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This is no doubt a condition which many of you have had and about which others of you have at least heard.\u00a0 Those in the former group will include many who have spent long hours computer keyboarding, but before you go running to your boss or your union, bear in mind that this syndrome dates back to the beginning of the 20th century, before the advent of computers.\u00a0 So you may have no case.<\/p>\n
Now, the bones in your wrist joint proper are called carpal bones, those in your hand the metacarpals, and then of course you have your fingers, or phalanges.\u00a0 You\u2019ll soon see why this condition was given this name.<\/p>\n
The carpal tunnel is a narrow passageway \u2013 about as big around as you thumb \u2013 bounded by bones (that\u2019s right, carpal bones) and ligaments.\u00a0 The tunnel is on the palm side of your wrist.\u00a0 It protects a main nerve, the median nerve, to your hand and nine tendons that bend your fingers.\u00a0 There\u2019s no rocket science about medicine, you know.\u00a0 This nerve is called median because it is the middle of the three main nerves that serve your hand.\u00a0 With your palm faced forward the outer one in the radial nerve, and the inner one the ulnar nerve.<\/p>\n
Pressure placed of the median nerve produces the numbness, pain, and, eventually hand weakness that is the carpal tunnel syndrome.<\/p>\n
SIGNS AND SYMPTOMS<\/p>\n
The syndrome typically starts gradually, with a vague aching in your wrist that can extend to your hand or forearm.\u00a0 Other common signs and symptoms include:<\/p>\n
TINGLING OR NUMBNESS<\/strong> in your fingers or hand, especially your thumb, index, middle, and one half of your ring fingers, but not your little finger.\u00a0 This is your ulnar nerve\u2019s baby.\u00a0 Now this is the typical anatomic picture, but none of us is 100% perfect, so there is sometimes a little overlap, in that some person\u2019s thumb may not be involved, or it may seem as if the whole ring finger is involved. The sensation often occurs while driving, holding a phone or newspaper, or upon awakening. A lot of people try to \u201cshake\u201d out their hands to relieve their symptoms.<\/p>\n PAIN<\/strong> RADIATING OR EXTENDING <\/strong>from your wrist up your arm to your shoulder or down into your palms or fingers, particularly after forceful or repetitive use.\u00a0 Of course, this will occur on the front (palm) side of your forearm.<\/p>\n A SENSE OF WEAKNESS<\/strong> in your hands, and a tendency to drop objects.<\/p>\n A CONSTANT LOSS OF FEELING<\/strong> in some fingers in advanced cases.<\/p>\n CAUSES<\/p>\n The cause of carpal tunnel syndrome is pressure on the median nerve.\u00a0 It is a mixed nerve, meaning it carries sensation (sensory function), and carries signals to your muscles to allow them to move (motor function).\u00a0 Pressure on the nerve can stem from anything that reduces its space in the tunnel.\u00a0 Causes may include bone spurs, or the most common one, which is swelling or thickening of the synovium, the lining and lubricating layer of the tendons in your carpal tunnel.<\/p>\n Usually the exact cause of the swelling isn\u2019t known, but a variety of factors can play a role: <\/strong><\/p>\n <\/strong><\/p>\n OTHER HEALTH CONDITIONS.<\/strong> Rheumatoid arthritis, diabetes, menopause, thyroid disorder, especially a suboptimally functioning thyroid, acromegaly (gigantism), are among them.\u00a0 Pregnancy and an abnormal protein produced by your bone marrow, amyloid, are others.\u00a0 Don\u2019t forget obesity.<\/p>\n REPETITIVE USE OR INJURY.<\/strong> Forceful or prolonged flexing and extending of the tendons in the hands and wrists can create the problem.<\/p>\n PHYSICAL CHARACTERISTICS<\/strong>.\u00a0 It may be that some people have a narrower than average tunnel, making pressure on the nerve easier to occur.<\/p>\n WHAT ARE SOME RISK FACTORS?<\/p>\n Overuse or strain in certain job tasks that require a combination of repetitive, forceful and awkward or stressed motion of your wrist or hand are thought to contribute to carpal tunnel syndrome. These include using power tools such as chippers, grinders, chainsaws or jackhammers.<\/p>\n Other risk factors have been mentioned under \u2018other health conditions.\u2019\u00a0 In addition, women have a three times greater risk compared to men, especially after menopause (above).\u00a0 Middle-aged men get it more than younger men do.