Carpal tunnel syndrome is becoming increasingly prevalent in the workplace. Most physicians seek to relieve symptoms with non-surgical options before considering endoscopic or open release surgery. One non-surgical option commonly sought is vitamin therapy, particularly using vitamin B-6. Despite the wide range of studies examining vitamin B-6 therapy for carpal tunnel syndrome, and the large number of people using this therapy, the evidence for its efficacy is lacking, according to the National Institutes of Health, or NIH.
Carpal Tunnel Syndrome
The Mayo Clinic describes carpal tunnel syndrome as an entrapment neuropathy of the median nerve. This means that the median nerve inside the wrist's carpal tunnel becomes squeezed and compressed. The squeezing occurs because tendons adjacent to the median nerve swell and apply pressure on the nerve. The result is neuropathy, which is a problem in the nerve's ability to carry sensory and motor signals between the periphery and spinal cord. This causes pain, numbness, weakness and other symptoms typical of carpal tunnel syndrome. Most therapies aim to reduce swelling in the tendons in order to decompress the median nerve.
Functions of Vitamin B-6
Vitamin B-6 plays many crucial roles in the body. It is a necessary component for building proteins and is needed in more than 100 enzyme reactions involving protein metabolism, says the NIH. In the nervous system, it is required to make the neurotransmitters serotonin and dopamine. These are necessary so that nerve cells may communicate. Vitamin B-6 may also have a role in the cause of chronic pain, and may be involved in the onset of Parkinson's disease, headache and seizures, says NIH.
Risks
Taking too much vitamin B-6, especially from supplements, can have harmful effects. The primary harmful effect is on the peripheral nervous system, resulting in neuropathy. The NIH says the harmful effects are reversible if the vitamin is discontinued. The NIH suggests that the upper tolerable limit for vitamin B-6 is 100 mg per day for all adults, although others suggest vitamin B-6 supplement levels under 200 mg per day are safe.
The Pros
Recommendations for vitamin B-6 therapy to treat carpal tunnel syndrome began three decades ago, says NIH. Today, popular books still recommend a dose of 100 mg to 200 mg of vitamin B-6 per day for carpal tunnel syndrome. Clearly, vitamin B-6 supplements for treating a generally painful condition like carpal tunnel syndrome are attractive since it is an easy and inexpensive option. Whether it actually works is controversial, yet many physicians still prescribe it for this condition. While there is little evidence for its direct role in alleviating carpal tunnel syndrome, vitamin B-6 may help in another way. It may be able to raise pain threshold levels, making the discomfort of carpal tunnel syndrome more bearable.
The Cons
The conclusion of the NIH is that in spite of the widespread use of vitamin B-6 therapy for carpal tunnel syndrome, scientific studies do not support it as an effective treatment. The NIH warns that anyone taking high doses of vitamin B-6 as a carpal tunnel treatment risks the detrimental neurological effects of excessive intake. The NIH says there are documented cases of neuropathy caused by excessive intake of vitamin B-6 to treat carpal tunnel syndrome.
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