Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Kathi Keville is a California herbalist whom I like and respect. Like me, she often spends days chained to her computer. Unlike me, she developed carpal tunnel syndrome (CTS), caused by compression of the nerve that passes through the "tunnel" formed by the wrist bones. The symptoms of CTS are pain, weakness, finger stiffness and a pins-and-needles sensation.

As Keville's CTS went from bad to worse, she had to give up her massage practice and stop playing the recorder because she lost so much sensation in her fingers. She could barely finish typing the manuscript for her book, The Illustrated Herb Encyclopedia. Finally, her CTS got so bad that she lost the ability to turn the doorknob to her house.

That's when Keville got a gentle reminder from an herbalist friend about practicing what she preached. She adopted an aggressive natural healing
program. She consulted an excellent osteopath, who manipulated her wrists and encouraged her to exercise, use more herbs and manage her stress more effectively. She received regular massages with relaxing aromatherapy oils. She took her own herbal nerve pain formula and also slathered liberal amounts of herbal oils on her wrists throughout the day.

Her recovery was slow, but she did recover, and without the wrist surgery that is frequently performed for CTS.

Repetitive Movements Hit Home

I may use a computer as much as Keville, or even more--sometimes as much as 14 hours a day. Why haven't I developed CTS?

Being a man is certainly a factor. Women develop carpal tunnel problems more than men do because the cyclical hormone fluctuations of the menstrual cycle, pregnancy and menopause can contribute to swelling of the tissues surrounding the carpal tunnel. But I also think my hand exercises have something to do with it. Adopting a Chinese technique that improves flexibility, I hold two steel balls in one hand and roll them around when I'm not typing. The Chinese balls provide a gentle form of exercise, and the rolling motion massages the tiny muscles and ligaments of the hands and wrists. When I'm at the computer, I take frequent breaks to twirl the Chinese balls in each hand.

Carpal tunnel syndrome is considered a repetitive motion injury--cumulative trauma associated with constant rapid use of the fingers (low-intensity, high-frequency finger work). CTS has been around for decades, the occupational hazard of bookkeepers and supermarket checkout clerks who punched buttons all day long. But it did not become a household word until the 1980s, when personal computers came to dominate so many workplaces. Suddenly millions of people's jobs required the kind of steady, rapid finger movements that can cause repetitive motion injuries like CTS. It is also a problem for some musicians, factory workers and other people who must constantly use their hands.

Green Pharmacy for Carpal Tunnel Syndrome

Fortunately, there are quite a few herbs that can help alleviate this problem.

Willow (Salix, various species). Willow bark, the original source of aspirin, contains chemicals (salicylates) that both relieve pain and reduce inflammation. You might also try other herbs rich in salicylates, notably meadowsweet and wintergreen.

With any of these herbs, I'd steep one to two teaspoons of dried, powdered bark or five teaspoons of fresh bark for ten minutes or so, then strain out the plant material. You can add lemonade to mask the bitter taste and drink two to three cups of tea a day. Remember, though, that if you're allergic to aspirin, you probably shouldn't take aspirin-like herbs, either.

Camomile (Matricaria recutita). Camomile tea is best known as a tasty way to calm jangled nerves. But its active compounds (bisabolol, chamazulene and cyclic ethers) also have potent anti-inflammatory action. Camomile is widely used in Europe for many inflammatory diseases. If I had CTS, I'd drink several cups of camomile tea a day.

Camomile Camomile flowers are used to make a sleep-inducing tincture and a tea with anti-inflammatory properties.

Pineapple (Ananas comosus). Pineapple contains a protein-dissolving (proteolytic) enzyme, bromelain, that is often recommended for CTS.

"Bromelain has well-documented effects on virtually all inflammatory conditions, regardless of cause," according to naturopaths Joseph Pizzorno, N.D., president of Bastyr University in Seattle, and Michael Murray, N.D., co-authors of A Textbook of Natural Medicine. "Bromelain can reduce swelling, inflammation and pain. Bromelain is extremely safe to use. In human studies, very large doses (nearly two grams) have been given without side effects."

