Practical ways to prevent-and treat-carpal tunnel syndrome
Heading out the door? Read this article on the new Outside+ app available now on iOS devices for members! Download the app.
Q: I’ve been diagnosed with carpal tunnel syndrome, and I’ve been told that the only way to relieve the pain is surgery. Are there any alternatives?
-Jane W., Santa Ana, CA
A: As always, an ounce of prevention is worth a pound of cure. If you’re in a profession that demands repetitive wrist movement (such as carpentry or typing) there are a number of ways to reduce the potential for inflammation between the delicate structures that form the wrist.
One reason why the wrist is so flexible-it’s the most versatile joint in the body-is because it’s composed of 8 carpal bones that fit together like a jigsaw puzzle bound by a series of ligaments and tendons with various nerves coursing through. When the structures of the wrist become inflamed and swollen from overuse, the pressure from the swelling can cause pressure on the nerves.
Diet and Exercise
B vitamins can be very helpful in aiding nerve healing. Whether you’re hoping to prevent carpal tunnel syndrome or already have it, consider taking 1,000-2,000 mcg of B12 (I prefer the sublingual “dots”) and 50-200 mg of B6 daily for 6-12 weeks. Also, to reduce the swelling, go easy on mammal food (beef, pork, dairy) for a few months because these foods are high in arachidonic acid, which promotes inflammation.
In turn, eicosapentaenoic acid (EPA) from fish oil is anti-inflammatory. You can take 1,500-3,000 mg a day for 6-12 weeks. I also recommend taking high-potency digestive enzymes (1,000-2,000 mg daily of a high-CFU-count bromelain) once or twice daily between meals. When you take digestive enzymes 30 minutes before or two hours after meals, they don’t work on the food in your stomach, but enter the bloodstream and act as “extra” white blood cells. Cellular debris-including injured tissue-is broken down enzymatically by the immune system. Specifically, white blood cells contain packets of enzymes called lysosomes that promote the degradation of waste. Enzymes drive just about all biochemical processes, so you can use them to your advantage whether to help digest food, or to help remove injured tissue. Lastly, injection of steroid medication into the carpal tunnel can be effective, particularly when localized with ultrasound guidance.
A simple wrist-stretch exercise can also help keep those joints flexible and less prone to strain. Standing, bring your arms parallel to the floor in front of you and stack the right wrist on top of the left. Then turn your thumbs pointing down to the floor, so your palms are facing each other. Deeply interlace the fingers. Pull the interlaced knuckles away from your body enough to straighten the arms, then tuck the knuckles down towards your belly, and sweep them up next to your chest and under the chin. From there, gently attempt to straighten your arms out and parallel to the floor again. It’s doubtful that you’ll be able to straighten your arms on your first attempts. However, with practice-once or twice daily-you will develop more flexibility.
Another fairly common wrist problem is ganglion cysts, which look like grape-sized (or smaller) protrusions, typically on the back of the hand close to the wrist. This occurs when tissue that houses lubricating synovial fluid becomes pinched between tiny bones and creates a “sac” that can fill with fluid. Ganglion cysts aren’t usually painful, but they can be disconcerting. The old-fashioned treatment was to smash the cyst with a heavy book, but this can actually cause damage to the delicate structures in the hand, so it’s no longer recommended.
Instead, you could ask your doctor to drain the fluid, then tape a coin over the area for several weeks to prevent the sac from filling up again. Doctors skilled in laser therapy may be able to reduce cysts without pain over several treatments. Sometimes identifying the Traditional Chinese Medicine meridian and massaging along the meridian can improve the drainage along that channel, and the cyst will slowly reduce and disappear.
Using vitamin E oil, or such lymphatic-stimulating lubricants as phytolacca (pokeweed) or castor oil, can also be effective. There are also a number of cyst-draining homeopathic remedies, mostly notably Calc fluor, which can be taken as a cell salt (6x or 12x potency), 3-4 pellets nightly until they no longer taste sweet. Reducing salt in your diet may also help drain the cyst, especially if you have high blood pressure.