Carpal tunnel syndrome: treatments and remedies

Repetitive hand motion is a well-known cause of carpal tunnel syndrome, but other trigger factors include pregnancy, contraceptive pills, rheumatoid arthritis, hypothyroidism, diabetes and being overweight.

While carpal tunnel syndrome (CTS) is not always caused by overuse, it came to public attention with the advent of widespread computer usage. Other repetitive activities that can cause CTS include playing the piano, hammering in nails or milking cows. Musicians, carpenters and dairy farmers are all prone to CTS.

The most common symptom is pins and needles; others are numbness in your fingers and thumb on either hand, pains that shoot up your wrist and forearm, soreness in the neck and shoulders and also hand weakness. Thankfully there are plenty of remedies.

If you're suffering from CTS, you may well need time off work because you need to take a break from whatever has inflamed the tendons inside your carpal tunnel. Once you give your wrists respite, you can use splints, supplements and exercises to help them recover. But as you heal, practice prevention and keep up the strengthening exercises.

To quickly ease the pain and inflammation, cool your wrists with an icepack wrapped in a thin towel. Leave it on for about 10 minutes. Repeat the treatment every hour or so.

Heat can also ease pain by relaxing muscles. Soak your hands and wrists in warm to hot water for 12 to 15 minutes before you go to bed each night. But don't do this if it makes your symptoms worse, as heat can also increase pressure in the area.

Wear a splint at night. While asleep, you may be making your CTS worse by the positions your hands move in to. A splint relieves pressure on the median nerve. It’s important to get the right size and make sure you know how to wear it properly–ask your pharmacist or a physiotherapist for advice. Wear the splint in the daytime as well if your job requires a lot of hand or wrist motion.

Twice a day, rub your wrists with an ointment containing arnica, which will help to ease aches and pains.

It's worth trying a few treatments of acupuncture for CTS. It is most likely to have a beneficial effect if the condition has been triggered by a passing event, such as pregnancy, rather than on-going pressure such as experienced by people spending long periods at a computer keyboard.

Yoga poses can also be a great help in restoring strength, notably the namaste, or prayer, position, where the hands are held together with palms flat against each other in front of the chest. This pose stretches the ligament around each wrist.

When using a computer or doing any job that involves repetitive hand motion, it's essential to take regular breaks and do stretching exercises. Try to take a 15 minute break every few hours.

Stand up, relax your shoulders and shake your arms to relax your wrists and restore circulation.

Make a fist with each hand, hold for a few seconds, then open it, separating your fingers and spreading them as wide as possible. Repeat 4 times.

Many people find that rapid wrist flicks help to ease their symptoms, especially at night.

If you spend a lot of time in front of the computer, adjust your chair and keyboard. Your arms should be bent at a 90-degree angle when you type so that your wrists are parallel with the ground. Your knees should also obey the 90-degree rule. And sit up straight, making sure your shoulders are not slumped forward and your head is not tilted downwards.

If the keyboard can be lowered, bring it down to a position where the keys are slightly lower than your wrists so that your fingertips drop down to rest lightly on the keys.

Tap the computer keys rather than pounding them. The less pressure you apply, the better.

Use ergonomic, hand-friendly products whenever possible. Especially helpful is a wrist rest, sold at most office equipment suppliers and larger department stores.

Get a contoured keyboard or split keyboard. These are specially designed so your hands can rest in a natural position while your fingers tap lightly on the keys. (The pressure required to depress a key is much lighter than on regular keyboards).

Bromelain, an enzyme derived from pineapples, digests inflammatory proteins, so it can reduce inflammation in sore wrists. Along with reducing the pain, it may also help you to heal faster. Take according to manufacturer's instructions. Take bromelain between meals because if you take it with meals, much of its potency will be wasted digesting your food.

The herb St John's wort can also help to repair nerve damage and reduce pain and inflammation. Take up to 250mg of extract standardised for hypericin content according to manufacturer's instructions, or more as professionally prescribed.

Take 1 tablespoon of flaxseed (linseed) oil every day, and give it at least 2 weeks to have an effect. Flaxseed oil is rich in omega-3 fatty acids, which reduce inflammation. Take it with food for better absorption. If you like, you can stir it into orange juice or add it to salad dressing.

Curcumin is an anti-inflammatory component found in the spice turmeric. Look for a supplement standardised to contain 95 per cent curcumin and take according to manufacturer's instructions.

Try taking 300mg of magnesium 2 or 3 times a day. The most absorbable form is magnesium citrate. If you have a problem with loose bowel movements, reduce the dose or try magnesium gluconate, which has a gentler effect on the digestive tract.

Vitamin B6 is probably the best-known supplement when it comes to treating carpal tunnel syndrome, but it is also controversial. Many experts claim it works but there are also those who claim it doesn't. On top of that, excessive vitamin B6 doses (anything over 50mg a day) taken for long periods can eventually lead to nerve problems.

To err on the side of caution, eat plenty of foods rich in Vitamin B6, including chicken breast, wholegrain cereals, brown rice, salmon, green vegetables and egg yolks. If you want to try a supplement, take up to 50mg of B6 a day, in divided doses, until your symptoms improve. If you then wish to continue supplementation, reduce the daily dose of B6 to 10mg a day.

Seek a doctor's advice if symptoms interfere with your daily activities. If carpal tunnel syndrome goes untreated, you could be left with a weakened grip in your hands and significant pain in your forearms or shoulders. Also, because the condition is associated with arthritis, diabetes and an under-active thyroid gland, a doctor should evaluate you to ensure you don't have any of those conditions in addition to CTS.