Carpal Tunnel Syndrome

Carpal tunnel syndrome is characterized by pain, numbness, and tingling that occurs in one or both hands. It often wakes people from their sleep, leaving them feeling like they have to “shake their hands out” to make the pain and symptoms go away.

This syndrome is caused by the compression of a nerve (the median nerve) as it goes through a narrow tunnel in the wrist formed by the carpal bone, hence the name carpal tunnel syndrome. According to the American Academy of Neurology, 10 percent of the population suffers from the syndrome. It also affects up to 50 percent of industrial workers. All too often the syndrome is addressed by surgery. Although this can be effective, it is also expensive and can leave people with residual problems due to the formation of scar tissue that can occur after surgery.

Fortunately, unless people are continuing to stress the wrist with repetitive stress injuries (e.g. handling heavy equipment or doing large amounts of typing), carpal tunnel syndrome can almost always be relieved without surgery. In almost all of my patients, their carpal tunnel syndromes have resolved by simply using vitamin B6 (250 mg daily), Armour thyroid hormone, and a wrist splint for six weeks. When your hand gets into funny positions while you are sleeping, it stretches and strains the nerve as it goes through your wrist. This is why you wake up in the night with numbness or tingling. The type of wrist splint to use is called a “cock up” wrist splint. It keeps your hand in the neutral position (i.e. the position your hand is in while holding a glass of water), which takes the stress off the nerve. Be sure to wear the splint for at least 6 weeks while you’re sleeping. During that period, also wear it during the day when you can.

Although the therapy above generally takes care of carpal tunnel syndrome, it is worth being aware of a new therapy as well. A portable wrist traction device combines neutral wrist position and stretching to decompress the carpal tunnel. It is used 10 minutes twice a day for 1 month, followed by 10 minutes once a day for a second month. It can be used at home or at work, making it very convenient. At the end of a study of 30 patients, most had normalization or near normalization of the nerve function. Other conservative measures can also be effective, including acupuncture, osteopathic manipulation, chiropractic manipulation, and myofascial release. Unfortunately, your doctor may be totally unfamiliar with these conservative therapies; in today’s medicine only expensive therapies tend to get attention. If surgery is recommended, ask your physician if you can try these conservative measures instead for 6 to 12 weeks.