Carpal tunnel syndrome (CTS) ranges from mild to severe. Proper treatment can often restore the functioning of the hand and wrist and relieve symptoms.
The condition affects between 4 and 10 million Americans. Home remedies may help to manage and ease the symptoms of mild to moderate CTS. However, severe CTS may require surgery.
What is carpal tunnel syndrome?
Carpal tunnel syndrome affects the wrist and hand.
The carpal tunnel is found on the palm side of the wrist. It is a narrow passageway that runs from the wrist to the hand. It is made up of bones, ligaments, and tendons.
A nerve called the median nerve passes through the tunnel.
The median nerve runs from a network of nerves that start near the neck and shoulder and run down to the hand. The median nerve provides sensation to the thumb, index finger, middle finger, and the thumb side of the ring finger.
CTS causes tingling or a "pins-and-needles," numbness, thumb weakness, and dull aching in the hand or arm. This happens because the median nerve is being compressed and pinched.
It is not always clear why the median nerve becomes compressed, but some conditions and risk factors appear to increase the risk.
- Being female, especially around menopause
- A short, wide hand size or square wrist shape
- Conditions such as diabetes and thyroid disease
- Musculoskeletal conditions such as rheumatoid arthritis and fibromyalgia
- Previous wrist fractures or tendon problems
- Family history of CTS
- Psychosocial factors
People who are overweight or obese appear to be more likely to develop the syndrome.
Those who use their hands and wrists repetitively and at high rates are also at risk.
CTS does not usually go away by itself. Left untreated, it can get worse. It is essential to see a doctor if there is persistent numbness or weakness in the hand.
The following lifestyle and home remedies may give some relief from mild to moderate CTS symptoms, but there is little clinical evidence that they work. It is always important to seek advice from a doctor.
The following 10 lifestyle changes may help relieve CTS:
- Avoiding repetitive hand and wrist movements where possible
- Paying attention to the hands and wrists, stopping activities if pain, discomfort, or numbness are felt
- Taking frequent breaks if activities that involve repetitive hand movements are unavoidable
- Trying to keep the wrist in a neutral position, without extending the wrist too far up or flexing it too far down
- Using the largest joints possible when lifting to avoid extra stress on the wrists, hands and fingers
- Not holding of objects in the same way for too long
- Avoiding the use of vibrating power tools, such as jackhammers and floor sanders
- Adapting the workplace to keep a neutral wrist position
- Relaxing grip or force during activities such as writing
- Trying not to sleep on the hands or with the wrists in bent positions
There is also some evidence that regular physical activity and exercise may help protect against CTS.
These 10 home remedies may help to relieve CTS.
Massaging the hand may help to relieve symptoms.
- Resting the affected hand and wrist for at least 2 weeks
- Using anti-vibration products with vibrating tools
- Wearing a wrist splint or brace to rest the median nerve
- Doing gentle hand, finger, and wrist-stretching exercises
- Massaging the wrists, palms, and backs of the hands
- Wearing work gloves to protect hands and wrists
- Applying heat to the wrist to help reduce pain
- Applying an ice pack, which may also help to lessen swelling
- Adding extra material to tool and utensil handles for a more comfortable grip
- Taking over-the-counter pain medication such as ibuprofen or naproxen
People who try these medications should be aware that studies have found that they don't provide full relief of CTS symptoms. They may also increase the risk of gut problems and bleeding.
Some alternative treatments may help improve the symptoms of CTS. Some studies have suggested that the following methods can provide short-term relief:
- Yoga stretching and strengthening exercises may reduce pain and improve grip.
- Hand therapy techniques used in physical and occupational therapy may relieve symptoms.
- Ultrasound therapy raises the temperature of the affected area, potentially lessening pain and helping recovery.
- Applying topical anti-inflammatory medications as well as ultrasound may also be used.
- Laser therapy might improve symptoms according to limited evidence.
- Chiropractic treatment may lessen symptoms in some people. Acupuncture may also benefit some people and improve symptoms. The American Academy of Orthopaedic Surgeons recommend additional research.
People should always check with their doctors before using any complementary or alternative treatment. Replacing conventional treatments with unproven therapies is not recommended.
Drug treatment and surgery
In addition to wearing splints and other comfort measures, prescription medications or injections are available.
Oral corticosteroid medication may decrease inflammation and swelling, which will help to reduce pressure on the median nerve. Corticosteroid medication may also be injected into the wrist. Injections seem to work better than oral corticosteroids for CTS.
There is a lack of evidence to support the use of nonsteroidal anti-inflammatory drugs (NSAIDs) to treat CTS.
Conventional treatments for CTS should be carried out under the guidance of a doctor.
If CTS develops during pregnancy, the symptoms usually go away 6 to 12 weeks after giving birth. Some specialists recommend putting a splint on the wrist while sleeping.
Sometimes, if the median nerve is severely compressed, there may be nerve damage or muscle wasting that requires further treatment.
Surgery may be recommended if CTS is severe, and if non-surgical treatments do not help. Surgical treatment of CTS does appear to have the best outcome. Studies have shown that 6 to 12 months after surgery, CTS improves more than it would with just a splint or some other non-surgical treatment.
Surgery for CTS involves cutting the ligament that presses on the median nerve. After surgery, the ligament slowly grows back together, leaving more room for the nerve.
The two types of surgery available for CTS are:
- Open surgery: A single incision is made over the palm-side of the wrist. A cut is made through the ligament to release the pressure on the nerve.
- Endoscopic surgery: A small scope-like device with a tiny attached camera called an endoscope is passed through small incisions in the wrist area to cut the ligament.
There may be less pain in the days or weeks following endoscopic surgery compared with open surgery. However, there are no long-term differences between the two methods.
After surgery, activities that might put a strain on the wrist should be avoided until recovery is complete. Recovery may take a few weeks to several months.
Some people may need to change jobs or to adjust duties to recover from CTS or after CTS surgery. With proper treatment, a return of CTS is rare, and most people recover completely.