Treatment Options for Carpal Tunnel Syndrome

Once carpal tunnel syndrome has been diagnosed by a physician, there are several treatment options to find relief from hand and wrist pain and other symptoms.

The initial, nonsurgical treatment options recommended for carpal tunnel syndrome include the following:

• Resting the affected hand and wrist for at least two weeks. This includes avoiding whatever activities usually trigger pain.
• Wearing a splint at night to immobilize the wrist in a neutral position. This is a good solution for people with mild to moderate carpal tunnel syndrome whose symptoms flare up for a few weeks, then dissipate. It is important to take occasional breaks from wearing the splint, as constant wear can contribute to joints stiffening and muscles weakening.
• Ice therapy can reduce swelling and numb pain signals in the wrist and hand. When using ice or a cold pack, limit sessions to no more than 20 minutes and use a barrier between ice and skin to protect the skin from damage.
• Workplace changes to improve ergonomics or reduce repetitive motions may be helpful. For assembly workers, this may include more frequent breaks or a temporary shift in assigned duties. For office workers, this may include the use of an ergonomic keyboard or supportive mousepad. However, there is not much evidence that modified computer equipment can prevent or relieve symptoms.¹O'connor D, Page MJ, Marshall SC, Massy-westropp N. Ergonomic positioning or equipment for treating carpal tunnel syndrome. Cochrane Database Syst Rev. 2012;1:CD009600.
• NSAIDs or diuretics can reduce inflammation and pain associated with carpal tunnel syndrome.
• Oral corticosteroids (such as prednisone) have also been shown to reduce inflammation and ease symptoms. Corticosteroids provide a stronger anti-inflammatory effect than NSAIDs and need to be prescribed by a physician and taken only as directed. These medications can cause a number of side effects, such as headaches, nausea, insomnia, and weight gain.
• Steroid injections into the carpal tunnel can offer significant pain relief if other treatments such as rest or splinting have been ineffective. If symptoms persist beyond a few injections, other options such as surgery may be considered.

See The P.R.I.C.E. Protocol Principles

Alternative Treatment Options

In addition to the proven treatments above, there are some additional treatments that don’t have solid evidence of their effectiveness. However, some experts and physicians believe feel they can be beneficial for carpal tunnel syndrome patients:

• Stretching and strengthening exercises for the hand and wrist may reduce pressure of the median nerve and improve circulation.
• Yoga has been shown to reduce pain and improve grip strength.
• Acupuncture and chiropractic manipulation have benefited some patients, but their effectiveness remains unproved.
• Some studies show that vitamin B6 (pyridoxine) supplements may ease the symptoms of carpal tunnel syndrome, according to the National Institute of Neurological Disorders and Stroke.

See 6 Myths and Truths About Carpal Tunnel Syndrome

If patients use one or more of the above treatment options for six months without finding relief from their symptoms or their symptoms are severe, they may be candidates for surgery. A procedure known as carpal tunnel release is generally considered safe and effective for those with carpal tunnel syndrome.

See Acute Injury: Additional Treatment Considerations