I want to know all the available treatments for carpal tunnel syndrome
besides surgery.

I have this in my hands. I have tried cortisone injections 4 times,
which give some relief for a couple months but then the symptoms
return full force and the doc says you can't do the injections too
many times. I am currently trying ibuprofin daily, but don't know if I
want to medicate daily forever to lessen the symptoms.

Doc says the only solution left may be surgery which I do not want. So
I want to find out if there are any other treatment methods for this
problem, maybe even alternative treatments modern medicine will not
acknowledge. Thanks.

Hi mmo,

As you're well aware, Carpal Tunnel Syndrome (CTS) can be a
frustrating and potentially debilitating condition. As you mentioned
in your question, surgery and cortisone injections are options, but
fortunately, many less invasive therapies exist. You're wise to
question the merits of surgery -- one study indicates that up to one
third of CTS patients who undergo surgery experience a recurrence of
symptoms within two years.

That said, here's the lowdown on alternative and non-surgical
treatments for CTS.

First and foremost, doctors recommend giving the affected wrist/hand a
complete rest for two weeks, preferably by bracing the forearm in a
splint. While you may lose some muscle tone, this can quickly be
regained through exercise. Simple splints can be found at any
drugstore. Heating pads may be applied to soothe the area, unless
there is swelling present -- the heat may encourage the swelling. In
this case, apply an ice pack.

Vitamin B deficiency is thought to be linked to Carpal Tunnel
Syndrome. Consuming vitamin B6, especially in combination with
vitamins B2 and B12, is widely touted as an effective remedy for CTS.
It helps to strengthen the sheath that supports the wrist tendon, thus
relieving pain. However, B6 in high doses can pose risks, so proceed
with care. I found the following dosage guidelines at <
http://alternative-medicine-and-health.com/conditions/carpal.htm >:

Take 300 mg. B6 daily for three months, followed by 50-100 mg. daily
maintenance dosage. This can be taken in combination with 100 mg. B2
and 1000 mcg. B12 in sublingual (capsule which dissolves beneath the
tongue) form.
Bear in mind that in can take up to three months to experience the
effects of B6.

Vitamin therapy is one of the most commonly recommended natural
therapies for CTS, but it is by no means the only one. All of the
following have proved effective in treating cases of CTS:

1. Massage. Used for many types of repetitive strain injury, massage
stimulates blood flow to the affected muscles and increases the range
of motion.

2. Acupuncture stimulates endorphin release, relieving pain. Many CTS
sufferers have found it extremely helpful. If you're averse to
needles, many practitioners now employ painless laser acupuncture,
which is just as effective as the traditional approach.

3. Chiropractic therapy can be of help if the CTS symptoms relate to
pinched nerves.

4. Physical therapy, the manipulation of the affected joints, can be
quite helpful, but only after the condition has been stablilized.

5. Osteopathy -- Osteopaths examine the body from a holistic
perspective, recognizing that problems in the forearm can stem from
problems originating in the back, neck, and/or shoulders.

6. Bromelain (Bromelian) is a natural enzyme found in pineapples. It
acts as an anti-inflammatory.

7. Yoga helps to stretch and strengthen muscles and tendons, and many
CTS patients have found it to be enormously beneficial to their
condition.

8. Other recommendations include cutting down on or eliminating
saturated fats, fried foods, and refined sugars, folic acid
supplementation, and undertaking a homeopathic full-body cleansing
regime. You could even try a device such as Armaid <
http://www.armaid.com/html/shop.php3/index.html >, a splint-type unit
which stimulates and massages the forearm.

Finally, you may find cognitive therapy helpful in managing the
emotional side-effects of CTS -- pain-related depression and anxiety.
Cognitive therapy essentially helps you to change the way you think
about pain. You can also visit the HealthCite.com Carpal Tunnel
Syndrome Message Board at
< http://eckerd.healthcite.com/Frame?return=%2FHealthReview%2Fp5221.html&url=http%3A%2F%2Fwww.healthboards.com%2Fcarpal-tunnel-syndrome%2F
>.

The following sources helped me find your answer:

Carpal Tunnel Questions and Answers -- Alternative Treatments
< http://www.carpal-tunnel-questions-and-answers.com/html/other_forms_of_treatment.html
>

What are nonsurgical treatments for carpal tunnel syndrome?
< http://www.ucdmc.ucdavis.edu/health/a-z/34CarpalTunnel/doc34nonsurgical.html
>

HealthCite: Carpal Tunnel Syndrome
< http://eckerd.healthcite.com/HealthReview/p5221.html#5227 >

You may find the following links useful:

Stretches for CTS
< http://www.carpal-tunnel-questions-and-answers.com/html/stretches_to_do_at_home.html
>

Alternative Aids for Carpal Tunnel Syndrome
< http://www.taoherbfarm.com/herbs/herbs/carpaltunnel.htm >

Bromelain information page
< http://www.anyvitamins.com/bromelain-info.htm >

All about carpal tunnel and alternative treatments 
< http://alternative-medicine-and-health.com/conditions/carpal.htm >

Carpal Tunnel Syndrome 
< http://www.onlinepharmacy.com.au/AilmentsandDiseases/carpal_tunnel_syndrome.htm
>
Includes directions for creating a ginger compress and homeopathic
compound recommendations for CTS

I hope you'll find these options worth exploring, and hopefully find
one or more that work for you. Please note that you should always
consult a medical professional prior to embarking on any new form of
treatment.

