Carpal Tunnel?

PRP could be an option for treatment

Carpal tunnel syndrome (CTS) is a common condition which develops when a large nerve (median nerve) becomes compressed as it passes through a channel in the wrist known as the carpal tunnel. The carpal tunnel is formed by eight small bones of the hand known as carpals (carpus from Greek meaning wrist) and a strong ligament called the transverse carpal ligament. The carpals form three of the walls of the carpal tunnel and the carpal ligament forms the other wall.

There isn’t a lot of space for the median nerve to pass freely through the carpal tunnel and any swelling around the joints or tendons can reduce the available space thus compressing and irritating the nerve. The median nerve is important as it’s responsible for sensation in the hand and the power we need for grip etc.
CTS is the most common nerve entrapment neuropathy and it's interesting to note that that it affects women significantly more than men.  As to why anyone might develop CTS, there is no definitive research, but age is a factor and being overweight, having hypothyroidism or diabetes, or having a family member who had CTS are potential reasons. An injury to the wrist such as a fracture could result in the onset of CTS as could activities which involve a lot of wrist movement and particularly frequent use of computer keyboards.
The first symptoms of CTS can often be experienced at night with tingling or numbness in the hands. This can lead to pain in the fingers and thumbs (not the little finger) which can travel up the wrist into the forearm, the upper arm and sometimes as far as the shoulders. A common symptom is loss of grip which is noticed when trying to remove lids from jars or bottles.
Treatments can include, analgesic painkillers, wearing wrist splints particularly at night, steroid injections and even a surgical release.  CTS can be a very debilitating condition which can significantly impact on quality of life and thus many who suffer with CTS would surely be interested in a simple treatment option that may not only relieve symptoms but repair damage to tissue in the carpal tunnel.
In a previous article I have written about the use of platelet rich plasma (PRP) for arthritis in joints. PRP is a simple very innovative treatment that enlists the body’s own resources to effect repairs.  PRP therapy involves taking blood from a patient’s arm and spinning it in a centrifuge. This separates the red blood cells from the plasma which is the liquid part of whole blood. The plasma contains platelets which are special blood cells that have key roles in clotting the blood at the site of an injury and releasing growth factors that harness the body’s ability to heal. PRP is becoming widely accepted as a form of regenerative medicine that can be used for an ever-increasing number of medical conditions.
Recently I read a study that assessed the effectiveness of using PRP to treat carpal tunnel syndrome. Sixty patients with single-side mild to moderate CTS were randomised into two groups of 30 (PRP and control groups). The PRP group was injected with one dose of PRP and the control group wore a night splint during the study period. Results showed that the PRP group exhibited a significant reduction in pain scores and improved function when compared to the control group.
Another study conducted in Egypt compared PRP treatment with steroid injections. The PRP group in the study reported significantly better outcomes than the group that was given a steroid injection. The researchers concluded that in CTS, PRP was a better treatment alternative with respect to pain and functional outcome. In addition, it was associated well with improved neurophysiological values than those observed after corticosteroid injection.
As I see it, any treatment that is safe and uses the body’s own repair mechanisms is certainly worth a try.


John Appleton  john@johnappleton.co.nz
09 489 9362  www.johnappleton.co.nz


Issue 116 February 2021