Because the initial symptoms of carpal tunnel syndrome are bothersome but may not be dangerous, it's possible to treat the condition with things short of surgical remedies. Positioning of the rest, especially in prolonged flexion, can precipitate symptoms, especially when we sleep at night and we're not conscious of where our risks are. Therefore, wearing a brace on the wrist to keep the wrist in a neutral position can often be the first line of defense in treating those initial symptoms. It can certainly help people sleep more comfortably at night without that troublesome numbness and waking frequently throughout the night. In addition, there are other treatments that your doctor can prescribe for you. One of them is physical therapy. Therapy can help to encourage mobility in the nerve and the tendons through the carpal tunnel and relieve swelling and adhesions. So therapy is often another first line of treatment for early carpal tunnel symptoms. Acupuncture has been shown to be of benefit in certain patients with carpal tunnel syndrome. It's not always helpful and it may be worth trying if your symptoms are initially mild and intermittent. Once patients have more profound and continuous symptoms, and especially if they start to experience some weakness in the muscles or pain associated with carpal tunnel syndrome, then medical treatment is really indicated. We often prescribe and perform steroid injections into the carpal tunnel, which helps to shrink swelling around the nerve and relieve pressure inside the tunnel. Studies have shown that on average, that provides somewhere between 6 and 12 weeks of symptom relief for people with carpal tunnel syndrome. However, that symptom relief is temporary and it's typical that the symptoms will gradually return and likely progress. So steroid injections are a good way to manage progressive symptoms, but do not offer a cure. When noninvasive remedies such as splinting and therapy, and sometimes a steroid injection have offered temporary relief, but the symptoms are returning and progressing, that's the time to consider more aggressive treatment. That treatment eventually leads to surgical release of the carpal tunnel or carpal tunnel release.
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