Carpal Tunnel

“The treatment for Carpal Tunnel Syndrome in its early stages is often directed at decreasing the inflammation of the tendons. The most common treatment without the use of drugs or injections is a “cock up” night splint which keeps the wrist in a neutral position during sleep, to prevent the normal bent position which often occurs during dreaming which puts pressure on the nerve.

This helps a CTS sufferer sleep better. Symptoms often worsen at night because the position of the hand is at the same level of the heart while lying down and fluid accumulates in the soft tissues within the canal. Patients do NOT wear a splint 24 hours a day —-this is another fallacy and can cause other physical problems. We DO encourage them to change their routine in the future and rest from repetitive activities. “Other options to treat mild symptoms include the use of non-steroid anti inflammatory drugs (NSAIDS) like Ibuprofen or Advil.

“There is a small amount of medical data that suggests high doses of Vitamin B6 may be helpful, acting as a physiological diuretic to decrease the swelling of the tendon sheaths. This shouldn’t be confused with other diuretics, such as those taken by heart patients. “An injection of corticosteroids such as cortisone within the carpal tunnel itself can relieve pain quickly by reducing tendon swelling. This “frees up space” to allow more room for the median nerve in the carpal tunnel and frequently, that resolves the problem.

However, this is a limited treatment option, and I recommend no more than two injections, about 6 months apart. “For patients whose symptoms don’t respond to these conservative treatments and those with a significantly positive nerve conductive study I recommend a minor surgical procedure called endoscopic carpal tunnel release to relieve the pressure on the nerve. This is a painless and very effective treatment.