Treatment

Treat carpal tunnel syndrome as early as possible after symptoms start.

Take more frequent breaks to rest your hands. Avoiding activities that worsen symptoms and applying cold packs to reduce swelling also may help.

Other treatment options include wrist splinting, medications and surgery. Splinting and other conservative treatments are more likely to help if you've had only mild to moderate symptoms for less than 10 months.

Nonsurgical therapy

If the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome, including:

  • Wrist splinting. A splint that holds your wrist still while you sleep can help relieve nighttime symptoms of tingling and numbness. Nighttime splinting may be a good option if you're pregnant.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil, Motrin IB, others), may help relieve pain from carpal tunnel syndrome in the short term.

    There isn't evidence, however, that these drugs improve carpal tunnel syndrome.

  • Corticosteroids. Your doctor may inject your carpal tunnel with a corticosteroid such as cortisone to relieve pain. Sometimes your doctor uses an ultrasound to guide these injections.

    Corticosteroids decrease inflammation and swelling, which relieves pressure on the median nerve. Oral corticosteroids aren't considered as effective as corticosteroid injections for treating carpal tunnel syndrome.

If carpal tunnel syndrome is caused by rheumatoid arthritis or another inflammatory arthritis, then treating the arthritis may reduce symptoms of carpal tunnel syndrome. However, this is unproved.

Surgery

Surgery may be appropriate if your symptoms are severe or don't respond to other treatments.

The goal of carpal tunnel surgery is to relieve pressure by cutting the ligament pressing on the median nerve.

The surgery may be performed with two different techniques:

  • Endoscopic surgery. Your surgeon uses a telescope-like device with a tiny camera attached to it (endoscope) to see inside your carpal tunnel. Your surgeon cuts the ligament through one or two small incisions in your hand or wrist.

    Endoscopic surgery may result in less pain than does open surgery in the first few days or weeks after surgery.

  • Open surgery. Your surgeon makes an incision in the palm of your hand over the carpal tunnel and cuts through the ligament to free the nerve.

Discuss the risks and benefits of each technique with your surgeon before surgery. Surgery risks may include:

  • Incomplete release of the ligament
  • Wound infections
  • Scar formation
  • Nerve or vascular injuries

During the healing process after the surgery, the ligament tissues gradually grow back together while allowing more room for the nerve. This internal healing process typically takes several months, but the skin heals in a few weeks.

Alternative medicine

Integrate alternative therapies into your treatment plan to help you cope with carpal tunnel syndrome. You may have to experiment to find a treatment that works for you. Always check with your doctor before trying any complementary or alternative treatment.

  • Yoga. Yoga postures designed for strengthening, stretching and balancing the upper body and joints may help reduce pain and improve grip strength.
  • Hand therapy. Early research suggests that certain physical and occupational hand therapy techniques may reduce symptoms of carpal tunnel syndrome.
  • Ultrasound therapy. High-intensity ultrasound can be used to raise the temperature of a targeted area of body tissue to reduce pain and promote healing. Research shows inconsistent results with this therapy, but a course of ultrasound therapy over several weeks may help reduce symptoms.
March 30, 2017
References
  1. Carpal tunnel syndrome fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm. Accessed Oct. 26, 2016.
  2. Carpal tunnel syndrome. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00005. Accessed Oct. 26, 2016.
  3. Kothari MJ. Clinical manifestations and diagnosis of carpal tunnel syndrome. http://www.uptodate.com/home. Accessed Oct. 26, 2016.
  4. Kothari MJ. Etiology of carpal tunnel syndrome. http://www.uptodate.com/home. Accessed Oct. 26, 2016.
  5. Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Oct. 26, 2016.
  6. Kothari MJ. Treatment of carpal tunnel syndrome. http://www.uptodate.com/home. Accessed Oct. 26, 2016.
  7. Hunter AA, et al. Surgery for carpal tunnel syndrome. http://www.uptodate.com/home. Accessed Oct. 26, 2016.
  8. Amadio PC (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 3, 2016.
  9. Petit A, et al. Risk factors for carpal tunnel syndrome related to the work organization: A prospective surveillance study in a large working population. Applied Ergonomics. 2015;47:1.
  10. Riggin ER. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Nov. 29, 2016.