CARPAL TUNNEL SYNDROME
Carpal tunnel syndrome is a common neurological disorder affecting one of the major nerves of the hand, the median nerve, when it is compressed or squeezed at the wrist as it passes through the carpal tunnel (a space at the base of the hand). Median nerve innervates the thumb, index and middle fingers and a part of ring finger. A fracture, tumor or cyst,
inflammation due to repeated use of wrist, rheumatoid arthritis etc can cause narrowing of thecarpal tunnel and irritate the median nerve leading to CTS.
Major symptoms are numbness, tingling sensation and pain in the thumb, index and middle fingers mostly at night. Pain can travel up to the forearm to the shoulder. Weakness and
clumsiness of the hand make it difficult to hold small objects, perform fine movements and often dropping things. In severe cases there is inability to differentiate between hot and cold by
touch and muscles of the thumb can waste away. Women are more likely to develop CTS than men.
CUBITAL TUNNEL SYNDROME
Cubital tunnel syndrome also known as Ulnar nerve entrapment occurs when ulnar nerve is compressed or inflamed as it passes through the cubital tunnel on the inside of the elbow. This can happen due to frequent bending of the elbows while pulling, lifting, leaning on the elbow a
lot, arthritis, bone growth, fracture or dislocation of the elbow etc.
Common symptoms include numbness and tingling in the hand, ring and little finger, mostly when the elbow is bent. Aching pain on the inside of the elbow and weak grip due weakness of muscles.
RADIAL TUNNEL SYNDROME
Radial tunnel syndrome is a condition that cause pain along the forearm and hand due to compression of radial nerve travelling through a very narrow tunnel called the radial tunnel on the outside of the elbow surrounded by muscles. Radial nerve starts from the side of neck and runs down the back of arm to the wrist. It is responsible for arm movements like forearm rotation, elbow extension and straightening of wrist and fingers. It occurs due to poor arm and wrist strength and flexibility, tumor or cyst in the arm. Symptoms include extreme pain and tenderness on the outside of the elbow down to the
forearm. Pain stays for a long time and cause fatigue. Pain worsens after excessive use of forearm and/or wrist like extending elbow, flexing wrist, forearm rotation. RTS can weaken forearm muscles and cause wrist drop. As compared to carpal or cubital tunnel syndrome numbness and tingling is not common in RTS.
TARSAL TUNNEL SYNDROME
Tarsal tunnel syndrome also known as posterior tibial neuralgia is caused by the compression of the posterior tibial nerve as it passes through the tarsal tunnel. It can cause pain, tingling or
numbness and burning sensation in the foot. Tarsal tunnel is located inside of the ankle and formed by ankle bones and the band of ligaments. The conditions like flat feet, inflammation of the ankle joint due to ankle sprain, arthritis, diabetes mellitus, varicose veins, cysts or bone spur can cause strain or inflammation of the tibial nerve.
MANAGEMENT
Diagnosis is made by medical practitioners on the basis of physical examinations. X-ray, MRI, Electromyography and nerve conduction studies may also be helpful for definitive diagnosis.
Most effective treatment is to avoid or modify the causative movements. Rest and splinting of the affected area to prevent compression and irritation of nerve can be helpful. Physical therapy exercises help to stretch out and loosen the tight muscle/tissue around the nerve.
AYURVEDIC APPROACH
Ayurvedic treatment includes medication and therapies which helps in reducing the inflammation or swelling in the affected area to reduce the compression on the nerves. It includes external therapies like lepanam (application of medicated paste), medicated bandages, sekam, pichu, dhara etc with medicated oils to reduce swelling and pain. This is followed by
treatments like shashtika pinda swedam for strenghthening the weak muscles. Ayurvedic medications are prescribed for balancing the vitiated doshas. The treatments should be done
under the supervision of ayurvedic practitioners.