Go for the cold. Applying cold packs can help control swelling in the wrists, says Susan Isernhagen, a physical therapist in Duluth, Minnesota. You can buy cold packs in drugstores, or you can make your own by putting a few ice cubes in a plastic bag. Wrap the pack in a cloth and apply it to your wrists for 15 minutes, then remove it for 15 minutes. Continue the 15-minutes-on, 15-minutes-off cycle for as long as necessary.
Slip on gloves. Cold hands mean constricted blood vessels. And constricted blood vessels mean less blood-and nourishment-to overworked hand and wrist tissues. Wearing gloves can help keep your hands warm and increase blood flow. What if you're keyboarding? Just cut off the fingertips of each glove, and you can type with ease.
Invest in a splint. Wearing a splint can prevent you from bending your wrist in ways that aggravate CTS symptoms. In one study of 331 people with CTS, 66 percent got relief with a combination of splinting and taking anti-inflammatory drugs.
A splint consists of a cloth-covered metal brace to support your wrist and Velcro straps for fastening. When you're wearing one, your wrist should be almost straight, in about the same position as when you're holding a pen. This position keeps the carpal tunnel as open as possible.
Splinting works best for people who are under age 50 and who have had CTS for less than 10 months, with only intermittent symptoms. A splint can be worn at night, during the day, or all the time-whenever your pain is worst. You can buy splints in medical supply stores and many drugstores. But check with your doctor to make sure your splint fits properly.
Cut out caffeine. Steer clear of caffeinated foods and beverages such as chocolate, cola, tea, and coffee. Caffeine constricts blood vessels, which reduces blood flow to the hands and aggravates CTS.
Get off your butts. Like caffeine, smoking constricts blood vessels, which impedes blood flow to the hands. And that worsens CTS symptoms.
Over-The-Counter Drugs
Choose an anti-inflammatory. Aspirin, ibuprofen, and naproxen (Aleve) all reduce pain and inflammation. If aspirin upsets your stomach, try the enteric-coated kind. It dissolves in the intestines rather than in the stomach.
What about acetaminophen? It's a pain reliever but not an anti-inflammatory. So it isn't especially effective against inflammatory conditions like CTS.
Other Good Choices
Massage
Let yourself be manipulated. Some people with CTS swear by deep-tissue bodywork targeting their arms, wrists, and hands.
Homeopathy
Try different remedies. According to homeopath Dana Ullman, wrist problems often respond well to microdoses of certain homeopathic medicines. The most effective preparations include Bryonia, Hypericum, Rhus toxicodendron, and Ruta graveolens. Which one will work best for you depends on your individual symptoms, so check with a homeopath.
Naturopathy
Take the plunge. Contrast hydrotherapy, which involves alternately dipping your hands and wrists in hot and cold water, is a favorite treatment among naturopaths. "It's a simple, efficient way to increase circulation to your wrists," says Douglas C. Lewis, N.D., a faculty member at Bastyr University in Kenmore, Washington. "It improves nutrition, eliminates wastes, and helps decrease pain."
Dr. Lewis recommends immersing your hands and wrists in tolerably hot water for 3 minutes, then in cold water for 30 seconds. Repeat three to five times, once or twice a day.
Medical Measures
For especially severe CTS symptoms, some mainstream doctors administer injections of powerful anti-inflammatories called corticosteroids. Unfortunately, this approach doesn't always work. In one study, 78 percent of people with CTS saw their symptoms return within 18 months of receiving corticosteroid injections. What's more, longterm use of corticosteroids can cause serious side effects such as high blood pressure, osteoporosis, and adrenal gland damage.
Surgery is considered a last-resort treatment for CTS. During the procedure, the surgeon removes a portion of the ligament that forms one side of the carpal tunnel. This usually relieves pressure on the median nerve-although in 15 percent of cases, CTS symptoms persist. After surgery, you must wear a splint for 2 to 3 weeks. You may experience swelling at the base of your thumb for up to 4 months. Up to 6 months may pass before your hand strength and endurance return to normal.
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