Carpal Tunnel Syndrome - Treatment

Highlights	Risk Factors	Treatment
Introduction	Prognosis	Surgery
Symptoms	Prevention	Resources
Causes	Diagnosis	References

Treatment

It is critical to begin treating early phases of carpal tunnel syndrome before the damage progresses. A conservative approach to CTS is the first step in treating this disorder, which may include corticosteroid injections and splinting.

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Nevertheless, relapse is common and studies suggest that surgery is a better option for severe CTS. In one study, 89% of patients who had conservative treatments suffered a recurrence of symptoms within a year. Conservative treatment works best in men under 40 and least well in young women. The conservative approach is also most successful in patients with mild carpal tunnel syndrome. According to one study, however, even among these patients, 60% can expect a relapse. Some researchers are reporting better results when specific exercises for carpal tunnel are added to the program.

Limiting Movement. If possible, the patient should avoid activities at work or home that may aggravate the syndrome. The affected hand and wrist should be rested for two to six weeks. This allows the swollen, inflamed tissues to shrink and relieves pressure on the median nerve. If the injury is work related, the worker should ask to see if other jobs are available that will not involve the same actions. Few studies have been conducted on ergonomically designed furniture or equipment or frequent rest breaks, but it is reasonable to ask for these if other work is not available.

Conservative Treatment Approach. In a major analysis, the following conservative approaches were shown to provide symptom relief:

Wrist splints.
Corticosteroids (steroids). Injected or short-term oral corticosteroids may be tried next if previous methods fail. (People with diabetes may find additional relief by including insulin injections with steroid injections.)
Yoga. In one study, after eight weeks regular yoga practice reduced pain significantly better than splinting.
Carpal bone mobilization. This is an approach that uses physical therapy to move the bones and tissues in the wrist.
Ultrasound. It may be necessary to undergo at least seven weeks of treatment before significant improvement is evident.

A major analysis of other conservative approaches found no significant relief from nonsteroidal anti-inflammatory drugs (NSAIDs), which include common pain relievers such as aspirin and ibuprofen (Advil). The same report also found no benefits from diuretics, which eliminate fluid, or a number of alternative methods, including magnet therapy, laser acupuncture, vitamin B6, exercise or chiropractic care. Other approaches that merit some research include omega-3 fatty acid and cognitive-behavioral therapy.