Halt the hurting in your hands and wrists so you can get back to
feeling well while you work. According to research or other evidence, the following self-care
steps may help relieve CTS symptoms:
- Add vitamin B6 to the mix
- Soothe symptoms by taking 300 mg a day for no more than three
months straight, and 50 to 100 mg per day after that
- Slip on a splint
- Reduce irritation by wearing a special wrist brace designed for
carpal tunnel syndrome; use it during working hours and at night
- Consider chiropractic care and physical therapy
- Consult a qualified practitioner for manipulative, soft tissue,
and other therapies to reduce symptoms and improve function
- Make an appointment with an acupuncturist
- See a qualified practitioner for treatments that may provide
relief
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full carpal tunnel syndrome
article for more in-depth, fully-referenced information on medicines, vitamins, herbs, and
dietary and lifestyle changes that may be helpful.
About carpal tunnel syndrome
Carpal tunnel syndrome (CTS) is a condition characterized by pain, tingling, and numbness
in the fingers and hand, sometimes radiating up into the elbow.
The painful sensations of CTS are caused by compression of the median nerve in the tunnel
of bones in the wrist. In many cases, the condition results from long-term repetitive motions
of the hands and wrists, such as from computer use. Although repetitive motion is often a
culprit, it does not explain the frequent occurrence of CTS with non-motion-related
conditions, such as pregnancy.
Product ratings for carpal
tunnel syndrome
What are the symptoms?
Symptoms of CTS include recurrent numbness, tingling, weakness, or pain in one or both hands in a characteristic location
defined by the median nerve, which is compressed as it passes through the carpal tunnel in the
wrist. Symptoms are usually worse at night and after prolonged use of the hands. Some people
may experience clumsiness in handling objects, with a tendency to drop things, and may also
have a decreased ability to feel hot and cold.
Medical options
Over-the-counter acetaminophen (Tylenol)
and nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin (Genuine Bayer, Ecotrin, Bufferin), naproxen (Aleve), and ibuprofen (Motrin IB, Advil) are used to treat
pain.
Prescription diuretic medications, such as
hydrochlorothiazide (HydroDIURIL) and furosemide (Lasix), as well as injections of corticosteroids such as methylprednisolone
(Depo-Medrol) into the wrist, might reduce swelling.
Splints are often recommended to immobilize the wrist, theoretically protecting it from
repetitive motion injury. A physical therapy program of hand- and wrist-strengthening
exercises, combined with the use of a wrist brace, is sometimes recommended. In more advanced
cases, a surgical procedure called a “release” may be necessary. The procedure
separates the ligaments covering the carpal tunnel in the wrist, which relieves painful
pressure on the median nerve.
Vitamins that may be helpful
Some, but not all, studies have found vitamin
B6 deficiency to be common in people with CTS.1 Supplementation with vitamin B6
has reportedly relieved the symptoms of CTS,2 but some researchers have not found
this treatment to be beneficial.3 4
Several studies report that people with CTS are helped when given 100 mg of vitamin B6
three times per day.5 6 Although some researchers have found benefits
with lesser amounts,7 8 9 10 using less
than 100 mg taken three times per day for several months has often failed.11
12 13 Most doctors assume that people with CTS who respond to vitamin B6
supplementation do so because of an underlying deficiency. However, at least one group of
researchers has found vitamin B6 to “dramatically” reduce pain in people with CTS
who did not appear to be B6-deficient.14 Some doctors believe that B6 is
therapeutic because it reduces swelling around the carpal tunnel in the wrist; this theory
remains completely undocumented.
Very high levels of vitamin B6 can damage sensory nerves, leading to numbness in the hands
and feet as well as difficulty in walking; supplementation should be stopped if these symptoms
develop after beginning vitamin B6 supplementation. Vitamin B6 is usually safe in amounts of
200 to 500 mg per day,15 although occasional problems have been reported in this
range.16 Higher amounts are clearly toxic.17 Any adult taking more than
200 mg of vitamin B6 per day for more than a few months should consult a doctor.
In order to be effective, vitamin B6 must be transformed in the body to
pyridoxal-5’-phosphate (PLP). Some doctors have suggested that people who do not respond
well to vitamin B6 supplements should try 50 mg of PLP three times per day. There is no clear
evidence that using PLP provides any advantage in reducing symptoms of CTS.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
Holistic approaches that may be helpful
Acupuncture may be useful in the treatment
of CTS. In a preliminary trial, people with CTS (some of whom had previously undergone
surgery) received either acupuncture or electro-acupuncture (acupuncture with electrical
stimulation). Eighty-three percent of the participants in this trial experienced complete
relief that lasted through two to eight years of follow-up.18 After reviewing all
available scientific literature on the topic, a consensus conference convened in 1997 by the
National Institutes of Health concluded that acupuncture for CTS “may be useful as an
adjunct treatment or an acceptable alternative or be included in a comprehensive management
program.”19
Manipulative procedures may have a role in treating CTS by decreasing symptoms and
improving function. A type of stretching treatment called myofascial release improved the
symptoms of a patient with CTS in one published case report,20 and similar
treatments combined with specific wrist manipulations and self stretches were further tested
in a small, preliminary trial.21 Participants in this study experienced a decrease
in pain, numbness, and weakness, and their
nerve function improved as well.
A small, preliminary trial assessed a
chiropractic treatment program consisting of exercises, soft tissue therapy, and
manipulation of the wrist, the upper extremity, the spine, and the ribs.22 The
treatment resulted in improvement in grip and thumb strength, muscle function, flexibility,
and overall function, as well as a decrease in pain among people with CTS. In a follow-up
study six months later, most of the improvement had been maintained.23 A controlled
clinical trial compared traditional medical and chiropractic care for CTS.24 People
with CTS received either standard medical care (ibuprofen and nighttime wrist supports) or
chiropractic care (manipulation of the wrist, elbow, shoulder, neck, and spine, as well as
massage to the soft tissues). Ultrasound and nighttime splints were also used in the
chiropractic treatments. People in both groups improved significantly and similarly in terms
of pain reduction, increased function, and improved finger sensation and nerve function, but
the chiropractic group reported fewer side effects.
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carpal tunnel syndrome. Arch Surg 1989;124:1329–30.
2. Keniston RC, Nathan PA, Leklem JE, Lockwood RS. Vitamin B6, vitamin C,
and carpal tunnel syndrome. J Occup Environ Med 1997;39:949–59.
3. Franzblau A, Rock CL, Werner RA, et al. The relationship of vitamin B6
status to median nerve function and carpal tunnel syndrome among active industrial workers.
J Occup Environ Med 1996;38:485–91.
4. Smith GP, Rudge PJ, Peters TJ. Biochemical studies of pyridoxal and
pyridoxal phosphate status and therapeutic trial of pyridoxine in patients with carpal tunnel
syndrome. Ann Neurol 1984;15:104–7.
5. Ellis JM, Azuma J, Watanbe T, Folkers K. Survey and new data on
treatment with pyridoxine of patients having a clinical syndrome including the carpal tunnel
and other defects. Res Comm Chem Path Pharm 1977;17(1):165–77.
6. Ellis JM. Vitamin B6 deficiency in patients with a clinical syndrome
including the carpal tunnel defect. Biochemical and clinical response to therapy with
pyridoxine. Res Comm Chem Path Pharm 1976;13(4):743–57.
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pyridoxine abuse. N Engl J Med 1983;309(8):445–8.
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19. NIH Consensus Conference. Acupuncture. JAMA
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