Etiology and Conservative Treatment of Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a neuropathy caused by entrapment and compression of the median nerve as it passes through the carpal tunnel in the wrist, leading to a decrease in nerve transmission to and from the hand. Symptoms include pain, numbness, tingling, aching, and loss of motor and sensory function in the first three digits of the hand. These symptoms are typically worse at night and can awaken the individual. CTS is more common in women than men, and is a common occurrence in occupations involving repetitive motions of the upper extremity. A vitamin B6 deficiency has been found in many patients with CTS, and treatment with B6 or its bioactive form, pyridoxal 5’ phosphate, is helpful in the majority of cases. Addressing the individual’s occupational biomechanical and/or ergonomic factors, in addition to manual manipulation and the therapeutic use of anti-inflammatory substances such as bromelain can be of significant benefit and may decrease the need for carpal tunnel release surgery. (Alt Med Rev 1997;2(1):26-35)