night.
Often the syndrome will begin showing itself with some tingling in the thumbs and fingers, which can slowly progress into pain – often termed neuropathy. While repetitive motion can worsen the condition, CTS has been linked to such internal issues as diabetes or lack of glucose control, arthritis, obesity, pharmaceutical use, stress and nutritional deficiencies. It is often related to other neuropathic conditions elsewhere in the body.
As few medications are known to help the condition, surgery is often resorted to. The typical surgery today is called endoscopic carpal tunnel release.
While conventional theory assumes a cause related strictly to alignment and physical function, it doesn’t explain why the condition is related to hypothyroidism, diabetes, obesity and rheumatism.
The intermittent and sometimes chronic tingling, pain and numbness of the hands resulting from carpal tunnel syndrome has also been associated with depression and even pregnancy.
The most used conventional medication for the symptoms of carpal tunnel syndrome is corticosteroid injections.
And as most medical professionals know, corticosteroid injections work by halting the inflammatory processes that occur among the various tissues.
And since corticosteroid injections are effective in the temporary relief of the syndrome, we can safely conclude that inflammation plays a large part in the condition.
And it so happens that greater levels of inflammation are also seen in hypothyroidism, diabetes, rheumatism and depression.
Chamomile oil improves carpal tunnel
In a 2017 study from Iran’s Shiraz University of Medical Sciences, researchers tested 86 patients with mild to moderate carpal tunnel. In this double-blind placebo-controlled trial, the patients were divided into two groups. One group was given topically-applied chamomile oil. The other group was given a placebo. Both groups also wore a wrist splint. The treatment lasted for four weeks.
After the four weeks, the researchers found that the chamomile oil significantly reduced pain and increased functionality for the CTS patients. The chamomile oil also decreased the compound latency in the medial nerves in the patients. The latency is a measure of nerve conduction. CT patients typically have larger latency periods than healthy people.
The researchers stated:
“Dynamometry, functionality, and symptom severity scores of the patients were significantly improved in the chamomile oil group compared with the placebo.”
Flaxseed relieves CTS pain and increases motion
This element ties precisely into the use of flaxseed oil because flax has been shown to significantly reduce inflammation.
This fact was illustrated in a study published in late 2014 in the DARU Journal of Pharmaceutical Sciences. This double-blind and randomized clinical study was conducted with 100 patients, of which 155 hands with carpal tunnel syndrome were tested.
In other words, both wrists are not always involved in the condition – for a reason not well understood.
At any rate, all 100 patients had mild to moderate conditions, and they were between 18 and 65 years old. The patients were randomized and divided into two groups. One group was treated with flaxseed oil and the other group was treated with a placebo oil.
Both groups were given a wrist splint to use at night and were told to apply the flaxseed oil onto the wrist and upper hands daily for four weeks.
Before and after the treatment, the patients were given a battery of tests and functional assessments, which included the Boston Carpal Tunnel Questionnaire and its functional status assessment. These rate the patient’s levels of pain, numbness, tingling and other symptoms of carpal tunnel syndrome, as well as mobility and function.
After the four weeks, the patients who applied the flaxseed oil had significant improvement compared to the placebo group using both of the above-mentioned assessments.
Scores on the Boston symptom test went from 2.74 to 1.90 on average during the four weeks for those who were treated with the flaxseed oil. For those who applied the placebo oil, the scores went from 2.79 to 2.59.
Meanwhile, during the four weeks, scores on the Boston function tests went from 2.61 to 2.17 in the flaxseed group and went from 2.41 to 2.59 in the placebo group.
Flaxseed oil is a general anti-inflammatory
Flaxseed oil can be used externally, to help reduce wrinkles and soothe the skin in general. While I haven’t found any studies to substantiate these uses, there are numerous studies showing the internal consumption of flaxseed oil has numerous benefits, including the potential to help prevent diabetes, cancer and cardiovascular diseases.
In addition, there is clear indication that flaxseed consumption may improve memory and cognition – making it useful for dementia.
All of these conditions, by the way, are related to inflammation. Flaxseed is high in omega-3 fatty acids such as alpha linolenic acid (ALA). ALA has been linked directly to reducing inflammation, as it inhibits the cyclooxygenase (COX) inflammatory pathways of COX-1 and COX-2. These inflammatory pathways are linked to numerous conditions, including the ones mentioned above, and of course, carpal tunnel syndrome.
Flaxseeds contain between 35 and 45 percent oil. Of this about 10 percent is palmitic and stearic acids, about 20 percent is oleic acid and other monounsaturates, and over 70 percent is alpha linolenic-type fatty acids.
Flax also contains significant protein levels, between 20 and 30 percent. It is also rich in B vitamins and minerals, as well as gamma-tocopherol – an antioxidant form of vitamin E.
Flaxseeds also contain a special type of lignan called secoisolariciresinol diglucoside. This is a phytoestrogen and significant antioxidant. Flax is the best source of this important anti-inflammatory lignan.
Because the skin does quite certainly absorb what is applied to it, it is not such a reach to assume the very omega-3 fatty acids, phytoestrogens and antioxidants that reduce inflammation when flaxseed is taken internally will have similar effects when applied externally.
