How depriving nerves of oxygen can help them heal and ease carpal tunnel syndrome

Short bursts of air with a lower than normal oxygen content may be a new way to deal with nerve pain.

The treatment, which involves breathing alternating normal air and deoxygenated air for about half an hour, has been shown in animal studies to help nerves regrow and repair.

One study found that it can help patients with spinal cord injuries, increasing their arm strength by up to 80 percent after one session (muscles are activated by nerves and an increase in strength can be a sign of nerve regeneration).

‘Peripheral’ nerve damage is a common problem, affecting nerves outside the brain and spinal cord.

Causes include injury, nerve entrapment, and diabetes, in which high sugar levels can damage the blood vessels that supply the nerves.

In addition to pain, it can lead to weakness and numbness. Treatments range from painkillers to surgery.

One form of surgery involves transplanting healthy nerves from elsewhere in the body — but less than 50 percent of patients regain full nerve function, and one in three experience no improvement.

In the study, published in the journal Experimental Neurology, researchers at the University of Alberta in Canada gave either therapy or a placebo to seven patients with incomplete spinal cord injury (where there is partial damage to the spinal cord that leaves some ability to move). move and feel). ).

Those receiving the therapy were given alternating cycles of breathing normal air for 60 seconds, followed by 60 seconds of air with half-normal oxygen levels, for half an hour.

Do I really need?

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CLAIM: A device that measures blood pressure from your wrist “using an innovative, inflatable air pump that measures pressure variations (in the bloodstream),” says its maker.

EXPERT VERDICT: ‘This can help identify hypertension [high blood pressure]which can strain the arteries and heart and lead to strokes, heart attacks and other health problems,” says Dr Nisa Aslam, a general practitioner in London.

“But the watch is not medically certified in the UK, which means we don’t yet know how accurate it is.

‘In addition, the NHS guidelines recommend that for more accurate blood pressure readings it should be measured at the upper arm [these devices can be bought for around £20] instead of the wrist.

“Having a watch-like device that monitors blood pressure all the time can lead to anxiety, as readings fluctuate over a 24-hour period.

The results showed that, in addition to improvements in strength after one session, elbow movement also increased by 91 percent, with no change in patients who received a placebo.

Previous work from the University of Saskatchewan in Canada found that the therapy promoted nerve healing in rats, with evidence of nerve repair up to 28mm from the injury site.

After ten weeks, movement also improved. Exactly why the new treatment works is unclear, but the repetitive changes in blood oxygen levels are thought to be key.

One theory is that the changes lead to the release of growth factors such as brain-derived neurotrophic factor (BDNF), which results in the growth of new nerve cells.

The treatment, known as acute intermittent hypoxia, is now being tested by the same researchers on patients with carpal tunnel syndrome, one of the most common peripheral nerve injuries, which affects up to 9 percent of the pressure on the median nerve — the main nerve. in the wrist as it passes through a narrow passage surrounded by bones and ligaments on the palm side of the hand.

One of the main causes of the condition is repetitive hand movements such as typing.

The 80 patients in the carpal tunnel test alternate between breathing 90 seconds of normal air followed by 90 seconds of air with half normal oxygen content for half an hour.

Mike McNicholas, trauma consultant and orthopedic surgeon at Liverpool University Hospitals, said: ‘This is a very important piece of research. ‘A technique using tourniquets – intermittent blood flow training – has been used for many years in limb rehabilitation and training, repeatedly showing that cutting off blood supply, and therefore oxygen, improved muscle function and led to strength gains.

“If this group proves their theory, it will certainly help a diverse cohort of patients living with nerve pain, muscle weakness and poor function.”

Electrical stimulation is being tested as a way to help regenerate damaged nerves in a trial of 66 patients at the Royal Alexandra Hospital in Alberta, Canada.

Patients with peripheral nerve damage in the hand who have to undergo surgery receive an electrical stimulation of the site via a skin implant for an hour three days before the operation, or receive a placebo.

The stimulation is thought to trigger the release of nerve growth factors that help repair damaged nerves – speeding recovery after surgery.

Eat more…

Tomatoes, to improve your gut health. A pig study by Ohio State University found that adding pigs to their diet shifted the balance of bacillota (“bad” bacteria) to bacteroidota (“good” bacteria) after just 14 days, compared to those who didn’t eat tomatoes. got. It’s not clear why.

Ask the AI ​​Doctor

How accurate is the health advice from the artificial intelligence bot ChatGPT?

This week’s question: What is best for a bad back?

CHATGPT’s answer: Try to avoid activities that may aggravate the pain or discomfort, and rest when necessary.

Apply heat or ice to the affected area to reduce inflammation and pain.

Low-impact exercises can strengthen the muscles in the back and improve flexibility. Some good options include walking, swimming, and yoga.

Over-the-counter pain relievers such as ibuprofen can help. A massage can help relieve tension.

If pain persists, seek medical attention.

EXPERT COMMENTARY: Philip Conaghan, a professor of musculoskeletal medicine at the University of Leeds, says: ‘On the whole, it’s generally sensible advice.

‘A big problem is that there is no mention of possible side effects of the recommended medicines.

“Medications such as ibuprofen can react with other drugs (e.g. warfarin) with potentially fatal consequences.”