Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) occurs when the median nerve, which runs from the forearm through a narrow, rigid passageway of ligament and bones at the base of the hand (the carpal tunnel), becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb, index, middle, and part of the fourth finger, as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.

CTS symptoms usually start with pain, weakness, burning, tingling, or itching numbness in the hand and wrist, radiating up the arm. Fingers may feel swollen even though no swelling is apparent. A person may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, decreased grip strength can make it difficult to form a fist, grasp small objects, or perform manual tasks.

CTS is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. There may be a localized cause, such as trauma or injury to the wrist, or the development of a cyst or tumor in the canal, or a more systemic cause, such as hypothyroidism or fluid retention during pregnancy, the principal cause is not “what we do with our elbows, wrists, or hands – it’s what we don’t do. By not engaging the shoulders and by disrupting the load-bearing capacity of the body, our upper limbs and extremities do not have access to the nuanced muscle power and biomechanical interaction required to stay healthy” (Pete Egoscue, Pain Free, 1998). Functional posture is bilateral, the weight distributed equally left to right, the load-bearing joints in vertical alignment, with horizontal lines running through those joints.

Judith Lasater, Ph.D., a physical therapist and yoga instructor for nearly 30 years, says that CTS healing really comes down to two key factors: awareness and postural alignment. "Because CTS is often made worse by improper alignment, yoga can be an aid to prevention and cure."

A 1998 University of Pennsylvania study published in the Journal of the American Medical Association showed that twice-weekly yoga classes for eight weeks significantly reduced pain and improved grip strength for those with carpal tunnel. The researchers propose that yoga helps because it eases the compression of the affected nerves, improves blood flow, and creates better joint posture.

Sandy Blaine, a yoga instructor who runs CTS preventive yoga workshops, says that combating mild to moderate CTS symptoms is primarily a matter of "counteracting the repetitive movements that created them. That means stretching out the upper back, neck, shoulders, arms, hands, and wrists."

Lasater highlights Mountain Pose as a key posture. "It brings awareness of the perfect standing position, which can then be transferred to the sitting position. When you sit or stand with the perfect spinal curves, you minimize the strain on the soft tissues of the head, neck, and arms which can lead to CTS." In addition, simple backbending poses "help counteract the forward-looking and forward-reaching posture many of us adopt when we sit all day at a desk."

Alternative therapies include massage and shiatsu, for stimulating blood flow, reducing edema (soft tissue swelling), and improving tissue health of the hands, wrists, arms, shoulders, and neck; Feldenkrais, a form of movement re-education which teaches people how to move their bodies more efficiently to improve their coordination, reduce joint stress and muscle strain, and improve flexibility; and acupuncture, helpful for reducing edema, and relieving neck pain, shoulder stiffness, eye strain, and headaches, symptoms commonly seen with CTS.

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