Wishing you health and prosperity,

Emjay-ga

Very pleased, I never knew that so many non-surgical were available to
me to look into, I am very happy to be able to read about and possibly
try all the different methods offered here by the researcher, thanks
so much for the fast help.

When you are through trying all of the above, and if you still have
symptoms (which is reasonably likely) you should know that the
surgery, as these things go, is relatively minor, simple, safe, and
highly effective.

My doctor says that with the surgery they only do one hand at a time,
and it can take 6 weeks to recover from each hand. My job is driving,
I need my hands to manage the wheel. I cannot afford to take off 12
weeks unpaid from work for this type of operation, and it's apparantly
not uncommon for the carpal tunnel to return within 2 years of
surgery. I just want to make sure I try everything else possibly
treatment available before going under the knife and giving up 3
months of income.

If your problem is felt to be work-related, you may qualify for
compensation through your state's labor and industry program. Also,
it's a bit long to need six weeks of recovery; it depends somewhat on
how the surgery is done. It can be done with a scope and tiny
incisions, which usually takes a lot less time for recovery. If your
surgeon isn't familiar with that technique, you might consider
gettting another opinion. There are hand specialists in most cities.

I have a similar but different problem, ie same symptoms but on the
other side of the hand, therefore associated with a different nerve. 
I am managing to control it with chiropracty, some extra pressure
point treatment by a "sadistic friend" (not really, because it's
helping, but it feels like sadism at the time :) ) and care about how
I work.  I have installed voice recognition software to reduce the
time I spend keyboarding.  Three months ago, I was weeping at my desk
some days because of the pain, but since finding an appropriate
chiropracter I have had no pain at all, although the tingling and
numbness is still present to some extent.  I am also taking B-complex
vitamin supplements.

I would not contemplate surgery for myself.  I have read too many
accounts of it going wrong or having little permanent effect.

Of course, what works for me might not work for you.  One thing I have
found is that driving does increase the tingling and numbness, and I'm
now trying to pay attention to how I hold the wheel, try to avoid
tensing etc.

It's not caused by the job, as I have experienced this before on and
off in my life before I got this job, but since this driving job, it's
gotten worse 10 fold, the repetitive driving every day has made any
past experience with carpal tunnel seem like nothing compared. I'm in
daily agony. Anyhow, just wanting to be as educated as I can about
treatments since this is such a big thing controlling my life and I
want to do every thing I can to learn about my options to treat it. I
had also asked another question which was answered about long term
ibuprofen use to make sure that was okay, as ibuprofen helps a bit to
curb the nighttime waking from the pain. I'm afraid of surgery, will
try all other options before researching that avenue.

Hello mmo,

I answered the ibuprofen question for you. I'm also trying to learn
about RSI to help myself. One thing I have found is that the trouble
can originate not only in the hand and wrist itself, but also in the
elbow or around the neck/armpit area - the nerve can be being
compressed in any of these areas.  That is one of the reasons why
carpal tunnel surgery does not work in all patients - they have been
treated for the wrong condition!!!  So one thing that might be worth
trying making sure that all possibilities have been investigated fully
and with an open mind by whoever is treating you.

Trigger point therapy amd stretches can help.  You can be taught to do
these for yourself, and so use them for relief as needed.  Doing
trigger point therapy on yourself is possible only if you can stand
self-infliction of pain! :)  There is a book published on
self-treatment of trigger points, but I think it is more useful to
have someone show you on your body exactly where you need to press. 
If you want to explore this option, you will need to find a
physiotherapist or chiropractor who has had some training in these
matters.

Posture is important. Look at the way you drive.  Is your back
properly supported?  How does your neck feel?  Are your hands and arms
tense?  Is any other part of your body tense, for example do you find
you clench your teeth when you drive?  Learn to recognise how a
relaxed muscle and a tense muscle feels, and then try to look at
yourself at random moments in the day and analyse what is going on in
your body.  A good back rest might be useful.  Some people find wrist
wraps or splints help, but you must not overdo these as they can cause
muscle wasting. I've also seen suggestion that a soft steering wheel
cover and/or the use of gloves while driving can help.  I hope you are
able to take frequent breaks!

emjay has given you loads of URLs to investigate.  I'm adding a rather
controversial one: http://www.rsiprogram.com/   It does promote a book
"Jack had surgery for computer-related RSI and his symptoms came back
in 3 weeks. Suparna helped him control the problem. This site helps
promote our book", but it also has links to a lot of interesting
information.  It is biased to computer-induced RSI, but I think that
the points being made are more widely applicable. I also found this
information about driving and RSI
http://swiftek.modwest.com/rsi/basics/driving.html.

What I've found most encouraging in my own searches on this topic is
how many people are managing to control their symptoms, and even reach
a point of having no symptoms.  This really seems to be an area where
self-help can achieve a lot.

