Conservative treatment
Treating carpal tunnel without surgery
Is there a natural way
to treat my symptoms?
Patients can take a few simple steps to treat their symptoms and find quick relief. This advice is most effective at the earliest stages of the condition.
Icing your hands
You may find your symptoms are less severe when you ice your hands. We recommend wrapping a bag of ice cubes in a dish towel and putting it where you’re feeling pain for 10-minute periods.
Using heat packs
Applying heat may also help ease your symptoms. Products like the Magic Bag are an easy option. You can also submerge your hand in a bowl of hot (but not scalding) water for three minutes. Some patients like switching between heat and cold.
Treating diabetes or hypothyroidism
Diabetes and hypothyroidism are the most common conditions associated with carpal tunnel syndrome. Research has shown that approximately 20% of diabetics and 17% of patients with underactive thyroid glands will get carpal tunnel in their lifetime.
Quitting smoking
Smoking is a carpal tunnel risk factor and can make the condition worse because it affects the supply of oxygen to the median nerve. If you have symptoms of any nerve compression syndrome, quitting smoking is strongly recommended.
Taking painkillers
Over-the-counter analgesics like Tylenol (acetaminophen) or Advil (ibuprofen) can temporarily ease pain. Make sure to consult your doctor or pharmacist if you have any questions about dosage.
Losing weight
In some cases, significant weight loss can make carpal tunnel symptoms go away.
Conservative treatment is effective when symptoms first start.
Are shots helpful?
When administered properly by a specialist, cortisone shots in the carpal tunnel are relatively painless and can temporarily relieve your symptoms. However, repeated shots are not recommended because they can mask lingering nerve compression symptoms, which can get worse under the surface. There is a risk that this could lead to permanent damage.
The risks associated with cortisone shots include injuring the median nerve, weakening tendon tissue, and skin atrophy. Cortisone shots can also lead to permanent skin hypopigmentation, where the skin loses its colour, and even tissue damage. There is also a risk of infection, as cortisone reduces the ability to fight off pathogens. Weight gain is not a side effect of cortisone injections.
Shots into the carpal tunnel can be helpful when your doctor is unsure of your diagnosis. If your symptoms improve, it means the diagnosis is correct, and your doctor can develop a long-term treatment plan. If you don’t see any improvement, even temporary, you probably have a different condition.
Cortisone is a powerful anti-inflammatory medication that, when injected into the carpal tunnel, can reduce the swelling of the flexor tendons that bend your fingers. This reduces the pressure on the median nerve in the tunnel, which relieves the nerve compression symptoms.
Unfortunately, this relief is temporary and usually only lasts several weeks to several months. Cortisone shots should not be repeated to avoid permanent damage.
Do you think you have carpal tunnel syndrome?
Take our diagnostic test
Can wearing a splint help?
Get a resting splint to keep your wrist in a neutral position. You can buy one from your pharmacy, an orthotist, or a specialized occupational therapist. Splints put the nerve in the carpal tunnel in a resting position, which helps avoid increased pressure in the tunnel due to flexing or extending the wrist. A neutral position is better than an extended one.
Splints can be bought pre-made or custom-made from moulded thermoplastic. Patients should wear them at night for four to at most six weeks, then stop to see if their symptoms come back and whether they’re better or worse. If they’re worse, it isn’t recommended to keep wearing the splint without talking to your doctor, as it means the compression is severe and progressing. If you’ve reached this stage, it’s important that you consult a hand surgeon.
What activities should be avoided?
- Repetitive actions: Repetitive actions, like knitting or needlework, are often associated with a higher risk of developing carpal tunnel syndrome.
- Extreme positions: Extreme positions where your wrist is bent or extended (especially combined with physical effort), as well as frequent wrist flexion or twisting can be bad.
- Vibrating tools: Using vibrating tools like sanders, grinders, or jackhammers can put you at risk of developing carpal tunnel syndrome. Using a cane, wheelchair, or crutches also increases this risk.
MEET YOUR HAND EXPERT
A first step towards recovery
Are there exercises for relieving carpal tunnel symptoms?
Certain stretches, like those you might do during yoga, relax and elongate the transverse carpal ligament that makes up the roof of the carpal tunnel as well as the ligaments that connect the bones that make up the tunnel’s floor. The goal of these stretches is to make the tunnel more flexible and reduce local pressure. They are effective for early stages of median nerve compression at the wrist. The goal is to stretch and elongate the nerve, thereby reducing pressure.
Figure 1
Extend your elbow, then fully extend your wrist while also stretching your fingers. Keeping the elbow straight, raise your hand and fingers upward.
Figure 2
Keeping the elbow straight, flex your wrist. Lower your hand toward the ground.
Alternate wrist positions between full extension and full flexion. Do these stretches whenever symptoms appear. You should do them slowly. Count to three before switching to the next full extension or flexion. Do each movement 5 to 10 times.
Figure 3
Do the same movements, this time with your elbow flexed. Bend your elbow 90 degrees (so it forms a right angle), bend your wrist back, and hold.
Figure 4
Maintaining the same elbow position, bend your wrist forward so it looks like the head of a duck.
Key takeaways
_________________
Can carpal tunnel go away on its own?
In some cases, such as after pregnancy, CTS can get better or completely go away on its own. Corrective actions and ergonomic adjustments can also be enough to treat carpal tunnel in its early stages. If symptoms persist or get worse despite conservative treatment, it means surgery is the best solution.
Are carpal tunnel braces effective?
Braces can be effective, as long as you understand their limitations. They should only be worn at night and from four to a maximum of six weeks. If your symptoms come back after you stop wearing the brace, it means the compression is severe and progressing and that you should consult a hand surgeon.
Are cortisone shots recommended?
Cortisone injections, preferably guided by ultrasound, are used to temporarily relieve the pressure inside the carpal tunnel. To avoid potentially irreversible nerve damage, repeated injections are not recommended, as they can mask the signs of nerve compression.
When is surgery needed?
Carpal tunnel release surgery is indicated when conservative treatment fails, or when patients already have a severe, advanced form of the condition.
Practical and comprehensive
medical guide
Everything you need to know to identify and treat Carpal tunnel syndrome. Written in clear and simple language by hand surgeon Dr. Jean-Paul Brutus, this e-guide identifies the causes, symptoms, and different ways to treat CTS and offers recommendations on how to ease your symptoms at home.
