Treating carpal tunnel syndrome can be difficult. When it come to applying ice & heat, carpal tunnel patients swear that one or the other works better. So are they  both good for carpal tunnel or is one just a placebo effect?

Importantly, ice and heat have two completely different effects on the body. Here's how ice & heat work, and which is  medically proven better for treating carpal tunnel syndrome.

If you have this condition then you already know the main warning signs of carpal tunnel syndrome. These are pain, numbness, tingling, burning, and weakness in your hand or fingers. However, your little finger is fine. 

Another main feature  about carpal tunnel syndrome is in the beginning, symptoms come and go. But as it progresses, they will persist throughout most of the day or night. 

To get relief, you’ve probably heard a lot about home remedies like ice or heat. Maybe you tried one. Actually, most people have tried both -- by alternating between hot and cold water (called contrast baths).

About half of patients tell me they prefer heat, while the other half say they prefer cold.

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In reality, neither are actual “treatments”. Ice just temporarily relieves pain, like a numbing agent. Medicines such as Advil and Tylenol do the same thing. However, none of these get rid of the actual source of the problem.

Alternatively, heat is well-known to attack the actual cause of carpal tunnel syndrome. That cause is tendon inflammation deep inside your wrist joint. It produces fluid buildup which in turn exerts pressure on the median nerve. This is when the most common carpal tunnel symptoms begin to show up. 

Therefore, using heat will not temporarily relieve pain like ice does. However, heat will help heal the inflamed tissues with prolonged application. 

A heating pad for carpal tunnel is both popular and effective. Most doctors agree that using heat is the better way to “treat” carpal tunnel syndrome.

Unlike ice, heat promotes healing and restoration of damaged tissues. The healing process is what will ultimately make the inflammation disappear for good. 

Therefore, a hot towel or heating pad will do just fine. However, a heating mitt is easier to use and is more effective at warming the entire hand and wrist area.

So whether you use a heat mitt or heating pad for carpal tunnel syndrome, you'll be applying a therapy that helps heal, rather than just temporarily relieve pain.

• Ice is fine for temporary pain relief but does nothing to heal carpal tunnel.
• Heat may or may not feel good, but is excellent for healing carpal tunnel.

Most doctors agree that using heat is better to “treat” carpal tunnel syndrome. Unlike ice, heat promotes healing. The healing process is what will ultimately make the inflammation disappear. 

But heat alone isn't the answer to eliminating the problem. That's especially true if you have severe carpal tunnel syndrome.

The debate over a heating pad or ice bath for carpal tunnel will undoubtedly go on. Ice feels good and relieves pain temporarily while heat doesn't always provide immediate relief. But only heat can fix the bigger problem. 

If you have carpal tunnel syndrome you need strong therapy to attack the problem at the root. That's especially important if you have severe symptoms. 

The underlying is problem tendon inflammation. Surgery can be one answer to reduce that inflammation. But surgery is only a temporary fix that normally lasts 1-3 years.  After that, symptoms return in about 50% of patients.

A better answer is myofascial release massage on the wrist area. It reduces inflammation because it breaks up the adhesions on the tendons which cause irritation. Also, massage drains excess fluid to relieve pressure on the median nerve. 

There are amazing benefits of massage for carpal tunnel. But you need it expertly performed by a therapist or by a partner who's willing to learn the technique. In addition, you need it every day for at least 4 weeks for maximum benefit.

The debate about ice, heat & carpal tunnel syndrome is all around us. We know an ice bath for carpal tunnel feels good, and is a temporary way to get fast pain relief. But it does nothing to heal the inflamed tendons below the skin. And ice certainly does nothing in the long-term for treating carpal tunnel. However, a heat for carpal tunnel is different. Heat increases blood flow and speeds tendon healing. That’s why heat is better to treat carpal tunnel syndrome as part of a long-term therapy program.