Carpal tunnel syndrome is a condition of the wrist and hand that results from compression of the median nerve. Symptoms may include pain in the wrist and hand, weakness in the grip and numbness in the hand that usually extends to the thumb and the adjacent two or three fingers. Surgical treatment involves cutting a band of fascia that crosses the wrist in order to reduce pressure on the nerve. Not all cases require surgery. There are several alternative treatments that may be helpful or even curative.
Bracing
Of the non-surgical, non-drug options, bracing the affected wrist has fairly strong evidence of effectiveness according to a 2003 Cochrane review of the scientific literature. Limiting flexion and extension, positions that may increase compression on the median nerve, may facilitate recovery. This can be especially important during sleep. Bracing also decreases movement and loading of the tendons of the wrist in cases where swelling due to overuse may be an underlying issue.
Manipulation/Mobilization
Manipulation or mobilization of the small bones of the wrist has been utilized with some success in the treatment of carpal tunnel syndrome. By improving the mobility and flexibility of the wrist joints, the tendency for compression of the median nerve is believed to be reduced. One small study published in the "Journal of Manipulative and Physiological Therapeutics" in 2007 showed improvements in wrist strength, wrist mobility and nerve conduction resulting from either of two mobilization techniques for the wrist.
Yoga
Though the exact mechanism is not fully understood, yoga postures and upper body relaxation techniques have shown promise in managing the symptoms of carpal tunnel syndrome. A 1998 study published in the "Journal of the American Medical Association" showed superior outcomes for patients performing yoga techniques compared to patients using other standard conservative treatments. Even though the nerve conduction measures did not change, the yoga subjects demonstrated reduced symptoms along with improved pain levels and improved wrist mobility.
Vitamin B6
Vitamin B6 has long been promoted for treatment of carpal tunnel syndrome. This vitamin is important for proper nerve conduction. Some investigators have reported low levels of this vitamin in patients with carpal tunnel syndrome. Though vitamin B6 is frequently recommended as a helpful conservative alternative to surgery for carpal tunnel patients, there is little consistency in the literature with regard to clinical outcomes. It should also be noted that the typically recommended therapeutic doses are well above the minimum daily requirement for this vitamin. Those taking high levels of vitamin B6 over a prolonged period of time should be monitored by a health-care provider, as some individuals may not tolerate the high doses.
References
- "Cochrane Database of Systematic Reviews"; Non-surgical Treatment (Other Than Steroid Injection) for Carpal Tunnel Syndrome; D O'Conner, S Marshall and N Massy-Westropp; 2003
- "Journal of Manipulative and Physiological Therapeutics"; A Pilot Study Comparing Two Manual Therapy Interventions for Carpal Tunnel Syndrome; J Burke, D Buchberger, M Carey Loghamani, et al; 2007
- "Journal of the American Medical Association"; Yoga-Based Intervention for Carpal Tunnel Syndrome; M Garfinkle, A Singhall, W Katz, et al; 1998
