Yoga for Carpal Tunnel Syndrome

by Ram

Face by hand on a red background by Fernand Leger*

As a neuroscience researcher, I have been involved in bench work activities for more than two decades. Routine laboratory work involves repetitive hand movements, tissue homogenization using hand-held homogenizers, pipetting using hand-held pipet aids, reagent and chemical preparations, and tabulating data (typewriters then and computers now). Call it luck or divine grace, but I have not suffered from any nerve compression in the wrists. 
It is well established that repetitive finger and thumb motions with the hand flexed either down or up at the wrist causes carpal tunnel syndrome (CTS). Carpal tunnel syndrome is a painful condition of the wrist and hand, which is caused by abnormal pressure on the median nerve. As the median nerve passes through the wrist and into the hand, it travels through a tunnel-like structure called the carpal tunnel. This tunnel is located on the thumb side of the palm. Within this tunnel lie tendons, ligaments, blood vessels, and the median nerve, all covered by a non-elastic tissue band called the transverse carpal ligament. Repetitive motions exert excessive pressure on the ligaments and tendons that lie within the carpal tunnel. The ligaments and tendons respond to this excessive pressure by swelling. Since the covering of the carpal tunnel is non-elastic, it cannot expand, therefore, the swollen structures press on the median nerve, often causing such great discomfort that individuals cannot perform their jobs. 
According to the Mayo clinic, the risk factors for CTS include:  

• Anatomical Problems: Fracture, dislocation, or arthritis that damages the small bones in the wrist can alter the space within the carpal tunnel adding excessive pressure on the median nerve.  
• Gender: Since the carpal tunnel area is relatively smaller in women than in men, women are more susceptible to CTS.
  Chronic Conditions: Chronic illnesses, such as diabetes, obesity, inflammation, rheumatoid arthritis, or fluid retention can increase the pressure within the carpal tunnel, affect the lining around the tendons and irritate the median nerve resulting in damage to the nerve.
• Repetitive Movements: People who are most at risk for experiencing the symptoms of CTS include but are not limited to those engaged in driving long distances, computer keyboard typing, use of tools that produce vibrations in the hand, repetitive assembly line work, and continuous knitting and sewing. 

Symptoms of CTS include tingling and numbness in the thumb, index, and middle finger (median nerve distribution), burning, pain, and weakness in the fingers and hand, aching in the forearm that can radiate to the shoulder, and clumsiness or weak grip. The numbness may become constant over time. Treatment of CTS involves immobilizing the wrist in a splint to minimize or prevent pressure on the nerves. Patients are sometimes given anti-inflammatory drugs or injections of cortisone in the wrist to reduce the swelling. A small percentage of patients may also require surgery. Not only are the treatment procedures expensive, but such medical interventions have met with mixed success, especially when the affected person resumes the same working conditions. 
Many yoga positions involve deep stretching and as such could help the repetitive trauma disorders like carpal tunnel syndrome. And a scientific study Yoga-Based Intervention for Carpal Tunnel Syndrome  published in the prestigious Journal of the American Medical Association concluded that indeed a yoga-based regimen is helpful in relieving CTS symptoms.This study was led by Dr. Marian Garfinkel, a senior Iyengar yoga teacher with over 30 years of experience.
The authors randomly divided 42 people with carpal tunnel syndrome into treatment and control groups. The control group received a splint to immobilize the joint. The treatment group practiced 11 yoga postures twice weekly for eight weeks. The postures were designed for strengthening, stretching, and balancing each joint in the upper body along with relaxation. After eight weeks, when the groups were tested to gauge the intensity of carpal tunnel syndrome, the group that practiced the yoga postures saw significant improvements in pain and grip strength giving credence to the practice of yoga asanas in facilitating wrist healing and rejuvenation. Since CTS aggravates primarily with improper alignment, yoga asanas can prevent by counteracting the repetitive movements that created them.
For those of you that need additional information on yoga for CTS, see Friday Q&A: Wrist Problems to learn more about wrists and wrist problems and about what you can do to help CTS and other problems. The underlying message is that stretching, strengthening, relaxation, and awareness developed through yoga practice could be helpful in avoiding stress-related injuries.
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