The first step is typically a splint that keeps the wrist in an open (unbent) position. This helps prevent compression of the median nerve, and can relieve mild to moderate discomfort and disability.
Wear the splint while sleeping. If you have constant pain, wear the splint during the day for four to six weeks, then decrease use of it over the next month. Because you're trying to avoid drugs and surgery, you may even benefit from wearing a splint intermittently for years.
You can also work with an occupational therapist (OT), who can teach you to use your hands in ways that will not aggravate your condition. An OT can also recommend adaptive equipment, such as gripping devices, or an ergonomically designed keyboard to use at home or at your office.
These non-surgical approaches usually provide relief. If they don't, injections of inflammation-calming medicine into the carpal tunnel may help. If surgery is required, it's pretty simple -- not a major operation. But non-surgical measures often are sufficient to fix the problem.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.