Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a common and often disabling condition most often associated with data entry and general computer use, but it can affect anyone who performs repetitive hand motions. CTS strikes women more often than men and is a relatively common complication of pregnancy. It also occurs frequently among people with rheumatoid arthritis and diabetes.

CTS is caused by compression of the median nerve. On its way to the hand, the nerve passes through an opening in the wrist called the carpal tunnel. Constant, repetitive hand motion may aggravate the ligaments and tendons encased in the tunnel, causing them to swell. As the tunnel walls close in, they compress the median nerve. This causes tingling and numbness in the thumb, index finger, middle finger, and half of the ring finger. The discomfort of CTS often wakes people during the night and eventually makes it difficult to grasp small objects.

Most instances of CTS are job related. Paying attention to proper ergonomics is essential for preventing CTS. This might involve repositioning a computer keyboard or taking breaks more often. Conventional medical treatment for more stubborn CTS cases is fairly successful. Splinting the affected hand, especially at night, may help reduce symptoms. Nonsteroidal anti-inflammatory medications such as ibuprofen or naproxen may help, as can cortisone injections. When such measures fail, the swollen ligament may be released surgically by cutting it at the base of the wrist, thus freeing the median nerve from pressure. In extreme cases, a person with work-related CTS may have to switch jobs.

Principal Proposed Treatments for Carpal Tunnel Syndrome:

More than 25 years ago, researchers noted that people with CTS seemed to be deficient in vitamin B6. This led to widespread use of B6 as a CTS remedy. However, a recent study found no association between CTS and B6 deficiency. In any case, even if B6 deficiency were common in CTS, that by itself wouldnt prove that taking B6supplements can reduce symptoms.

A few studies have investigated the effectiveness of vitamin B6 for CTS. Most were poorly designed and involved few people. The two (albeit small) randomized, double-blind placebo-controlled studies that do exist found no evidence that vitamin B6 effectively treats CTS. The first study, which enrolled only 15 people, found no significant difference after 10 weeks among those taking vitamin B6, placebo, or nothing at all The second, involving 32 people, did find some benefits, but these were fairly minor. There was no improvement in nighttime pain, numbness, or tingling, nor in objective measurements of median nerve function. Some benefit, however, was seen in the relatively less important symptoms of finger swelling and discomfort after repetitive motion.

The bottom line: Because vitamin B6 has not been proven effective and may be harmful in high doses, we do not recommend it for carpal tunnel syndrome.

For more information, including dosage and safety issues, see the full vitamin B6 article.

Other Proposed Treatments for Carpal Tunnel Syndrome:

Bromelain and other proteolytic enzymes are sometimes recommended for the treatment of carpal tunnel syndrome, but there is no evidence as yet that they work.

Acupuncture has also been tried, but has not been proven effective for CTS.