Conventional Approaches
Traditional approaches to treating carpal tunnel syndrome include painkillers that block pain, rather than targeting the condition, wrist restraints/splints that relieve stress and symptoms in one muscle group while possibly promoting them in another, and high-risk surgical decompression techniques (more than 100,000 yearly in the United States alone), with their associated risk of side effects.
A number of alternative remedies exist, however, that either treat the problem at its source or promote lifestyle changes that can significantly reduce the pain and discomfort of this condition. In most cases, short-term alterations in habit coupled with longer-term supplementation yield optimal results.
Foods
To prepare a bromelain-rich, anti-inflammatory fruit salad (or AI Salad), combine pineapple and papaya with grated ginger and enjoy! For more information on bromelain, see Miscellaneous, below.
Food Supplements
Essential fatty acids interrupt the inflammation process and help soothe inflamed nerves and tissues. Flaxseed/linseed oil, borage oil, pumpkin seed oil, hemp seed oil, evening primrose oil, fish, eggs, and walnuts are all sources of EFA's. The oils may be the most ideal. Take one tablespoon daily on yogurt, rice and/or bean dishes, salads, and vegetables. If using flaxseed oil capsules, take 2 to 3 capsules daily, in the morning. If using evening primrose oil take 1 500mg capsule daily, in the morning. You will begin to notice an effect after 2 to 4 weeks of supplementation.
Herbs
Cayenne is well known for its anti-inflammatory properties. Indeed, this fiery plant contains six pain relieving and seven anti-inflammatory compounds, with capsaicin being the most well known constituent. Add several teaspoons powdered cayenne to 1/4 cup skin lotion and rub into your wrists. Alternatively, prepare your own skin application by steeping five to ten red cayenne peppers in 1 litre/2 pints rubbing alcohol for several days. NOTE: Many people are quite sensitive to cayenne. Apply to a small test area on your skin before using a full application. Discontinue use if irritation occurs. In addition, be sure to thoroughly wash your hands with soap and water after use and take great care to avoid eye contact.
Along with its calming abilities, chamomile contains several compounds (bisabolol, chamazulene and cyclic ethers) that have anti-inflammatory properties and this herb is commonly used in Europe to treat inflammatory conditions. To prepare an infusion, add 2 teaspoons dried herb to one cup hot water. Drink three times daily. If using a tincture, take 40 to 80 drops three times daily. NOTE: Chamomile oil can act as a uterine stimulant. Do not use during pregnancy.
When applied externally, comfrey can relieve swelling, inflammation, and pain. Add several teaspoons comfrey leaves or minced root (soaked in boiling water beforehand) to 1/4 cup skin lotion and rub into your wrists. Alternatively, prepare your own skin application by steeping 8 to 10 tablespoons fresh or 4 to 5 tablespoons dried comfrey in 1 litre/2 pints rubbing alcohol for several days.
Add cumin to foods and curried rice. This herb contains a number of pain-relieving, anti-inflammatory compounds that also reduce swelling.
Six anti-inflammatory compounds present in sage make it an ideal addition to many meals as well. NOTE: Do not use this herb if you are pregnant.
St. John's Wort promotes the recovery of damaged, inflamed, or strained nerves and has been used to relieve nerve pain and tingling for generations. The sedative properties help reduce pain while its anti-inflammatory actions help shrink swollen tendons. Take 300 to 500mg two to three times daily. If desired, you may choose a preparation standardized to 0.3% hypericin, however, traditional herbalists prefer preparations involving the herb in its entirety. You will likely need to take this herb for several weeks before noting any improvement. NOTE: Do not use this herb if you are pregnant.
Turmeric contains curcumin, which has anti-inflammatory properties. As this compound is present in only 1 to 4% of dried turmeric, supplementation is recommended. Take 250 to 500mg pure curcumin daily, between meals. Maintain this dosage until symptoms subside and follow with a 125 to 250mg maintenance dosage for 1 to 2 weeks. If you enjoy this spice, add liberally to food. NOTE: Do not use this herb if you are pregnant.
