Carpal Tunnel

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a painful progressive condition caused by compression of a key nerve in the wrist.   It occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist.  Symptoms usually start gradually, with  pain, weakness, or numbness in the hand and wrist, radiating up the arm.  As symptoms worsen, people might feel tingling during the day, and decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks.  In some cases no direct cause of the syndrome can be identified.   Most likely the disorder is due to a congenital predisposition - the carpal tunnel is simply smaller in some people than in others.  However, the risk of developing carpal tunnel syndrome is especially common in those performing assembly line work or work that requires repetitve motion.

Treatments for Carpal Tunnel:

Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may ease pain. Cool (ice) packs and prednisone (taken by mouth) or lidocaine (injected directly into the wrist) can relieve swelling and pressure on the median nerve and provide immediate, temporary relief.  

Natural approaches for Carpal Tunnel:

• If you work with repetitive tasks, stop occasionally and make slow circles with your hands to restore circulation and relieve pressure.
• You may want to use a simple splint--available at a pharmacy--to immobilize the hand and relieve pain until the other measures begin to take effect.
• A heating pad or warm moist compress can help relieve pain.

Additional supplements that may provide help:

• Vitamin B6: 300 mg. daily for no longer than three months; take 50 to 100 mg. daily as a maintenance dosage. Remember that it can take up to three months for the effects of the supplementation to be felt. Warning: Vitamin B6 can be toxic at high levels. Do not take more than the recommended amount
• Vitamin B2: 100 mg. daily.
• Vitamin B12:1,000 mcg. daily in tablet form dissolved under the tongue.
• Folic acid: 800 mcg. daily.

Alternative Therpaies that may provide help:

• Accupuncture Studies suggest that acupuncture restores normal nerve function and can provide long-term relief of pain associated with CTS.
• Accupressure
• Massage The use of rosemary and/or St. John's wort oil are used may provide help with pain relief. Deep Tissue and Tia Massage help stretch muscles which can provide relief from tight muscles.
• Chiropractic The methods most chiropractors use to treat CTS include manipulation of the wrist, elbow, and upper spine, ultrasound therapy, and wrist supports.
• Herbs A combination of the following herbs in equal parts may decrease inflammation, provide some pain relief, and enhance healing.
  Cramp bark (Viburnum opulus)
  St. John's wort (Hypericum perforatum)
  Wild yam (Dioscorea villosa)
  These herbs are available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). If you use the teas, add 1 heaping tsp. of herb to 1 cup of water and steep for 10 minutes (roots need 20 minutes). The recommended dose is 1 to 3 cups of tea per day or 30 drops of tincture three times per day.
• Homeopathy An experienced homeopath can prescribe a regimen for treating CTS that is designed especially for you. Some of the most common acute remedies are listed below. An acute dose is three to five pellets of 12X to 30C every one to four hours until symptoms clear up.
  Apis mellifica for joints that are red, hot, or swollen
• Arnica montana, four times per day, for a bruised, beat-up feeling, soreness, achy muscles after trauma or overuse; this treatment may be especially effective if the gel or cream form is used topically
• Guaiacum for CTS that is improved by the use of cold applications
• Physical Medicine Contrast hydrotherapy—alternating hot- and cold-water applications—may offer relief from CTS symptoms. This approach decreases inflammation, offers pain relief, and enhances healing. Immerse your wrists fully in hot water for three minutes followed by one minute in cold water, and repeat three times. Do this two to three times daily.
  

Signs and Symptoms of Carpal Tunnel:

• Nighttime painful tingling in one or both hands, frequently causing sleep disturbance
  Feeling of uselessness in the fingers
• A sense that fingers are swollen even though little or no swelling is apparent
• Daytime tingling in the hands, followed by a decreased ability to squeeze things
• Loss of strength in the muscle at the base of the thumb, near the palm
• Pain shooting from the hand up the arm as far as the shoulder

Tips for prevention of Carpal Tunnel:

• Stretch or flex your arms and fingers before beginning work and at frequent intervals.
• Alternate tasks to reduce the amount of repetitive movements.
• Modify or change daily activities that put pressure on your wrists.
• Modify your work environment. If you use a computer, have an adjustable keyboard table and chair, and a wrist rest.

A common ailments that is similar to Carpal Tunnel

• Repetitive Strain Injury (or RSI)
• Repetitive strain injury, repetitive stress injury, or RSI is a term that most people have heard of. RSI is really a blanket name that is used to describe many different types of soft tissue injury including Carpal tunnel syndrome and tendinitis. It is usually caused by a mixture of bad ergonomics, poor posture, stress, and repetitive motion.

Organization Links

Organization Address (st) City and state email Web

American Chronic Pain Association (ACPA) P.O. Box 850 Rocklin, CA   95677-0850 ACPA@pacbell.net http://www.theacpa.org

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) National Institutes of Health, DHHS 31 Center Dr., Rm. 4C02 MSC 2350 Bethesda, MD   20892-2350 NIAMSinfo@mail.nih.gov http://www.niams.nih.gov

Centers for Disease Control and Prevention (CDCP) U.S. Department of Health and Human Services 1600 Clifton Road, N.E. Atlanta, GA   30333 inquiry@cdc.gov http://www.cdc.gov

Occupational Safety & Health Administration U.S. Department of Labor 200 Constitution Avenue, NW Washington, DC   20210 http://www.osha.gov

American Academy of Orthopaedic Surgeons/ American Association of Orthopaedic Surgeons 6300 North River Road Rosemont, IL   60018 hackett@aaos.org http://www.aaos.org

American Society for Surgery of the Hand 6300 North River Road Suite 600 Rosemont, Il   60018-4256 info@assh.org www.assh.org

Supporting Research

Banner R, Hudson EW. Case report: acupuncture for carpal tunnel syndrome. Can Fam Physician. 2001;47:547-549.

Bartram T. Encyclopedia of Herbal Medicine. Dorset, England: Grace Publishers;1995:100, 369-370.

http://www.umm.edu
http://www.ninds.nih.gov

Related NINDS Publications and Information

Carpal Tunnel Syndrome Fact Sheet

Carpal Tunnel Syndrome fact sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS).

Publicaciones en Español

Síndrome del Túnel Carpiano
Información del Síndrome del Túnel Carpiano/Spanish-language fact sheet on carpal tunnel syndrome compiled by the National Institute of Neurological Disorders and Stroke (NINDS).