Carpal tunnel syndrome

The bones and ligaments in the wrist (medically known as the carpus, from the Greek karpos) form a pathway called the carpal tunnel. Here the median nerve, which controls movement and feeling in most of the hand, and the tendons that connect the arm and hand muscles pass from the forearm into the hand. The tunnel can be narrowed by swelling of ligaments or tendons, bone dislocation, bone spurs, or fluid retention. This narrowing may compress the median nerve, causing the pain, numbness, and weakness characteristic of carpal tunnel syndrome.

Symptoms may develop gradually or suddenly, and they tend to be most painful at night (95% of patients with this condition report being awakened by pain). Symptoms may last for a few days and disappear without treatment or persist for months and require medical intervention.

Carpal tunnel syndrome is usually a stress injury induced by prolonged, repeated movements of the hands or fingers. Overuse of the hands on the job (typing at a computer, working on an assembly line) or during leisure activities (knitting, playing musical instruments) can inflame the tendons or ligaments, causing them to swell and compress the median nerve.

Changes in hormonal balance during pregnancy, while taking birth control pills, or during menopause may also bring on or worsen carpal tunnel symptoms. Underlying disease (diabetes, hypothyroidism, Raynaud's disease, rheumatoid arthritis) or trauma to the wrist may result in carpal tunnel syndrome as well.  Carpal tunnel syndrome occurs three times more often in women than it does in men and is particularly common in overweight women ages 30 to 60 who have been pregnant.

Supplements and herbs

Several studies have suggested that a vitamin B6 deficiency can make you susceptible to the numbness and pain of carpal tunnel syndrome. This vitamin is important in maintaining healthy nerve tissue, relieving inflammation, and improving circulation. It also may increase the brain's production of the nerve chemical GABA (gamma-aminobutyric acid), which helps control pain sensations. If you don't notice any improvement after taking vitamin B6 for three weeks, switch to pyridoxal-5-phosphate (P-5-P), a form of the vitamin that the body eventually produces as it breaks down vitamin B6. Some people find this form works better for them.

In addition to B6, some therapists believe that bromelain, a powerful anti-inflammatory enzyme found in pineapple, is very effective in treating the inflammation and any resulting pain. The combination of bromelain and vitamin B6 works better than either supplement alone. Turmeric, a member of the ginger family, is another useful herb. When turmeric is taken with bromelain, they enhance each other's anti-inflammatory properties and together may help relieve the pain of carpal tunnel syndrome. Though turmeric is safe to use over the long term, cut the dose in half once your symptoms subside. (This herb can be expensive.)

Homeopathy

Homeopathic remedies often help to relieve discomfort and limitation.

• Arnica montana
  This remedy can be used for flare-ups of inflammation or new injuries caused by repetitive use of the fingers and wrists. The area feels bruised and sore, and cramping may occur. External application of herbal Arnica lotion or ointment may help to ease the swelling and soreness, while other remedies are used internally.
• Calcarea phos.
  When this remedy is indicated, pain is felt in the bones and nerves of the wrists and arms, and stiffness and discomfort may also involve the neck. Cold and drafts often aggravate discomfort. The person may feel irritable and sensitive, or weak from overwork and pain.
• Causticum
  This remedy is useful when carpal tunnel syndrome is long-lasting or recurring. The area feels bruised, with drawing, burning pains. Stiffness and a feeling of weakness and contraction may be felt in the muscles of the hand and forearm. The condition is worse from getting cold and improved by warm applications. People who need this remedy often feel best in rainy weather.
• Hypericum
  This remedy may be useful if sharp or shooting pains are felt extending from the wrist. Hypericum is known for its soothing effect when body parts containing many nerves are injured, as well as in other traumatic nerve conditions.
• Rhus tox.
  This remedy is useful when stiffness and pain are worse on initial motion and improve as movement continues. Overuse may lead to soreness, pain, and further stiffening. Discomfort is relieved by warmth and worse in cold, damp weather.
• Ruta
  This remedy is indicated when overuse of joints and irritation of nerves lead to tremendous stiffness. A feeling of bruising and lameness may be present, even when the wrist is allowed to rest. Weakness in the arms and wrists, especially after repetitive tasks causing wear and tear on the joints and nerves, often indicates Ruta.
• Viola odorata
  This remedy is useful for many conditions that involve the wrist and hand, especially the right. Pain and numbness may extend from the wrist through the hand and into the fingers, and the hands and arms may tremble. Symptoms are worse from getting cold.

What else you can do

• Take frequent breaks when performing any repetitive hand activity, such as typing, knitting, or playing an instrument. Stop at least once an hour to flex your fingers and shake your hands.
• Apply ice to your wrists when pain strikes. Use a flexible ice pack-or even a bag of frozen peas-and put it on for 10 minutes every hour to ease the pain and reduce the inflammation.
• Elevate your wrists with a pillow when you lie down.

How much to take

Vitamin B6

50 mg 3 times a day until symptoms subside.
200 mg daily over long term can cause nerve damage.

Bromelain

1,000 mg twice a day during acute phase. Reduce to 500 mg twice a day when symptoms subside. Take between meals.
Eliminate after two weeks if ineffective.

Turmeric

400 mg 3 times a day.
Standardized to contain 95% curcumin. Should be used with bromelain.

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