Carpal-Tunnel-Syndrome Explained

Carpal Tunnel Syndrome

Vitamin B6
Vitamin B6 deficiency is common in people with carpal tunnel syndrome, supplementing with the vitamin has reportedly relieved symptoms.
Dose:
100 to 300 mg daily for no more than three months; 50 to 100 mg daily after that
Vitamin B6
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Some, but not all, studies have found vitamin B6 deficiency to be common in people with CTS.¹ Supplementation with vitamin B6 has reportedly relieved the symptoms of CTS,² but some researchers have not found this treatment to be beneficial.³^,4
Several studies report that people with CTS are helped when given 100 mg of vitamin B6 three times per day.⁵^,6 Although some researchers have found benefits with lesser amounts,⁷^,8^,9^,10 using less than 100 mg taken three times per day for several months has often failed.⁴^,12^,13 Most doctors assume that people with CTS who respond to vitamin B6 supplementation do so because of an underlying deficiency. However, at least one group of researchers has found vitamin B6 to “dramatically” reduce pain in people with CTS who did not appear to be B6-deficient.¹⁴ Some doctors believe that B6 is therapeutic because it reduces swelling around the carpal tunnel in the wrist; this theory remains completely undocumented.
Very high levels of vitamin B6 can damage sensory nerves, leading to numbness in the hands and feet as well as difficulty in walking; supplementation should be stopped if these symptoms develop after beginning vitamin B6 supplementation. Vitamin B6 is usually safe in amounts of 200 to 500 mg per day,¹⁵ although occasional problems have been reported in this range.¹⁶ Higher amounts are clearly toxic.¹⁷ Any adult taking more than 200 mg of vitamin B6 per day for more than a few months should consult a doctor.
In order to be effective, vitamin B6 must be transformed in the body to pyridoxal-5’-phosphate (PLP). Some doctors have suggested that people who do not respond well to vitamin B6 supplements should try 50 mg of PLP three times per day. There is no clear evidence that using PLP provides any advantage in reducing symptoms of CTS.

Holistic Options

Acupuncture may be useful in the treatment of CTS. In a preliminary trial, people with CTS (some of whom had previously undergone surgery) received either acupuncture or electro-acupuncture (acupuncture with electrical stimulation). Eighty-three percent of the participants in this trial experienced complete relief that lasted through two to eight years of follow-up.¹⁷ After reviewing all available scientific literature on the topic, a consensus conference convened in 1997 by the National Institutes of Health concluded that acupuncture for CTS “may be useful as an adjunct treatment or an acceptable alternative or be included in a comprehensive management program.”¹⁸

Manipulative procedures may have a role in treating CTS by decreasing symptoms and improving function. A type of stretching treatment called myofascial release improved the symptoms of a patient with CTS in one published case report,¹⁹ and similar treatments combined with specific wrist manipulations and self stretches were further tested in a small, preliminary trial.²⁰ Participants in this study experienced a decrease in pain, numbness, and weakness, and their nerve function improved as well.

A small, preliminary trial assessed a chiropractic treatment program consisting of exercises, soft tissue therapy, and manipulation of the wrist, the upper extremity, the spine, and the ribs.²¹ The treatment resulted in improvement in grip and thumb strength, muscle function, flexibility, and overall function, as well as a decrease in pain among people with CTS. In a follow-up study six months later, most of the improvement had been maintained.²²A controlled clinical trial compared traditional medical and chiropractic care for CTS.²³ People with CTS received either standard medical care (ibuprofen and nighttime wrist supports) or chiropractic care (manipulation of the wrist, elbow, shoulder, neck, and spine, as well as massage to the soft tissues). Ultrasound and nighttime splints were also used in the chiropractic treatments. People in both groups improved significantly and similarly in terms of pain reduction, increased function, and improved finger sensation and nerve function, but the chiropractic group reported fewer side effects.