Peter Amadio, M.D., a Mayo Clinic hand surgeon

The most important nonsurgical treatment is looking at the activities that you're doing and making sure you are not doing any of these awkward activities with the wrist bent, strong pinching, strong gripping, that might predispose or aggravate people to have carpal tunnel syndrome. After the activity modifications, it's important for people to remember to take frequent rest breaks, perhaps five minutes every hour. Do something a little bit different (with their hands) to give their hands a chance to get some more circulation back as they are doing activities throughout the day and to vary activities as much as you can throughout the day. So activity modification is very important.

After that, splinting is very helpful, especially at night. Many people wake up in the middle of the night with their hands numb and tingling. It's a very common symptom of carpal tunnel syndrome. That symptom can often times be controlled by wearing a brace on your wrist at night. Wearing a brace during the day usually just makes you do things differently and may actually aggravate the symptoms of carpal tunnel syndrome because you're doing things in a more awkward fashion. But at night, splinting can be very helpful. The other time that splinting is useful is when you're driving a car or something like that where you are doing prolonged gripping, and again, the splint helps to hold your wrist in a straighter position that can be helpful.

The third nonsurgical treatment that is particularly effective is a cortisone injection into the wrist. We don't know exactly how it works, but it does seem to provide at least temporary relief in almost everybody with carpal tunnel syndrome, and then (in) about a third of people, it can provide quite long-lasting relief.

So, activity modifications, splinting at night, and cortisone injections are the main nonoperative treatments that help. Vitamins, anti-inflammatory medications, fluid pills of those natures don't appear to be as effective.

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