Naturopaths suggest taking 250 to 1,500 milligrams of pure bromelain a day, between meals, to treat inflammatory conditions such as CTS. Bromelain is available at many health food stores. Since I favor food sources, however, I prefer to get my bromelain from pineapple itself. Ginger and papaya also contain helpful proteolytic enzymes. You might enjoy a Proteolytic CTS Fruit Salad composed of pineapple and papaya and spiced with grated ginger.

Red pepper (Capsicum, various species). Also known as cayenne, red pepper contains six pain-relieving compounds and seven that are anti-inflammatory. Especially noteworthy is capsaicin. Commercial salves containing capsaicin, such as Zostrix and Capzasin-P, are widely used to treat pain.

I would try this herb if I had CTS. You might add several teaspoons of powdered cayenne to a quarter-cup of skin lotion and rub it on your wrists. Or you could make a capsaicin lotion by steeping five to ten red peppers in two pints of rubbing alcohol for a few days. Just wash your hands thoroughly after using any topical capsaicin treatment, as you don't want to get it in your eyes. Also, since some people are quite sensitive to this compound, you should test it on a small area of skin before using it on a larger area. If it seems to irritate your skin, discontinue use.

I'd also suggest adding a few drops of lavender oil to your red-pepper salve. Lavender oil is a mainstay of aromatherapy, useful for treating inflammation and burns. Its aroma is also quite relaxing, which helps when you're feeling the pain of CTS.

Turmeric (Curcuma longa). This herb contains curcumin, a potent anti-inflammatory chemical. Some studies suggest that curcumin is only about half as effective as the pharmaceutical anti-inflammatory medication cortisone, but consider that cortisone is expensive and can have nasty side effects. Turmeric is much easier on the system and the pocketbook, not to mention a lot tastier.

Naturopaths suggest taking 250 to 500 milligrams of pure curcumin a day, between meals. Dried turmeric contains about 1 to 4 percent curcumin, so to get the dose that naturopaths recommend, you would have to consume 10 to 50 grams (5 to 25 teaspoons) of dried turmeric. That's a lot more than even I would add to a curried rice dish. Instead, try using turmeric liberally on food and then taking some more in capsules.

comfrey (Symphytum officinale). My good friends, pharmacognosist (natural product pharmacist) Albert Leung, Ph.D., and noted Arkansas herbalist and photographer Steven Foster, in their excellent Encyclopedia of Common Natural Ingredients, explain that applying comfrey to the skin can help relieve pain, swelling and inflammation. This has been confirmed through studies using laboratory animals. The active compounds are allantoin and rosmarinic acid.

comfrey has gotten a lot of bad press in recent years because it also contains pyrrolizidine alkaloids, compounds that may cause liver damage when the herb is ingested. But there's no evidence that comfrey is risky when applied to the skin, which is what I would suggest for CTS (and arthritis). Add a few teaspoons of dried, powdered comfrey to the recipe mentioned above for red pepper or to any favorite skin cream.

Cumin (Cuminum cyminum). Cumin is used liberally in Mexican foods. My former U.S. Department of Agriculture colleague, molecular biologist Stephen Beckstrom-Sternberg, Ph.D., and I once studied the properties of this spice and discovered three pain-relieving compounds, seven that are anti-inflammatory and four that combat swelling. If I had CTS, I'd use lots of cumin on food and add it to my curried rice.

Sage (Salvia officinalis). Dr. Beckstrom-Sternberg and I identified six anti-inflammatory compounds in sage. If I had CTS, I'd use this spice liberally in all sorts of foods, not just turkey stuffing.

Foods high in vitamin B₆. Naturopaths suggest getting 40 to 80 milligrams of vitamin B₆ twice a day to treat CTS. In one study of people with this condition, two-thirds of those using this amount of B₆ reported improvement.

Foods high in B₆ include cauliflower, watercress, spinach, bananas and okra. It would be difficult to get enough B₆ to treat CTS solely from food. If you have this condition, you might consider a supplement. The Daily Value is only 2 milligrams, however, and getting too much of this vitamin has been linked to nerve disorders. If you'd like to try this therapy, please discuss it with your doctor.