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CARPAL TUNNEL SYNDROME

BACK IN THE DAYS BEFORE COMPUTERS, carpal tunnel syndrome seemed to happen only to dairy farmers and needleworkers. Now that so many of us are 'mousing and keyboarding' for hours on end this disorder of a nerve in the wrist affects thousands of people.

Carpal tunnel syndrome, a type of repetitive strain injury (RSI), involves the compression of the median nerve, which passes between the bones and the ligaments of the wrist through what is called the carpal tunnel. When this nerve is repeatedly compressed, it can react by swelling. Typical symptoms include a tingling feeling in affected fingers, weakness, pain upon gripping, shooting pains that go into the fingers or up into the forearm, a sensation of tingling when the wrist is tapped or increased pain at night, especially if the wrists are bent. The thumb and any of the next three fingers might be affected. The disorder can occur in one or both hands.

Hairstylists, carpenters, food-service workers and anyone else who uses repetitive hand motions in their work may also be at risk. Even pregnancy may play a role because of the fluid retention that mothers­to-be experience. Sometimes the tendons of middle-aged women thicken, narrowing the tunnel and causing pressure on the nerve.

If carpal tunnel syndrome is severe enough, doctors may use a steroid injection to alleviate inflammation, although this approach doesn't cure the condition. Sometimes the only course of treatment is surgery to free the affected nerve.

SUPPLEMENTS FOR SUPPLENESS

If you're at risk for developing carpal tunnel syndrome, you may want to check your intake of the following nutrients:

Vitamin B6. Clinical data strongly suggest that a vitamin B6 deficiency may contribute to carpal tunnel syndrome. While 25 milligrams of vitamin B6 is considered adequate, some treatments for carpal tunnel syndrome involve taking 200 milligrams for two or three weeks, then half that dose for another one or two weeks. Results are not usually seen for a month or sometimes six weeks.
Caution: discuss your dosage with your doctor, because high doses of vitamin B6 can be toxic. This vitamin also works best in combination with others, so a doctor's advice is doubly crucial.

Vitamin C with bioflavonoids. This broad-spectrum nutrient is vital to tissue repair and healing, and it can contribute to reducing inflammation. Vitamin C also plays a significant role in connective tissue regeneration.
Typical dosage:
1,000 milligrams with each of three meals.

Bromelain. Anyone who requires surgery for carpal tunnel syndrome should take bromelain for its ability to lessen swelling and inflammation. If you choose not to undergo surgery, bromelain helps prevent further tissue inflammation.
Typical dosage: 500 milligrams one to three times daily.

Grapeseed extract. Also known as pycnogenol, this compound contains powerful compounds that inhibit swelling and inflammation. Added benefit: it's good for your heart.
Typical dosage: 500 milligrams two or three times per day.

DRUG TREATMENT

Anti-Inflammatories
Ibuprofen, naproxen.
Function: reduce inflammation and swelling by blocking the production of compounds called prostaglandins.
Side effects:
gastrointestinal problems such as stomach ulcers and bleeding, constipation, heartburn, dizziness, kidney and liver damage.

Diuretics
Hydrochlorothiazide (HydroSaluric), furosemide (frusemide; Lasix).
Function:
force the kidneys to excrete fluids at a higher rate; relieve swelling that can play a role in carpal tunnel syndrome.
Side effects:
an imbalance in body chemistry that can affect bowel and heart function; low blood pressure; elevated blood levels of sugar, uric acid and fats.

HERBAL REMEDIES

Turmeric (Curcuma longa)
This common kitchen spice contains a substance that can lower prostaglandin levels and reduce inflammation.
Typical dosage: one 300-milligram capsule (standardised to 95 per cent curcumin, the active ingredient) one to three times per day; or 10 to 30 drops of tincture up to three times per day; or up to 1 teaspoon of powdered spice per day in food.

Boswellia (Boswellia serrata)
This tree resin can block the production of leukotrienes and prosta­glandins, two body chemicals that favour inflammation. It has long been used in Ayurvedic medicine for various types of joint, nerve and muscle pain.
Typical dosage:
300 to 350 milligrams in capsules two or three times per day (look for products that contain 65 per cent boswellic acid).

Ginkgo (Ginkgo biloba)
Concentrated extracts of compounds from this tree's leaves increase blood flow and reduce swelling. Ginkgo also protects nerves and helps them heal.
Typical dosage: 60 milligrams of extract in capsules or tablets standardised to 24 per cent flavone glycosides, two or three times per day.

CARING FOR HARDWORKING WRISTS

In addition to taking herbs internally, there's a great deal you can do to prevent carpal tunnel syndrome or to treat a mild case before it worsens. You can apply herbs topically, or you can try wearing a wrist splint through the night or while working. Take frequent breaks, stretching your wrist and neck muscles when you do. Many doctors advise consulting a physical therapist for an individually tailored exercise programme that takes into account the severity of your condition. One exercise suggested by the British Physiotherapy Association involves resting your forearm on a table or desk. With the other hand, grab the resting hand's fingertips. Pull back gently for 3 to 5 seconds. Repeat for the other hand.

Other ways to take the burden off your wrists:

Hydrotherapy. Alternating between cold and hot packs may bring some pain relief, although the effect is usually only temporary.

Acupuncture or acupressure. Either technique may help stimulate circulation and relieve pain. Consult a qualified practitioner trained in these disciplines.