What makes your foot go numb when you sit too long with your legs crossed? Bad circulation, right? That’s why it helps to stand up and stomp the pins and needles out. It gets the blood moving again. What’s really going on doesn’t have anything to do with blood flow, though. The numbness occurs when a nerve, not a blood vessel, is compressed. That’s the same thing that happens—in a different part of the body, of course—when someone has carpal tunnel syndrome (CTS).
Instead of being compressed by a weight, the median nerve that runs to your thumb and first two fingers is constricted when your body’s tendons and tissues swell and press against it. The nerve and the nine tendons that move your fingers are encased in a sheath called the synovium, making a sausagelike bundle that passes through the bony, hourglass-shaped passageway on the underside of the wrist that’s known as the carpal tunnel.
When you’re doing things like typing or bowling, the repetitive motions of your hand and wrist can cause the tendons and synovium to become inflamed and swollen. Even slight swelling in the wrist area can press the nerve enough to short-circuit the signal.
Women, especially pregnant women, are more prone to CTS than men. Regardless of your sex, however, you’re at greater risk for CTS if you’re overweight and if you don’t exercise very much. Women’s risk is also increased by taking oral contraceptives and during menopause.
The first symptoms of CTS aren’t that far removed from the sensation you get in your foot when it "falls asleep." You may experience tingling, numbness, or pain in the hand and fingers, especially in the thumb and first two fingers. The more you use your hand, the more it will hurt. As the condition progresses, your hand can become so weak that you can’t even grip a glass. For severe cases like this, a doctor may recommend surgery to relieve pressure on the entrapped nerve.
Naturopathic doctors recommend that you first take steps to avoid surgery by working on the mechanical problem of CTS as well as taking supplements. You may be able to get relief and reduce inflammation right away with simple measures like splinting your wrist in a neutral position and altering your activity. You can also use heat and cold to help relieve your symptoms.
In addition you’ll probably want to try some of the supplements that can help. Here are some vitamins and herbs to soothe and heal the irritated nerve.
Vitamin B6 Gets a Boost
Vitamin B6 seems to help relieve the symptoms of CTS, says Jill Stansbury, N.D., assistant professor of botanical medicine and chair of the botanical medicine department at the National College of Naturopathic Medicine in Portland, Oregon.
While doctors aren’t sure why this supplementation works, some speculate that CTS is actually caused by a deficiency. Although you can get B6 pretty readily from everyday foods like potatoes, brown rice, bananas, green vegetables, and chicken breast, the average diet doesn’t usually provide the Daily Value of two milligrams.
Also, the content of your diet doesn’t really tell the whole story when it comes to CTS. Low levels can be caused by other factors, says Dr. Stansbury. "Some people may just need more of this vitamin because they use more up," she says. "Stress is one factor that can increase your need for B6 as well as other B vitamins."
Researchers hit on the link between low levels of this vitamin and CTS in the late 1970s. One early study found that 22 of 23 people who took between 50 and 300 milligrams of B6 for 12 weeks got complete relief from pain and tingling in their hands. How this happens is still a bit of a mystery, says Dr. Stansbury.
The problem is that B6 has so many roles in the body that doctors have had difficulty pinpointing any one key action that could have a direct effect on the carpal tunnel area. Like other B vitamins, B6 works with enzymes, the chemicals that spark reactions in your body. It is an essential part of many chemical reactions involved in the body’s production of energy, protein, and fats. "It gets around," says Dr. Stansbury. While that emphasizes the fact that we really need this vitamin, however, it doesn’t say anything about the direct role that it plays in helping to relieve CTS.
Vitamin B6 seems to work best on mild to moderate cases of CTS, says Thomas Kruzel, N.D., a naturopathic doctor in Portland, Oregon. To end the tingling, take 50 milligrams of B6 each day, he suggests, and give it time to work. It usually takes 12 weeks to get the full benefit.
You can boost the healing power of B6 by taking at least 10 milligrams of riboflavin along with it, says Dr. Kruzel. The riboflavin seems to improve the effect by converting B6 to a more active form that is essential to more than 60 chemical reactions in your body.
