The carpal tunnel syndrome is the most common of the repetitive strain injuries. It is usually brought about by overuse of the wrists in an incorrect position and therefore found commonly in typists, computer users and keyboard players. It is less frequently found in workers who use their wrists and hands in a repetitive manner.

Carpal tunnel syndrome may be associated with conditions such as rheumatoid arthritis and other autoimmune diseases, hypothyroidism, calcium deficiencies, certain drugs and, not uncommonly, pregnancy. These conditions lead to a deficiency of vitamin B6 which is relevant to the condition.

The condition is characterized by pain, pins and needles, and loss of sensation in the thumb, index finger and third finger as well as the palm and, to some extent, the back of the hand and the wrist. A diagnostic technique is to flex the wrist for about lmin, which should bring on or intensify the symptoms, and then extend the wrist to relieve the symptoms.

Carpal tunnel syndrome is caused by swelling of the tendons that control the flexion of the wrist and fingers. Overuse causes extra blood to be pulled into the area to supply the muscles with oxygen and this swelling puts pressure on the median nerve that nestles in-between these tendons. All of these, along with other nerves, veins, arteries and the lymphatic system, are sheathed in a tight covering that does not allow the swelling to move outwards and therefore causes pressure directly applied to the nerve.

A persistence of this problem needs to be checked by a GP to rule out any underlying condition such as those mentioned above.

Ensure that the position of your chair, when at a computer, typing or at a keyboard, is such that your wrists are at a slightly higher level than the keyboard.

If you are taking any drugs, check that they do not cause vitamin B6 or calcium deficiency.

Avoid oral contraception or HRT, any colourings in foods and an excess of protein in the diet, all of which can reduce vitamin B6 levels.

Supplement your daily diet with vitamin B6 and calcium at each meal.

Use a teaspoonful of turmeric mixed with half a pint of skimmed milk four times per day.

It may be necessary to avoid the repetitive action that triggered the problem for up to six weeks which may be inconvenient for many professions. A persistence of the problem will require this as a medical necessity and if not heeded can lead to permanent damage which will require surgical intervention.

Acupuncture and osteopathy in combination is most often curative.

Chinese, Tibetan and Ayurvedic herbal medicines can be of benefit and should be used before considering surgery.

Homeopathic remedies Magnesia phosphorica, Hypericum and Nitric acid can all be used at potency 6, one dose every 2hr for three days during an acute attack and then one dose twice a day for ten days.

Hot and cold applications around the wrists and up the arm and also gentle massage of Arnica cream can be swiftly relieving and even permanently curative.