Carpal Tunnel Syndrome (CTS)
The carpal tunnel is a very small opening just below the base of the wrist, between the arm and the hand. It allows the median nerve to pass from the bones and the mus- cles of the forearm to the palm, the thumb, and the ﬁngers. Because the opening is so small, it is vulnerable to pressure and swelling. Inﬂammation from overuse, hor- monal changes, or arthritis causes the pain and the numbness of carpal tunnel syn- drome (CTS). CTS may begin as a mild tingling that’s worse in the morning or the evening and can progress to a crippling, excruciating pain.
CTS has always afﬂicted people who consistently use their hands in a repetitive motion: Knitters, musicians, writers, grocery clerks, and assembly-line workers have tra- ditionally suffered from the effects of CTS. But in the last decade, as work has increas- ingly centered on the personal computer, CTS has reached near-epidemic proportions. At least 10 percent of people who work at computers have CTS, and that number is projected to rise.
The best way to treat CTS is to prevent it from happening. If you work at a computer, use a wrist rest to relieve pressure on the carpal tunnel, and take a break every hour to rotate your hands. If you think you may already have CTS, see your doctor for a test called an electromyograph. If the test proves that you do have CTS, complementary ther- apies can help relieve your pain. Treatments include removing the source of pain when possible, improving circulation, and reducing swelling. Since a vitamin B6 deﬁciency has been linked to CTS, complementary treatment also encourages the consumption of that nutrient. Specif ic treatments from a chiropractor, an acupuncturist, or an osteopath can be very effective in addressing the underlying structural cause of carpal tunnel syndrome. Surgery for this condition should be avoided, if at all possible, because of its high failure rate.
Symptoms can occur in one or both hands.
In a preliminary trial, people with CTS (some of whom had previously undergone surgery) received either acupuncture or electroacupuncture (acupuncture with electrical stimulation). Researchers found
that 83 percent of the participants experi- enced complete relief that lasted two to eight years after follow-up.
• Numbness, tingling, or pain in the thumb and the ﬁrst three ﬁngers
• Pain is worse at night and/or in the morning.
• Weakness of the thumb and the ﬁrst three ﬁngers
• Inability to make a ﬁst
• Pain may radiate to the forearm or the shoulder.
• Continuous use of the ﬁngers and the hand
• Constant vibration of the ﬁngers and the hand (as in holding a jack- hammer for long periods of time)
• Pregnancy or other hormonal changes that cause ﬂuid retention
• Inﬂammatory arthritis in the wrist
• Bone spurs in the wrist
• Vitamin B6 deﬁciency
The following test helps to assess possible metabolic reasons for carpal tunnel syndrome:
Vitamin B6—blood test
CTS is often brought on or made worse by pregnancy. If you’re pregnant or nursing, check with your doctor before taking any herbs or supplements or making radical changes to your diet.
If you’re overweight, there’s a good chance you will ﬁnd relief from the pain of CTS by following a wholesome diet based on whole grains, fresh fruits and vegetables, and lean protein (especially beans and soy). This eating plan will help you lose weight safely and will take pressure off the carpal tunnel.
Drink a glass of clean water every two waking hours to combat ﬂuid retention.
A deﬁciency of vitamin B6 may be a cause of CTS, so consume plenty of beans, brewer’s yeast, and wheat germ. Green leafy vegetables are good sources of B6 as well.
Green drinks are also good for reducing inﬂammation.
Food to Avoid
Fluid retention puts pressure on the carpal tunnel, so eliminate sources of sodium from your diet.
Avoid saturated fat, which slows circulation.
Super Seven Prescriptions—Carpal Tunnel Syndrome
Super Prescription #1 Vitamin B6
Take 100 mg three times daily. Studies show that this vitamin reduces the nerve inﬂammation that is found with carpal tunnel syndrome. Also, take a B-complex to prevent an imbalance of the other B vitamins.
Super Prescription #2 Bromelain
Take 500 mg three times daily between meals. Look for products standardized to 2,000 M.C.U. (milk-clotting units) per 1,000 mg or 1,200 G.D.U. (gelatin- dissolving units) per 1,000 mg. Bromelain has a natural anti-inﬂammatory effect. Protease enzyme products also have this beneﬁt.
Super Prescription #3 Boswellia (Boswellia serrata)
Take 1,200 to 1,500 mg of a standardized extract containing 60 to 65 percent boswellic acids, two to three times daily. It acts as a natural anti-inﬂammatory.