Willow is the original source of aspirin and contains salicylates that reduce inflammation and relieve pain. To prepare an infusion, bring 1 1/2 cups water and 1 teaspoon herb to a boil and simmer 10 minutes. Cool, strain, and enjoy. You may wish to add lemonade if you find the taste too bitter. Drink two to three cups daily.
Meadowsweet and wintergreen also contain salicylates and may prove useful. Prepare as willow, above.
Homeopathy
Certain remedies can be used in acute situations if your symptoms fit the symptom picture of the remedy. For dosages, see the dedicated section on Homeopathy. Consult your homeopath or naturopath to determine your constitutional remedy: the remedy that best fits you as a whole person. Your homeopath or naturopath will take a complete case history considering all of your mental and physical ailments and match these symptoms with the symptom picture of the remedy.
Arnica: Arnica is the classic remedy used to treat muscle injuries and may prove useful in treating carpal tunnel syndrome. Use for flare-ups or inflammation of new injuries caused by the repetitive use of the fingers and wrists. Area feels bruised and sore and cramping may occur. External applications are also available in cream or gel form. Use to ease soreness and swelling.
Calcarea phosphorica: Painful bones and nerves of the wrist and arm. Possible neck stiffness and discomfort. Cold rooms and drafts aggravate the condition. Person is irritable, sensitive, and weak from excess work or pain.
Causticum: For chronic carpal tunnel syndrome. Area feels bruised with drawing, burning pains. Muscles of the hand and forearm are weak, stiff, and feel contracted. Condition improves with warmth and is made worse by the cold. Person feels better in rainy weather.
Guaiacum: Wrists (primarily the left) are stiff with burning pain that is relieved by the application of ice or ice-cold water. Person may feel the need to stretch their wrists due to tightness, regardless of the resulting pain.
Hypericum: Sharp, shooting pains originating from the wrists. Useful for its soothing effect when body parts containing many nerves are injured. Also used for traumatic nerve conditions.
Rhus toxicodendron: Stiffness and pain feel worse on initial motion and made better as movement continues. Overuse can cause increased stiffness, pain, and soreness. Condition improves with warmth and is made worse by cold, damp weather.
Ruta: For excess stiffness resulting from joint overuse and nerve irritation. Wrist may feel bruised and weak, even when at rest. Repetitive tasks that stress joints and nerves cause weakness in the arms and wrists.
Viola odorata: Useful for conditions affecting the right wrist and hand. Pain and numbness start at the wrist and continue through the hand into the fingers. Hand and arms may tremble. Condition made worse when person gets cold.
Lifestyle
Take frequent breaks. It is important to step away from the task at hand and have your body do something physically different. This includes relaxing and stretching (see below). If you have been sitting for an extended period, get up and walk around. Grab something to eat. Go for a stroll. In short, offering yourself a frequent change of pace, as it were, allows you to use different muscle groups and reduces stress on your fingers, hands, wrists, and lower arms.
Stretch! Along with the rest of your body, hand stretching is very important before, during, and after intense use of your fingers, hands, wrists, and lower arms. Stretch before you start, to warm up your muscles. Stretch while you work, to relieve tension and stress and work different muscle groups. And, just as in a workout, stretch when you are done, to "cool down" and release tension from the various muscle groups. Open and close your fingers. Press your hands together. Keep your fingers curled together and pull your hands apart. Bend your wrists in both directions. Gently rotate your wrists in a circle for two minutes, stretching the hand muscles. Rest one forearm on the table, grasp the fingertips, and gently pull back and hold for five seconds. Repeat with the other arm. Press your palms flat on the table, in a "push-up" position. Lean forward to stretch the forearm muscles and wrists. In short, anything that extends the range of motion in your fingers and wrist is beneficial. In the end, give your hands a good, gentle shake. You can also relieve stress and tension in your shoulders, neck, and upper back by raising your arms above your head and rotating your arms and wrists.
Writing lightly, using a soft led pencil or free-flowing ink pen, also reduces strain in your hand. Choose writing instruments that are more fat and round, too.
