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Health Condition

Carpal Tunnel Syndrome

About This Condition

Carpal tunnel syndrome (CTS) is a condition characterized by pain, tingling, and numbness in the fingers and hand, sometimes radiating up into the elbow.

The painful sensations of CTS are caused by compression of the median nerve in the tunnel of bones in the wrist. In many cases, the condition results from long-term repetitive motions of the hands and wrists, such as from computer use. Although repetitive motion is often a culprit, it does not explain the frequent occurrence of CTS with non-motion-related conditions, such as pregnancy.

Symptoms

Symptoms of CTS include recurrent numbness, tingling, weakness, or pain in one or both hands in a characteristic location defined by the median nerve, which is compressed as it passes through the carpal tunnel in the wrist. Symptoms are usually worse at night and after prolonged use of the hands. Some people may experience clumsiness in handling objects, with a tendency to drop things, and may also have a decreased ability to feel hot and cold.

Other Therapies

Splints are often recommended to immobilize the wrist, theoretically protecting it from repetitive motion injury. A physical therapy program of hand- and wrist-strengthening exercises, combined with the use of a wrist brace, is sometimes recommended. In more advanced cases, a surgical procedure called a “release” may be necessary. The procedure separates the ligaments covering the carpal tunnel in the wrist, which relieves painful pressure on the median nerve.

References

1. Fuhr JF, Farrow A, Nelson HS. Vitamin B6 levels in patients with carpal tunnel syndrome. Arch Surg 1989;124:1329-30.

2. Keniston RC, Nathan PA, Leklem JE, Lockwood RS. Vitamin B6, vitamin C, and carpal tunnel syndrome. J Occup Environ Med 1997;39:949-59.

3. Franzblau A, Rock CL, Werner RA, et al. The relationship of vitamin B6 status to median nerve function and carpal tunnel syndrome among active industrial workers. J Occup Environ Med 1996;38:485-91.

4. Smith GP, Rudge PJ, Peters TJ. Biochemical studies of pyridoxal and pyridoxal phosphate status and therapeutic trial of pyridoxine in patients with carpal tunnel syndrome. Ann Neurol 1984;15:104-7.

5. Ellis JM, Azuma J, Watanbe T, Folkers K. Survey and new data on treatment with pyridoxine of patients having a clinical syndrome including the carpal tunnel and other defects. Res Comm Chem Path Pharm 1977;17(1):165-77.

6. Ellis JM. Vitamin B6 deficiency in patients with a clinical syndrome including the carpal tunnel defect. Biochemical and clinical response to therapy with pyridoxine. Res Comm Chem Path Pharm 1976;13(4):743-57.

7. D'Souza M. Carpal tunnel syndrome: clinical or neurophysiological diagnosis. Lancet 1985;i:1104-5.

8. Driskell JA, Wesley RL, Hess IE. Effectiveness of pyridoxine hydrochloride treatment on carpal tunnel syndrome patients. Nutr Rep Internat 1986;34(4):1031-9.

9. Ellis JM. Treatment of carpal tunnel syndrome with vitamin B6. Southern Med J 1987;80(7):882-4.

10. Browning DM. Carpal tunnel syndrome: clinical or neurophysiological diagnosis? Lancet 1985;i:1104-5 [letter].

11. Amadio PC. Pyridoxine as an adjunct in the treatment of carpal tunnel syndrome. J Hand Surg 1985;10A(2):237-41.

12. Stransky M, Rubin A, Lava NS, Lazaro RP. Treatment of carpal tunnel syndrome with vitamin B6: a double-blind study. Southern Med J 1989;82(7):841-2.

13. Bernstein AL, Dinesen JS. Brief communication: effect of pharmacologic doses of vitamin B6 on carpal tunnel syndrome, electronencephalographic results, and pain. J Am Coll Nutri 1993;12:73-6.

14. Gaby AR. Literature review & commentary. Townsend Letter for Doctors and Patients.1990;Jun:338-9.

15. Parry G, Bredesen DE. Sensory neuropath with low-dose pyridoxine. Neurology 1985;35:1466-8.

16. Schaumburg H, Kaplan J, Windebank A, et al. Sensory neuropathy from pyridoxine abuse. N Engl J Med 1983;309(8):445-8.

17. Chen GS. The effect of acupuncture treatment on carpal tunnel syndrome. Am J Acup 1990;18:5-9.

18. NIH Consensus Conference. Acupuncture. JAMA 1998;280:1518-24.

19. Sucher BM. Myofascial release of carpal tunnel syndrome. J Am Osteopathic Assoc 1993;93:92-101.

20. Sucher BM. Palpatory diagnosis and manipulative management of carpal tunnel syndrome. J Am Osteopathic Assoc 1994;94:647-63.

21. Bonebrake AR, Fernandez JE, Marley RJ, et al. A treatment for carpal tunnel syndrome: evaluation of objective and subjective measures. J Manip Physiol Ther 1990;13:507-20.

22. Bonebrake AR, Fernandez JE, Dahalan JB, et al. A treatment for carpal tunnel syndrome: results of a follow-up study. J Manip Physiol Ther 1993;16:125-39.

23. Davis PT, Hulbert JR, Kassak KM, et al. Comparative efficacy of conservative and chiropractic treatment for carpal tunnel syndrome: a randomized clinical trial. J Manipulative Physiol Ther 1998;21:317-26.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

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