The wrist is surrounded by a supporting band of fibrous tissue. The tight space between this fibrous band and the wrist bone is called the carpel tunnel, through which passes the median nerve which supplies the thumb, index and middle fingers of the hand. A swelling in this fibrous tissue irritates the median nerve, causing tingling and numbness of the thumb, index and middle fingers. This condition is known as carpal tunnel syndrome. A similar but less common condition occurring in the foot is known as tarsal tunnel syndrome. A repetitive movement of the fingers from work – such as uninterrupted typing – leads to tendon inflammation which in turn causes the carpal tunnel syndrome. Obesity, pregnancy, hypothyroidism, arthritis, diabetes and trauma are also known causes of this condition. Common symptoms include numbness, tingling and pain in the fingers, which are more pronounced at night. Later symptoms include burning, cramping and weakness of the hand, and occasionally, wasting of the hand muscles.
The Ayurvedic treatment of these conditions is aimed at reducing the inflammation and swelling in the affected fibrous tissue surrounding the wrist and ankle. Medicines used to treat inflammation and swelling are: Yograj-Guggulu, Kaishor-Guggulu, Punarnavadi-Guggulu, Maha-Vat-Vidhwans-Ras, Vat-Gajankush-Ras, Dashmoolarishta, Maha-Rasnadi-Guggulu and Maha-Rasnadi-Qadha. Herbal medicines which can be used for this purpose are: Rasna (Pluchea lanceolata), Deodar (Cedrus deodara), Vishwa (Zinziber officinalis), Erandmool (Ricinus communis), Bala (Sida cordifolia), Shalparni (Desmodium gangeticum), Prushnaparni (Uraria picta), Kuchla (Strychnos nuxvomica) and Nirgundi (Vitex negundo). Vishgarbha oil and Mahanarayan oil are used for local application, followed by a steam fomentation of Dashmool-Qadha or Nirgundi-Qadha. Blood-letting with the application of leeches in the wrist or ankle area is also a good way of reducing numbness and pain, especially for patients who do not respond to other conventional treatment.
In order to reduce or correct the nerve injury, medicines like Tapyadi-Loh, Ekang-Veer-Ras, Vish-Tinduk-Vati, Yashtimadhuk (Glycerrhiza glabra), Abhrak-Bhasma and Trivang-Bhasma are used. If there is an accompanying muscular atrophy, it is treated with additional medicines like Trayodashang-Guggulu, Ashwagandha (Withania somnifera), Shatavari (Asparagus racemosus), Bala and Naagbala (Grewia hirsuta). Other conditions like obesity, arthritis and diabetes need to be treated adequately in order to get a good response in the treatment of carpal or tarsal tunnel syndrome.
Most persons affected with these conditions recover completely with appropriate treatment and adequate rest. Occupational and recreational modifications need to be made in order to avoid an aggravation or recurrence of these conditions. Periodic resting, stretching exercises, and avoiding repetitive overuse can help in preventing these conditions.