Reorganization of your workspace often yields positive results. An analysis of your chair, keyboard, desk, and monitor will show which areas require improvement. Your monitor should be just below eye level, at least twenty four inches away, and should not be facing or reflecting the light from a window. Watch your posture and sit straight (but not rigid) in your chair. Your elbows should be at a 90º angle when typing and manipulating the mouse, while your forearms should be parallel to the floor. Your wrists and hands should be straight. Your knees should also be at a 90º angle with the floor and your feet should be flat on the floor. If not, lower your chair or purchase an ergonomic foot rest. Due to their smaller footprint, notebook computers indirectly promote poor hand, wrist, forearm, and elbow positions. If possible, use an external keyboard and mouse on a proper desk.
Machinery vibrations cause you to grip tools and objects more forcefully in order to keep things steady, straining your wrists and hands. This includes electric knives, power tools, and wood-cutting machines. Extensive damage leads to a condition called hand-arm vibration syndrome. When purchasing tools such as power saws, chain saws, and wood-cutting tools, look for products with "vibration control".
In keeping with the home improvement theme, enlarge the handles of commonly used tools such as the broom and rake. Small handles press directly on tendons and the median nerve in your palm, promoting CTS. Cover handles with foam rubber or tape. Make the handle a comfortable size -- too big will also hurt your wrist.
Sharpen knives and shears. Using dull knives to cut meat or dull blades to clip hedges causes excess strain on your carpal tunnel. By keeping these items sharp, you reduce the amount of pressure exerted by your hands and arms during use.
Miscellaneous
Bromelain is a protein-dissolving (proteolytic) enzyme that can be used both as a digestive supplement after a particularly large meal as well as a CTS treatment that reduces swelling, inflammation, and pain. For CTS, take 250 to 1,500mg pure bromelain daily in divided doses, between meals (or the enzymatic energy will be used up in the digestive process). Supplements with a higher milk-clotting unit (mcu) and gelatin-dissolving unit (gdu) rating have greater potency. Look for a supplement containing 1,800 to 2,400mcu or 1,080 to 1,440gdu per capsule. Alternatively, obtain your bromelain as part of an "AI Salad" described under Foods, above.
Using Chinese hand balls makes for a gentle, massaging hand exercise. The balls are usually made of steel, may have a chrome, brass, or copper coating, and are slightly heavy. They are available at many small markets and Asian stores. When taking your break, hold the two balls in your hand and roll them around. The rolling motion massages the small muscles and ligaments in your hand and wrist. Switch to the other hand and repeat. Do this often whenever you take a break -- or make it your break!
Cool your wrists. When you experience swelling, inflammation, and pain, place an ice pack or bag of frozen vegetables wrapped in a towel on your wrist. Ice cubes wrapped in the same manner will also do the trick. Leave for 10 to 15 minutes, then remove for an equal length of time and reapply if desired. This method reduces the possibility of "freezer burn" on your skin.
Warm your wrists. In stark contrast to the remedy listed above, hold a warm compress or heating pad between your wrists to relax tense, overworked muscles. You may need to try both the cold application above and this warmth remedy to determine the one most suitable for your needs.
Vitamins
It is widely believed that a vitamin B6 deficiency is a critical factor in developing symptoms associated with carpal tunnel syndrome. Adequate levels of vitamin B6 reduce synovium swelling and increase elasticity and may also relieve pain. Take 50 to 100mg daily, in divided doses. Consult with your naturopath or other health practitioner if exceeding 100mg daily. Note that doses exceeding 1,000mg can cause neurological damage. Foods that contain B6 include avocados, bananas, beans, blackstrap molasses, brewer's yeast, brown rice, cabbage, chicken, corn, eggs, fish, meat, peas, potatoes, soy, spinach, walnuts, wheat bran, and wheat germ. You will likely require supplementation for 6 to 12 weeks before noticing an improvement.
It is best to take B6 as part of a B Complex supplement instead, which keeps the B vitamins balanced in the body and synergistically provide a number of beneficial effects. Take one 50mg capsule once or twice daily. Do not take more than 50mg at one time, as your body cannot absorb a larger amount in a single dosage
