Mrs. P, a successful manager at a leading IT company, was driving home after an exhausting office meeting. Afternoon, she was experiencing slight weakness in her wrist and two fingers, especially while she was typing or holding a telephone headset for a long time. Today, while she was driving the car, she began to experience intense tingling and numbness with a stabbing pain in the palm of her hand. After a while, she couldn’t even drive the car efficiently and she had to make an effort to get home safely. She immediately made an appointment with a neurologist, who confirmed that it was the classic case of ‘Carpal Tunnel Syndrome’.
Bottom:
Carpal tunnel syndrome (CTS) is a compressive neuropathy characterized by weakness and pain in the hand and wrist. Its manifestations can range from a minor inconvenience to a severely disabling condition, depending on its cause, treatment, and maintenance factors.
The incidence is so common that it is estimated that approximately 500,000 people undergo surgery for CTS in the US alone.
The pathophysiology:
The carpal tunnel is located at the base of the palm of the hand and is bounded on 3 sides by the carpal bones and anteriorly by the transverse carpal ligament. Inside runs the median nerve, the flexor tendons and their synovial sheaths. CTS is primarily caused by compression of the median nerve at the wrist, due to inflammation or growth of the flexor synovium. Pain in CTS is usually a secondary phenomenon rather than direct physical damage.
Risk factor’s:
- It usually runs in families.
- Obesity – or sudden increase in weight.
- Occupation involving repetitive movements of the wrist joint, for example, pianists or typists.
- Medical conditions, such as diabetes, hypothyroidism, acromegaly, gout, or rheumatoid arthritis.
- It is more common in middle-aged women.
Clinical presentation:
Carpal tunnel syndrome symptoms usually progress gradually over weeks, months, and sometimes years. Anyone with recurring or persistent pain, numbness and tingling, or weakness in the hand should see a doctor for a diagnosis. Symptoms often develop as follows:
- Initial symptoms include pain in the wrist and palm of the hand. Symptoms commonly occur in both hands. (Even when only one hand hurts, the other hand often shows signs of nerve conduction abnormalities on testing.)
- Initially, the patient also often reports numbness, tingling, burning, or some combination of symptoms on the palm side of the index, middle, and ring fingers. (Usually the fifth toe has no symptoms.) Such sensations may radiate to the forearm or shoulder.
- Over time, the hand can become numb, and patients may lose the ability to feel hot and cold. Patients may experience a feeling of weakness and a tendency to drop things.
- Patients may feel that their hands are swollen even though there is no visible swelling. This symptom can actually become an important indicator of a more serious CTS.
Diagnosis:
- A plain radiograph is of minimal use in the diagnosis of CTS.
- an MRI [MRI] it is reasonably accurate in locating the lesion.
- electromyelography [EMG] or nerve conduction studies may reveal nerve block.
Treatment:
drugs:
- These cases are usually treated with analgesics.
- Local steroid injections can dramatically reduce symptoms.
- A splint that minimizes movement in the wrist joint.
Exercises:
- Extend and straighten both wrists and fingers sharply as if in a handstand position. Hold this position for a count of five.
- Stretch both wrists and relax your fingers as you count to five.
- Make a tight fist with both hands. Then bend both wrists down while keeping your fist. Hold while you count to five.
- Stretch both wrists and relax your fingers as you count to five.
- Repeat each exercise 10 times, then hang your arms by your sides and shake them for a couple of seconds.
Surgery:
In more severe and limiting cases, surgical correction can be considered by releasing the transverse carpal ligament. Surgery for CTS has a long-term success rate of greater than 75%.
Role of homeopathy:
Since allopathic medicines provide temporary pain relief and surgery is not indicated in most CTS cases, a well-selected homeopathic remedy has a key role to play in the treatment of CTS by reducing edema and swelling. nerve compression. . The usual duration of therapy depends on the severity and depth of the condition and concomitant medical conditions. It usually takes about 6-8 months to get significant relief.
In my experience, both constitutional and locally acting remedies such as Paris quadr, Hypericum, Guiacum, Causticum, or Rhus tox have given relief. Key symptoms to elicit from the patient include: type of pain, side of pain, causative factors, modalities, and comorbidities.
CTS efficiently falls under the psychotic miasm and therefore an antipsychotic countercurrent is needed whenever the case is stopped.