Conquering Carpal Tunnel Syndrome
You have been working at your keyboard for hours and your hands are cramping up, feeling tingly numbness with little movement. You might be experiencing carpal tunnel syndrome.
Carpal tunnel syndrome results when the median nerve is trapped and compressed as it and the tendons that flex the muscles of the hand pass through the carpal tunnel from the forearm to the hand.
Carpal tunnel syndrome is caused by inflammation of the tendons running through it, which typically results from long hours of repetitive hand motions such as typing, sewing, or piano playing. However, the syndrome can be produced by anything that puts pressure on the median nerve and flexor tendons within the tunnel. These include bleeding, swelling, or fracture following trauma, developmental malformations, tumors, and an excess accumulation of fat.
The typical symptoms of pain, burning or tingling of the thumb, index, middle and adjacent half of the ring finger usually precede any muscle weakness and atrophy (wasting). Some individuals complain of pain and numbness that awakens them in the middle of the night; others report pain that is worse on awakening in the morning.
Some people with severe symptoms complain of weakness in the muscles of the hand, making it difficult to fasten jewelry or to hold on to a slippery drinking glass or bottle without dropping it. Many people describe the sensation as a "loss of circulation." Women are typically affected more than men. The chance of getting carpal tunnel syndrome increases with age.
Just know that certain repetitive movements in slightly awkward positions, worsen the symptoms. There are activities that require flexion (downward bending) of the wrist, prolonged slight positioning of the wrist angled outward (as at a keyboard), and repetitive grasping use of the hand. Certain underlying medical conditions that affect one’s fluid balance (increasing one’s tendency to have swelling) can increase one’s risk to have symptoms. Some of these conditions are rheumatoid and inflammatory arthritis, diabetes, pregnancy, alcoholism, and kidney failure.
Other factors can contribute to the development of carpal tunnel syndrome including heredity, hemodialysis (a process where the blood is filtered), wrist facture and dislocation, hand or wrist deformity, a mass (tumor) in the carpal tunnel, or amyloid deposits.
Not all hand pain is carpal tunnel syndrome. Some other forms of hand pain include De Quervain’s tendinosis, which is a condition where swelling (inflammation) affects the wrist and base of the thumb; trigger finger where the condition causes soreness at the base of the finger or thumb and also causes pain, locking (or catching) and stiffness when bending the fingers and thumb; and arthritis, the general term for many conditions that cause stiffness and swelling in the joints. Arthritis can impact many joints in your body and ranges from causing small amounts of discomfort to breaking down the joint over time.
Carpal tunnel syndrome is diagnosed by taking a full medical history and other tests like Tinel’s sign where your doctor taps over the median nerve at the wrist to see if it produces a tingling sensation in the fingers. Your doctor might also perform a wrist flexion test where you rest your elbows on a table and allow the wrist to fall forward freely. Individuals with carpal tunnel syndrome will feel numbness and tingling within 60 seconds. The quicker the symptoms appear, the more severe the condition. Your physician may also want to do an X-ray to see if there is limited wrist motion or whether some other condition may play a role such as arthritis or trauma. An electromyography and nerve conduction studies to determine how well the median nerve is working might need to be performed as well.
Carpal tunnel syndrome can be treated nonsurgically and surgically depending on how severe the condition is. Nonsurgical solutions such as stretch breaks are a good idea for anyone who works at a computer, rides a bike, plays racket sports or performs other repetitive hand and wrist motions on a regular basis. Nighttime and daytime wrist splints are used to rest the wrist. Nonsteroid anti-inflammatory drugs such as ibuprofen may be useful to treat the pain. Cortisone injections may be suggested depending on the severity.
Surgical intervention may be in order if the condition doesn’t seem to improve through these nonsurgical measures. Surgery may be required to increase the size of the tunnel in order to decrease the pressure on the nerves and tendons that pass through the space. This is done by cutting or releasing the ligament that covers the carpal tunnel at the base of the palm. The ligament is called the transverse carpal ligament.
The whole procedure can take place on an outpatient basis where local anesthesia will be administered so you can be asleep during the process. You will experience brief discomfort 24 to 72 hours after the surgery and should feel some nighttime relief. Your stitches can be removed 10 to 14 days after surgery. And with the use of certain exercise programs, hand and wrist function can gradually be restored. Keep in mind that you will not be able to do heavier activities for four to six weeks. But you should eventually experience relief from carpal tunnel syndrome symptoms.
You can integrate some alternative medicine in order to heal from carpel tunnel syndrome. For example, yoga may provide for stretching, strengthening, balancing the upper body and joints that may reduce pain and improve grip strength. Occupational hand therapy may also reduce symptoms of carpal tunnel syndrome. In addition, your health care provider may suggest ultrasound therapy where high intensity ultrasound is used to raise the temperature of a targeted area of body tissue to reduce pain and promote healing.
What has been your experience with carpal tunnel syndrome? Let me know in the comments.