Best of luck to you, in hope that you can beat this

There is a study on serratio peptidase (an enzyme manufactured by the
silk worm)

Since it has no side effects, should be good to try. Depending on
where you live you should be able to get it. If you are in North
America, here is a chemist who should know   tedscharf@hotmail.com  
If in Europe, it is called Aniflazyme (made by Danzen in Japan).

A Preliminary Trial of Serratiopeptidase in Patients with Carpal
Tunnel Syndrome
A Panagariya, AK Sharma
Dept. of Neurology, SMS Medical College and Hospital, Jaipur. 

Received : 30.12.1997; Revised : 18.6.1998; Accepted : 9.8.1999


ABSTRACT
•
Objectives : This study was planned to assess the response of
serratiopeptidase in patients with carpal tunnel syndrome (CTS).
•
Methods : Twenty patients with CTS were evaluated clinically. After
baseline electrophysiological studies, these patients were given
serratiopeptidase 10 mg twice daily with initial short course of
nimesulide. Clinical and electrophysiological reassessment was done
after 6 weeks.
•
Results : Mean age was 43.9 years with male to female ratio of 1:2.33.
Sixty five percent cases showed significant clinical improvement which
was supported by significant improvement in electrophysiological
parameters. Recurrence was reported in four cases. No significant side
effect was observed.
•
Conclusions : Serratiopeptidase therapy may proved to be a useful
alternative mode of conservative treatment. Larger study may be
further helpful to establish the role of serratiopeptidase in CTS.
(JAPI 1999; 47 : 1170-1172)

Two things:

Flextend
www.flextend.com

Cold laser therapy
http://www.wten.com/Global/story.asp?S=1562553

My doctor had me try Nerve Formula which helps repair the nerves that
are causing the inflamation.  It took me about 2 months to feel
results.  But it helped more than the ibuprofin because it stopped the
inflammation by healing the nerve and helping repair the tissue.  Its
all natural and I found it to work well.  I found it at
www.trivita.com/products.asp?prodid=1043

mmo you like many others are struggling with CTS and the limited
options for effective treatment.  There are over 8 million people
suffering from chronic CTS and the 27 million suffering from mild
symptoms of CTS in the USA, with 800,000 new cases of chronic CTS
diagnosed each year.   So you are not alone in seeking a new solution.
300,000 undergo surgery every year with marginal results.  There is a
new product many CTS sufferers are finding helpful called the Hand
Restorer.  It is designed for self application at home to relieve pain
associated with Carpal Tunnel Syndrome (CTS) and restore full activity
to the hand. People suffering from CTS now have a non-invasive, self
treatment alternative that costs less than the co-pay associated with
a few doctor?s visits or physical therapy.  The product is much more
convenient, requires significantly less time at doctors offices,
clinics and hospitals and eliminates the personal risks associated
with surgery.  It also allows people to return to work and restore
their earning power more quickly than with the previous offerings.

Self applied and worn at night while sleeping, the product gently
decompresses the soft tissue in the base of the hand around the Carpal
Tunnel and relieves pressure on the Median Nerve.  While the hand is
completely relaxed, the simple product reshapes the soft tissue
sufficiently to relieve pain, eliminate sleep disruption common with
CTS and restore the hand to full activity.  In mild cases that are
caught early, measurable progress is felt by the person within the
first day of treatment.  In chronic cases of CTS, home treatment can
take up to 5 to 7 days for significant improvement.  Treatment at
night allows hands to be active during the day creating an effective
rhythmic therapy which prevents muscle atrophy.

http://www.handwristrestorer.com/

The Hand Restorer was developed with state-of-the-art polymer
technology by a physician/inventor in the Eureka Medical Inventor
Network and identified by Eureka?s distinguished Medical Advisory
Board as a breakthrough treatment for CTS
(http://www.eurekamed.com/advisory-board.html).

The current medical standard for treating CTS offers two conservative
treatment options with poor prognosis. Symptoms recur in 80 percent of
patients with conventional treatments.  Surgery is recommended when
chronic CTS does not respond to conservative measures.  Surgery offers
only marginal results.

Conservative Treatments:
1-	Wrist supports may be helpful, but can result in muscle atrophy and
other complications.
2-	Oral corticosteroid therapy and local corticosteroid injections can
offer short-term relief.

Surgery is done under anesthesia through an incision on the wrist, the
carpal ligament is severed to relieve the pressure on the nerve. The
incision is sutured closed with the expectation that the ligament
tissue scars back together over several months creating more space.
?	Cost of surgery and rehab is $4,000 to $10,000 with improvement
achieved in 85% of cases.
?	 Full restoration is achieved in less than 70% of surgeries.  
?	Often workers have to transfer to new jobs or adjust activities at
work even after surgery.
Symptoms can reoccur within a few years.

(Treatment options based on peer reviewed article:  Management of
Carpal Tunnel Syndrome by ANTHONY J. VIERA, LCDR, MC, USNR, Naval
Hospital, Jacksonville, Florida in American Family Physician, July 15,
2003 Issue.)

Try the Hand Restorer ---It will put you in control of your symptoms. 
Good Luck!  Let me know how it works.