An Herb with Nerve
Widely known for its ability to treat depression, St. John’s wort also helps nerves recover when they are damaged, inflamed, or strained, says Dr. Stansbury. Thousands of years before doctors coined the term carpal tunnel syndrome, the relaxing herb was used to heal nerve pain and tingling, she says.
For the squeezed median nerve, St. John’s wort helps in two ways. Its sedative effect helps to reduce pain, while its anti-inflammatory activity can help shrink swollen tendons. Don’t expect the kind of quick pain relief that comes from popping a pharmaceutical like aspirin or ibuprofen, though; St. John’s wort typically takes a few weeks to start working.
Start out with 150 to 250 milligrams of extract standardized to 0.3 percent hypericin three times a day, says Dr. Stansbury. You should start to see some improvement in about two weeks. If you don’t, take a little more, she says—300 to 400 milligrams three times a day.
While St. John’s wort is generally very safe, pregnant women should not take it without a doctor’s okay.
Some Wrist Action for Pineapple
When it comes to inflammation, sometimes your body just doesn’t know when to stop. With CTS, you need to reduce the inflammation in the swollen tendons and synovium in order to relieve the pain. Pharmaceutical anti-inflammatories like aspirin or ibuprofen might be all you need, but some people find that they experience side effects from these drugs, particularly upset stomach and ringing in the ears.
For relief with fewer side effects, you have the option of trying some supplements that can be very effective. One of these is bromelain, an enzyme found in pineapple that is nature’s anti-inflammatory medicine. This hungry enzyme can take a bite out of pain and swelling and help you heal faster, says Dr. Kruzel. Just be sure you don’t blunt its effect by taking it with meals. If you do, all of its enzymatic energy is just digested. If you take it between meals, however, it goes to work digesting the products of inflammation.
When the tingling pain of CTS strikes, take two 500-milligram tablets or capsules of bromelain between meals two or three times a day, says Dr. Kruzel. Bromelain is measured in milk-clotting units (mcu) or gelatin-dissolving units (gdu). The higher the number, the greater its potency. Look for a supplement with a strength between 1,800 and 2,400 mcu or 1,080 and 1,440 gdu in each capsule.
Pouring On the Flaxseed Oil
You can also soothe the inflamed nerve and tissues with flaxseed oil, a supplement rich in omega-3 essential fatty acids, says Ellen Potthoff, D.C., N.D., a chiropractor and naturopathic doctor in Pleasant Hill, California. Any type of inflammation responds well to essential fatty acids because no matter where it hurts, they interrupt the process of inflammation early.
You should feel better in two to four weeks if you start taking one tablespoon of flaxseed oil every day, says Dr. Potthoff. Taste is one way to tell if you’re getting good-quality flaxseed oil. "It should have a really nice, nutty flavor and a dark amber color," she says.
The Power of Turmeric
Turmeric is an herb that contains a powerful anti-inflammatory chemical called curcumin. The herb has traditionally been used in India’s Ayurvedic medicine to treat pain and inflammation.
The effect of turmeric has been compared to that of cortisone, the pharmaceutical sometimes used to treat CTS symptoms. Although turmeric’s pain-fighting power is not as strong as cortisone’s, the herb is a lot easier on your system, says Dr. Kruzel.
Turmeric’s action is similar to that of bromelain. For some relief, opt for capsules of the standardized extract. Unlike the turmeric on your spice shelf, the capsules contain 95 percent pure curcumin.
Dr. Kruzel gives people with CTS 250 to 500 milligrams of curcumin a day. Keep taking this dose until the inflammation has been reduced, he advises, then take half that dose for one to two weeks until your symptoms are gone.
If the symptoms return, repeat with the high dose and return to the lower dose again after they improve. Do not use turmeric supplements without talking to your doctor, especially if you are pregnant.
You might also consider adding bioflavonoids to your supplement arsenal, suggests Dr. Potthoff. Rich in powerful antioxidants, bioflavonoids are used to treat injuries because they relieve pain and promote healing, she says. She recommends taking 1,000 milligrams of a broad-range bioflavonoid supplement that contains citrus bioflavonoids and quercetin three times a day.
