Along with cubital tunnel syndrome, carpal and radial tunnel syndromes are disorders that impact the wrist and forearm.
What are Carpal Tunnel and Radial Tunnel Syndromes?
Carpal tunnel syndrome occurs when the median nerve of the forearm is squeezed. That nerve, when pressed upon at the wrist, impacts sensations to the thumb and fingers. The tendons and median nerve are housed in the carpal tunnel, and when that tunnel is narrowed, symptoms such as weakness, numbness, and pain occur. The pain can be in the hand and wrist, and it can also move up the arm. CTS is an entrapment neuropathy. Tingling sensations can be the first sign of carpal tunnel syndrome, but itching, burning, and numbness are also common symptoms. Some people may be 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 cause carpal tunnel syndrome.1 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. RTS can be caused by bone or fatty tumors, inflammation, and injury. The radial tunnel syndrome symptoms include a stabbing pain, or a feeling of cutting or piercing, affecting the back of the hand or forearm.2
Treatment is necessary for these disorders, because they can worsen over time. Using a wrist splint, cold packs, or taking NSAIDs (i.e., aspirin, ibuprofen), can help with the pain and inflammation. Some patients may be prescribed diuretics, or water pills, to cut down on swelling. Others may take corticosteroids (i.e., prednisone). Vitamin B6 may also be a useful supplement for carpal tunnel syndrome symptoms. Doctors and physical therapists may prescribe exercises to strengthen and stretch the region. Carpal tunnel surgery could be recommended to some patients after 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 weak in radial tunnel syndrome.4
Proper ergonomics, rest breaks, and stretching exercises, as well as the use of splints and correct posture can all prevent carpal tunnel syndrome. Yoga has been shown to “improve grip strength” and “reduce 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. 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. Acupuncture is also being investigated for carpal tunnel syndrome.7 Friction massage and active release would be treatment options chiropractors could offer for radial tunnel syndrome, as well as splinting. Chiropractors can also help determine if the pain is from tennis elbow or radial tunnel syndrome.8
1, 3, 5 http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm