Carpal tunnel syndrome (CTS) is the most common peripheral compressive neuropathy: it affects 3 to 6% of the adult population, with a higher prevalence in women (3:1). It results from compression of the median nerve within the carpal tunnel—an osteofibrous tunnel formed by the carpal bones and the annular ligament of the carpus. The median nerve supplies sensation to the first three fingers and half of the fourth, as well as the thenar muscles (thumb opposition). Its compression causes paresthesias, pain radiating to the hand and forearm, and, in cases of prolonged compression, atrophy of the thenar muscles with loss of grip strength. The diagnosis is clinical and confirmed by electromyography. Treatment is managed by a physician or surgeon, depending on the severity.
Several factors increase the risk of CTS:
Characteristic early signs include nocturnal paresthesias in the first three fingers (waking up and shaking the hand), numbness while driving or talking on the phone, and a decrease in fine sensation. These symptoms should prompt a medical consultation.
Vitamin B6 (pyridoxine) is the most widely studied supplement for carpal tunnel syndrome. Studies have suggested a possible benefit in patients with a documented B6 deficiency (50 to 100 mg/day), but recent systematic reviews show mixed results, and the evidence remains insufficient for a formal recommendation. An important caution: doses exceeding 100 mg/day over several months may paradoxically cause sensory neuropathy. Vitamin B12 (methylcobalamin) is a cofactor in the myelination of the median nerve, and its deficiency exacerbates neuropathic sensitivity. These supplements should be discussed with the treating physician.
Magnesium modulates NMDA receptors involved in central sensitization to chronic neuropathic pain. A deficiency worsens nerve hyperexcitability and pain perception. Supplementation may support overall comfort in cases of persistent neuropathic pain, in addition to medical treatment. Omega-3 EPA/DHA reduce pro-inflammatory mediators involved in carpal tunnel syndrome (prostaglandins, leukotrienes) and help protect nerve fiber membranes. These supplements are intended as a supportive measure and do not replace medical treatment for carpal tunnel syndrome.
Turmeric (curcuminoids with piperine) inhibits the NF-kB and COX-2 pathways involved in synovial and tendinous inflammation of the carpal tunnel. It may help reduce local inflammation that exacerbates compression of the median nerve, in addition to medical measures (night splints, corticosteroid injections). Its favorable safety profile makes it an attractive option for managing chronic inflammation. Topically applied Arnica montana (gel or cream) exerts a localized anti-inflammatory and analgesic effect on the painful wrist. These active ingredients are not a substitute for medical treatment of carpal tunnel syndrome.
Sleep is affected in two ways by carpal tunnel syndrome: nighttime paresthesias disrupt deep sleep phases, and sleeping with the wrists flexed exacerbates compression of the median nerve. Nighttime wrist splints that hold the wrist in a neutral position are recommended as a first-line treatment for mild to moderate cases. In terms of ergonomics, several adjustments can reduce mechanical strain:
