Carpal Tunnel Syndrome and Whole Body Vibration

The carpal tunnel is a rigid structure at the base of the wrist that is made up of bones and ligaments. Several structures run through the carpal tunnel including the median nerve. The median nerve innervates the skin and muscles in the palm of the hand. Carpal Tunnel Syndrome (CTS) occurs when there is thickening of the tendons running through the tunnel or other types of swelling that result in the compression of the median nerve. This causes numbness and weakness in the palm side of the thumb and fingers as well as pain that radiates up the forearm. Individuals often report that their hands feel clumsy, and weakened grip strength is also common. There are several causes of CTS which include a congenital predisposition (the carpal tunnel is naturally smaller), sprain or fracture of the wrist, hypothyroidism, overactive pituitary, work-related stress, repetitive use of vibrating hand tools, fluid retention during pregnancy or menopause, rheumatoid  arthritis, and a cancer or cyst within the carpal tunnel. Treatments include rest from activities that aggravate symptoms and splinting the wrist to ensure that it remains immobilized. Medications are also used to reduce inflammation and pain. Exercises to stretch and strengthen the wrist may be done when symptoms have improved. An individual may also have surgery to release the carpal tunnel.

There is little evidence to suggest whether exercise is beneficial for individuals with CTS. One study found that aerobic exercise was beneficial for individuals with CTS by improving peak oxygen consumption while decreasing body mass index and percentage of body fat. Additionally, improvements in CTS symptoms were also found ¹.  Another study looked at an exercise program that involved movements of the arm, hand and other exercises specific to the upper extremities. The researchers found improvements in grip strength with no difference in other CTS symptoms compared with the control group ².

There is no research looking at the benefits and risks of Whole Body Vibration (WBV) and its effect on CTS. However, it seems prolonged exposure to vibration, during work related activities, can lead to CTS. It is important that an individual with CTS discuss WBV with their physician before adding it to an exercise program to ensure that underlying causes of CTS are not a contraindication. Once cleared by a physician an individual should begin using the WBV platform at a reduced intensity and duration. Exercises that involve hands and forearms on the platform are not recommended. WBV should not be used if there is acute inflammation. If any symptoms related to CTS increase or occur while using WBV, it should be discontinued immediately. Once an individual has

become comfortable with the machine, and there is no change in symptoms, the intensity may be increased. In general, if an individual experiences any pain, dizziness or shortness of breath while using the WBV platform it should be discontinued immediately.

References

1.       Nathan PA, Wilcox A, Emerick PS, Meadows KD, McCormack AL. 2001. Effects of an aerobic exercise program on median nerve conduction and symptoms associated with carpal tunnel syndrome, Journal of Occupational and Environmental Medicine, 43(10), 840 – 3.

2.       Thomas RE, Butterfield RK, Hool JN, Herrick RT. 1993. Effects of exercise on carpal tunnel syndrome symptoms, Applied Ergonomics, 24(2), 101 – 8.  

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