Alpha-lipoic acid and curcumin for CTS
Most recently, researchers from Milan’s Sesto San Giovanni Hand Surgery Unit have determined that a combination of alpha-lipoic acid, curcumin phytosome, and B-group vitamins helps ease pain and increase motion in carpal tunnel syndrome.
The researchers randomly separated 180 patients with CTS into three groups. The patients were all scheduled to receive surgery to decompress the median nerve – a conventional therapy for carpal tunnel.
The researchers gave one group a combination supplement twice a day for three months – prior to the surgery. They gave a second group the supplement twice a day three months before the surgery and three months after the surgery. A third group served as the control group – they were not given any supplementation program prior to or after the surgery.
The researchers found that those taking the supplementation program fared significantly better than those patients not taking the supplements. Those taking the supplements before and after surgery had fewer nocturnal symptom scores and better Phalen testing than the control group.
The researchers concluded:
“We conclude that oral supplementation with alpha-lipoic acid, curcumin phytosome, and B-group vitamins twice a day both before and after surgery is safe and effective in CTS patients scheduled to undergo surgical decompression of the median nerve.”
Other research has indicated that lipoic acid and curcumin can reduce pain and increase motion in CTS. In a 2013 study, Italian researchers tested 135 patients with neuropathic pain including low back pain and/or carpal tunnel syndrome with a supplement containing the curcumin phytosome, lipoic acid and piperine (found in black pepper and the Ayurvedic herb Piper longum) in a formulation called Lipicur.
The researchers found that the supplement significantly reduced pain by more than 66% among the patients, and reduced the patients’ intake of dexibuprofen – which the patients were also taking as part of their therapy.
What is Lipoic Acid?
Lipoic acid or alpha-lipoic acid is readily available in many whole foods, but in supplement form, it is typically synthesized from octanoic acid. It is considered a organosulfur element because of its sulfur atoms.
Alpha-lipoic acid has been found to reduce neuropathy in other research. A 2006 study among 89 diabetic polyneuropathy patients found that ALA significantly reduced pain and impairment among the group taking ALA versus a placebo.
What about the B vitamins?
B vitamins have a long history of application in neuropathy. Vitamin B6 and vitamin B12 have had the most focus. However, clinical evidence of their effects to reduce pain or improve movement is weak. Combination studies such as the one shown above seem to indicate usefulness, but it remains to be seen whether its benefit lies in simply reducing deficiency or whether they are therapeutic in themselves.
Curcumin for CTS
A therapeutic benefit of curcumin in CTS is backed by other research evidence that shows turmeric and its central constituent, curcumin, has the ability to reduce inflammation and to some degree, neuropathic pain.
Piperine from either black or long pepper, has also been shown to reduce inflammation, along with being a potent antioxidant.
CTS remedies from Persian Medicine
In a 2018 study, researchers from Iran’s Tehran University of Medical Sciences studied the literature relating to Persian traditional medicine for carpal tunnel syndrome. Persian traditional medicine is one of the oldest medical arts, dating back more than two thousand years.
The researchers found a number of natural therapies that have been clinically applied in this ancient Middle Eastern medical practice.
They identified a number of herbs that have been proven in the research as being therapeutic for CTS, and the nerves in general. Here are the most known of those herbs (“internal” means taken as a supplement and “topical” means applied to the skin) from the researchers’ list:
• Agrimony leaf (Agrimonia eupatoria) internal
• Alfalfa leaf oil (Medicago sativa) topical
• Anise fruit (Pimpinella anisum) topical and internal
• Artichoke leaf (Cynara cardunculus) topical and internal
• Cardamom fruit (Elettaria cardamomum) topical and internal
• Common Rue leaf (Ruta graveolens) internal
• Costus Root oil (Costus sp.) applied topical
• Fenugreek (Trigonella foenum) topical and internal
• Garlic (Allium sativum) topical and internal
• Henna leaf (Lawsonia inermis) topical and internal
• Lavender (Nepeta menthoides) internal
• Lettuce seed (Lactuca sativa) topical and internal
• Linseed oil (Linum usitatissimum) topical
• Mulberry leaf (Morus alba) topical and internal
• Mustard Seed (Brassica nigra) topical
• Olive oil (Olea europaea) topical and internal
• Pinecone (Pinus sylvestris) internal
• Rose oil (Rosa Damascena) topical
• Saffron flower and seed (Colchicum autumnale) topical and internal
• Spurge (Euphorbia resinifera) internal
• Trefoil leaf and seed oil (Trifolium aureum) topical
Persian medicine also advises a diet consisting of a minimum of red meats and increased fruits and vegetables is helpful for carpal tunnel.
These therapies have been scientifically shown to reduce CTS pain and increase mobility. As to whether they provide a complete resolution to carpal tunnel syndrome, this remains a question for longer application in clinical study. Certainly, remediating some of the causes, especially if it is related to a poor diet, type 2 diabetes, obesity or other nutritional factors, is worth consideration. But CTS progression can be debilitating and should nevertheless involve the consultation and advice from a medical doctor trained in neuropathic disorders.
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Setayesh M, Zargaran A, Sadeghifar AR, Salehi M, Rezaeizadeh H. New candidates for treatment and management of carpal tunnel syndrome based on the Persian Canon of Medicine. Integr Med Res. 2018 Jun;7(2):126-135. doi: 10.1016/j.imr.2018.02.003.
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