To Your Health

Q. I have recently begun to suffer what my doctor diagnoses as carpal tunnel syndrome, apparently connected with long hours at my computer keyboard. I am now wearing a "splint" and have changed my keyboard, but would like to do more. What nutrients might help?

A. Carpal tunnel syndrome has gained a lot of attention over the past decade, partly because of so many complaints from computer users. However, this problem was noticed long before computers became almost universal. It results from any of several situations in which the hand or wrist is overused or poorly positioned while being used.

The carpal tunnel is a passageway through the wrist that protects the nerves and tendons that serve the hand. The passageway is narrow and some nerves and tendons are very close together. When one of the tendons is overworked it becomes inflamed and swollen, and a nerve, usually the median nerve, is compressed in the carpal tunnel. This compression of the median nerve produces numbness in the thumb and all the fingers except the little finger and perhaps part of the fourth finger. There may also be shooting pain up the arm or down into the hand. The pain or numbness is frequently worse at night. Although it may develop in any person and at almost any age, the problem is more frequent in women past age 50.

Studies conducted and published back in the 1970s reported that many people with carpal tunnel syndrome were deficient in vitamin B-6, and vitamin B-6 supplementation frequently enabled people to avoid surgery. The physician who pioneered this work, John Ellis, M.D., in Mount Pleasant, Texas, reported that 100 to 200 mg daily of vitamin B-6 for three months helped about two-thirds of the patients. Laboratory determination of vitamin B-6 status usually confirmed the clinical experience that vitamin B-6 worked.

Another study reported that a patient with a three-year history of carpal tunnel syndrome was found by laboratory tests to have a vitamin B-2 deficiency. This is reasonable since vitamin B-2 is required to "activate" vitamin B-6. Combined supplementation with vitamin B-2 and vitamin B-6 resulted in a complete disappearance of the patient's carpal tunnel syndrome.

Although there are no clinical trials using omega-3 fatty acids for the treatment of carpal tunnel syndrome, an understanding of the anti-inflammatory activity of omega-3 fatty acids suggests that they might provide some benefit. Omega-3 fatty acids are made into anti-inflammatory prostaglandins and these have proved very useful in other conditions where inflammation is a big part of the problem. Fish oil at 2 to 3 grams per day would be worth a try. When taking omega-3 fatty acid supplements, it is advisable to also take at least 400 IU of natural vitamin E per day.

Although not a nutritional remedy, scientific studies have also shown that using a specialized wrist rest while working at a computer keyboard will significantly reduce strain on the hands and reduce the incidence of carpal tunnel syndrome.

Carpal tunnel may be another of the "diseases of civilization" that are increasingly a sign of our technology-based society, but hopefully other technology, in the form of better nutritional awareness, will provide an answer to this problem.