Carpal and Radial Tunnel Syndromes: Causes | Treatments

What Are Carpal Tunnel and Radial Tunnel Syndromes?

Along with the disorder of cubital tunnel syndrome, carpal and radial tunnel syndromes are disorders that impact the patient’s wrist and forearm. The functioning of the arm and hand are often impaired. This makes regular daily life more difficult for patients who suffer from these disorders. Carpal and radial tunnel syndromes physically affect people in their arms and make regular functioning more difficult.

How Carpal Tunnel Syndrome Occurs

Carpal tunnel syndrome occurs when the median nerve of the forearm is squeezed. There are a number of reasons why the median nerve might have become squeezed. That nerve, when pressed upon at the wrist, impacts the communication of sensations to the thumb and fingers. The tendons and median nerve are housed in the carpal tunnel. When that tunnel is narrowed, symptoms such as weakness, numbness, and pain in the hands and arms are likely to occur. The pain is generally known to be in the hand and wrist. However, it can also move up the arm and further impede movement and activities.

CTS is an entrapment neuropathy. Tingling sensations can be the first sign that the patient is beginning to develop carpal tunnel syndrome. Itching, burning, and numbness are also common symptoms. Some people may be unfortunately born with a more narrow carpal tunnel, but injury and trauma to the wrist, work stress, overuse of vibrating tools, menopause, tumors, hypothyroidism, diabetes, and rheumatoid arthritis are all risk factors that can contribute to the development carpal tunnel syndrome beyond a defect in the carpal tunnel from birth.¹

How Cubital and Radial Tunnel Syndromes Occur

Cubital tunnel syndrome affects the ulnar nerve at the elbow. Radial tunnel syndrome involves the radial nerve, which runs in the forearm and elbow. Radial tunnel syndrome, unlike cubital and carpal tunnel syndromes, rarely causes symptoms of tingling and numbness, since the radial nerve’s impact is on the muscles. Bone or fatty tumors, inflammation, and injury can cause RTS. The radial tunnel syndrome symptoms include a stabbing pain, or a feeling of cutting or piercing. These symptoms primarily affect the back of the hand or forearm.²

Traditional Treatments for Carpal and Radial Tunnel Syndromes

Treatment is necessary for carpal and radial tunnel syndromes because they can continue to worsen and cause more and more problems over time. Using a wrist splint, cold packs, or taking NSAIDs, including the likes of aspirin, ibuprofen, can help with reducing the pain and inflammation. Some patients may be prescribed diuretics, or water pills, to cut down on the swelling in the arms. Others may take corticosteroids, such as prednisone. Vitamin B6 may also be a useful supplement for managing the symptoms of carpal tunnel syndrome.

Doctors and physical therapists may prescribe exercises which are meant to strengthen and stretch the region. However, carpal tunnel surgery could be recommended to some patients in cases where the patient has experienced 6 months of symptoms. Open release surgery involves a 2-inch incision in the wrist so that the surgeon can cut the carpal ligament, enlarging the carpal tunnel. Endoscopic surgery may have faster recovery and less pain, where only two ½ inch incisions are made to make way for a camera while the surgeon cuts the carpal ligament while viewing it on a screen.³

Radial tunnel syndrome (and cubital tunnel syndrome) may also respond to standard treatments of NSAIDs, corticosteroids, and splinting. Surgery might be a final option, especially if the wrist becomes too weak in radial tunnel syndrome.⁴

Alternative Care for Carpal and Radial Tunnel Syndromes

Proper ergonomics, rest breaks, and stretching exercises, as well as the use of splints and correct posture can all help the patient avoid the onset of preventable carpal and radial tunnel syndromes. Yoga has been shown to encourage the improvement of grip strength and reduce the severity of pain in carpal tunnel syndrome patients.⁵ Conservative care for radial tunnel syndrome includes heat, cold, ultrasound, and stretching and strengthening exercises.⁶

Chiropractic care aims to resolve the underlying problem, instead of masking symptoms. Some patients might unknowingly worsen their own condition by not following the right method of treatment or by failing to treat the cause of the carpal tunnel syndrome. Chiropractors could recommend rest, immobilization, and cool packs for carpal tunnel syndrome, as well as B6. Joint manipulation and soft tissue mobilization techniques may also help patients. A chiropractor might recognize instances where the patient is contributing to their own detrimental condition through improper posture or repetitive stress.

Acupuncture is also being investigated as a method of treatment for carpal tunnel syndrome.⁷ Friction massage and active release are treatment options chiropractors could offer for radial tunnel syndrome, as well as splinting. Chiropractors can also help determine if the pain that the patient is experiencing is originating from tennis elbow or radial tunnel syndrome in order to work towards the proper methods of treatment.⁸