The carpal tunnel syndrome is annoying, because it can cause numb hands and fingers, things falling out of your hand, and also a lot of pain, especially at night. There is not much you can do about it; many people do not like the idea of an operation, so it is good to know there is an endogenous pain reliever, with the difficult name palmitoylethanolamide (PEA), which can help to relief pain in patients suffering from the carpal tunnel syndrome.
Palmitoylethanolamide (PEA) to treat pain caused by the carpal tunnel syndrome
In a study on the action mechanism of PEA in the occurrence of the carpal tunnel syndrome, 25 patients were treated with 1200 mg PEA per day over a period of two months, and 25 patients were used as a control basis. The pain was measured on the visual analogue scale (VAS, a 100 mm scale), the functions of the hand were measured via a special scale, the “Boston Carpal Tunnel Questionnaire”, and also the nerve functions were observed. To this end, the speed of the nerve impulse and its size were (amplitude) were measured.
After 2 months clearly less carpal tunnel pain!
The pain significantly decreased after 2 months (from 4.8 to 1.3) and also the functions improved greatly. There was also a much improvement in the nerve conduction. 
This is not the only study showing that the endogenous analgesic substance palmitoylethanolamide really works well. There have been 15 clinical studies that prove this substance to be safe and effective.
Since, many thousands of patients have been observed in studies, and many hundreds of thousands have been treated in general, and no awkward side effects or adverse interactions with medicinal products have been noticed. Normast gets a green light for treating pain caused by the carpal tunnel syndrome.
Research into the carpal tunnel
A diagnosis can be expected on the basis of the complaint pattern. Disorders in thumb, forefinger, and middle fingers can be revealed during the physical examination, and the ball of the thumb can appear to be a little thinner at places, but mostly there are no abnormalities. A similar pattern of complaints that might lead to confusion about the diagnosis, occurs in the event of a pinched nerve caused by neck hernia, cervical osteoarthritis (wear), or compression in the shoulder (the so-called scalenus syndrome or cervical rib syndrome).
The causes must be found by exclusion through neurological examination, because they require a different treatment. Blood tests can provide an answer to the cause, an X-ray can be made if there is suspicion of a bone cause.
To confirm the diagnosis, a muscle examination will be requested (EMG = electromyography), which shows a delay in the nerve conduction on the part of the sciatic medianus in the carpal tunnel. Apart from confirming a diagnosis, it can also give an answer on whether the nerve might be pinched in another place.
Treatment of the carpal tunnel syndrome
If a carpal tunnel syndrome diagnosis is confirmed, the neurosurgeon will discuss treatment options with the patient. Sometimes treatment is not necessary or it might be better to wait and see whether the complaints remain small or are transient (for example during a pregnancy). It is also possible to adjust an artificial splint, so the wrist can rest and complaints reduced in that way.
An injection in the wrist with adrenal cortical hormones (cortisone) and a local narcotic substance can help for a longer time.
Often an operation is decided on. A splint then can provide alleviation during a possible waiting time.
Today, also the use of palmitoylethanolamide (PEA) has become a treatment option.
Operation of the carpal tunnel syndrome
Blood-thinning medication must be stopped before the operation in consultation with the doctor.
The hand will be anesthetized locally via an often painful prick in the palm of your hand or wrist. After that, the operation itself is not painful anymore. The feeling in the fingers often remains present.
The connection between the pink and the ball of the thumb, the roof of the carpal tunnel, is cut to free the content, particularly the soft tissue nerve, of the pinch.
Some surgeons prefer to carry out the intervention via laparoscopic (keyhole) surgery. The operation takes about a quarter to half an hour. After suturing the hand, a sling will be put on.
Possible complications of the carpal tunnel operation
As with all interventions, unexpected complications may occur during carpal tunnel surgery. These are however rare. They consist mainly of bleedings and infections.
In the occurrence of excessive pain or wound exudate, it is important to contact your surgeon. Sometimes a tiny nerve branch leading to a number of muscles in the thenar can get damaged because it starts from the sciatic medianus in the operated area. Usually this does not have any significant effects, but thumb movements may be distorted.
In rare cases, an operation does not to have the desired result and additional surgery has to be carried out. A serious, but fortunately very rare, complication which may be caused by surgery and which is hard to anticipate, is the so-called dystrophy of the hand. It leads to swelling of the entire hand, which is painful, particularly when moving. The colour varies from red at heat to pale white and blue at cold.
In the event of such symptoms, it is important to consult your doctor as soon as possible, so he can take the necessary measures.
 Assini A, Laricchia D, Pizzo R, Pandolfini L, Belletti M, Colucci M, Ratto S. | P1577: The carpal tunnel syndrome in diabetes: clinical and electrophysiological improvement after treatment with palmitoylethanolamide | Eur J Neurol | 2010: 17(S3):295.