Super Prescription #4 Calcium and magnesium
Take a complex containing 500 mg of calcium and 250 mg of magnesium twice daily. This reduces muscle tightness and nerve irritation.
Super Prescription #5 White willow (Salix alba)
Take a product standardized to contain 240 mg of salicin daily or 5 ml of the tinc- ture form three times daily. This herbal extract reduces pain and inﬂammation.
Super Prescription #6 Homeopathy
Pick the remedy that best matches your symptoms in the Homeopathy section. For acute wrist pain, take a 30C potency four times daily. For chronic wrist pain, take twice daily for two weeks to see if there are any positive improvements. After you notice improvement, stop taking the remedy, unless symptoms return. Consulta- tion with a homeopathic practitioner is advised.
Super Prescription #7 Ginkgo biloba
Take 120 mg twice daily of a product standardized to 24 percent ﬂavone glycosides. Gingko improves circulation.
Dandelion leaf (Taraxacum ofﬁcinale) is a natural diuretic that is considered to be safe during pregnancy. Take 300 mg or 2 ml three times daily. It should be used under the supervision of a doctor, though.
DMSO (dimethyl sulfoxide) is a topical pain reliever. Work with a doctor to use this substance.
Arnica (Arnica montana) and hypericum (Saint-John’s-wort) oil can be rubbed over the affected area to reduce pain and swelling.
Arnica (Arnica montana) is for deep pain that feels bruised. It is best used for the ﬁrst two days after an injury.
Causticum is a remedy for recurring or long-lasting carpal tunnel syndrome. The wrist area feels bruised, with burning or drawing pains. There is often stiffness and contracture of the wrist and the forearm. Symptoms are better with warm applications.
Hypericum (Hypericum perforatum) is for shooting nerve pains that extend from the wrist.
Rhus Toxicodendron is for achy pain that improves with movement and dry warmth and is worse with inactivity and windy, rainy weather.
Ruta (Ruta graveolens) is for stiff, bruised pain and aching of the wrist. The wrist feels lame and weak from overuse.
• The best points for easing wrist pain are Pericardium 6 and 7 and Triple Warmer 5. You can easily practice this short acupressure routine while at your desk or when you’re taking a break from work.
Work Those Wrists!
Your wrists, like the rest of the body, need exercise to stay strong and supple. Practice the following recommended exercises at the beginning of every workday, and take breaks every few hours to go through the routine again. It’s also a good idea to use these exer- cises as a warm-up for yoga, tennis, rock climbing, and other hand-intensive sports.
• Begin by shaking out your wrists for about ten seconds.
• Gently rotate your wrists clockwise through their full range of motion. Do this ﬁve times, and then repeat, this time going counter-clockwise.
• Hold your arm straight out in front of you, palm facing outward, and use the opposite hand to gently pull back your ﬁngertips. Hold for a few seconds and then release. Repeat with the other arm.
Work the areas corresponding to the lymph system, the kidneys, and the adrenals to reduce swelling and inﬂamma- tion. This gentle therapy is especially good for pregnant women.
Contrast hydrotherapy will improve blood ﬂow and provide pain relief. Submerge your hand and wrist in hot water for a couple of minutes; then immerse them in cold water for about thirty seconds. Repeat the sequence several times.
Other Bodywork Recommendations
You may want to look into magnet therapy, which many pain sufferers claim to be quite effective. Although the ben- eﬁts of magnets are not proven, it is thought that they relieve pain by stimulating blood ﬂow.
An experienced chiropractor or osteopath, especially one who specializes in sports therapy, can perform adjustments of the wrist, the arm, the shoulder, and the neck. Make sure to ﬁnd a qualiﬁed practitioner.
• Use a cold compress to reduce swelling.
• Cigar and cigarette smoke disturbs the circulation. If you smoke, quit. If
you’re exposed to secondhand smoke, remove yourself from the smoky
environment as much as possible.
• Pregnant women whose CTS is brought on by edema will ﬁnd that their symp- toms disappear after their babies are born.
• If your CTS has been caused by overuse of the wrist and the ﬁngers, stop all repetitive hand motions for a few days. When you return to your work, you’ll need to alternate repetitive tasks with other activities. Take a break every hour to rest and to rotate your wrists, and try to keep your work environment warm and dry, as cool, humid conditions can aggravate CTS.
• If you work on a computer, make sure your screen is two feet away from your body and slightly below your line of vision. Also, use a wrist rest. Most employers are now aware of CTS and will provide ergonomic workspace if you ask for it.