<\/p>\n Cigarette smoking<\/strong> causes worse symptoms and slower recovery from the syndrome than is the case with non-smokers.\u00a0 Interesting huh?\u00a0 How often have I warned against cigarette smoking, for any number of reasons?\u00a0 Here\u2019s another one.<\/p>\n DIAGNOSIS<\/p>\n As always, the doctor will listen to your symptoms, your history, and can get a pretty good idea from this that you have carpal tunnel syndrome.\u00a0 Doctor will also test the feeling in your fingers and the strength of your hand muscles, because the syndrome can affect these.\u00a0 Pressure on the median nerve at the wrist, by tapping at the site (Tinnel\u2019s sign), by bending the wrist or simply pressing the nerve, can bring on the symptoms in many people.<\/p>\n If you have signs and symptoms of the condition, we may recommend the following diagnostic tests:<\/p>\n ELECTROMYOGRAM<\/strong>. Electromyography measures the small electrical discharges produced in muscles.\u00a0 A thin- needle electrode is inserted into the muscle of interest.\u00a0 An instrument records its electrical activity at rest and as you contract the muscle.\u00a0 This test can help determine if muscle damage has occurred.<\/p>\n NERVE CONDITION STUDY<\/strong>.\u00a0 In a variation to electromyography, two electrodes are taped to your skin.\u00a0 A small shock is passed through the median nerve to see if electrical impulses are slowed in the tunnel.<\/p>\n TREATMENT OF CARPAL TUNNEL SYNDROME<\/p>\n Some persons with mild symptoms can find relief by resting their hand more frequently and applying cold packs to reduce occasional swelling.\u00a0 If these don\u2019t help, other options include wrist splinting, medications and surgery. <\/strong><\/p>\n <\/strong><\/p>\n Non-surgical<\/strong> therapy include:<\/p>\n * Splinting your wrist to keep it still while you sleep can help, more so if you\u2019ve had only mild to moderate symptoms for less than a year.<\/p>\n * Non-steroid anti-inflammatory drugs (NSAID\u2019S) may help relieve pain if you have an associated inflammatory condition, such as rheumatoid arthritis.\u00a0 Otherwise, they are unlikely to be of much use.<\/p>\n * Corticosteroids. An injection of one of these into the tunnel may relieve pain and, by decreasing inflammation, relieve pressure on the nerve.\u00a0 Taken by mouth, they are not as effective.<\/p>\n Surgery<\/strong><\/p>\n For persistent pain and numbness, surgery may be the best option.\u00a0 There are a few accepted techniques, but in all procedures, the ligament pressing on your nerve is cut.\u00a0 Some may even be done by endoscopy (similar to laparoscopy) where tiny incisions are made and the surgeon does his thing by finding his way via a tiny television camera.\u00a0 Cool, huh?\u00a0 In other cases, an incision is made in the palm of your hand over the carpal tunnel and releasing the nerve.<\/p>\n PREVENTIVE MEASURES<\/p>\n Reduce your force and relax your grip.<\/strong> For instance, if you use a cash register, hit the keys softly.\u00a0 For prolonged hand writing use a big pen with an oversized, soft grip adapter and fee-flowing ink, so that you don\u2019t have to grip the pen tightly or press as hard on the paper.<\/p>\n Take frequent breaks, <\/strong>like every 15 to 20, minutes whenever you\u2019re doing anything repetitive or forceful with your hands.<\/p>\n Watch your form.<\/strong> Try not to bend your wrist all the way up or down.\u00a0 If you use a keyboard, keep it at elbow height or slightly lower.<\/p>\n Keep your hands warm.<\/strong> You\u2019re more likely to develop pain and stiffness if you work in cold environment.\u00a0 If you can\u2019t control the temperature at work, put on fingerless gloves to keep your hands and wrists warm.<\/p>\n Improve your posture.<\/strong> It you don\u2019t, your shoulders will roll forward, shortening your neck and shoulder muscles, compressing nerves in your neck.\u00a0 This can affect your wrists, fingers, and hands.<\/p>\n See you next week..<\/p>\n <\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":"This is no doubt a condition which many of you have had and about which others of you have at least heard.\u00a0 Those in the former group will include many who have spent long hours computer keyboarding, but before you…","protected":false},"author":15,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_cbd_carousel_blocks":"[]","footnotes":""},"categories":[49],"tags":[],"class_list":["post-37631","post","type-post","status-publish","format-standard","hentry","category-health-talk"],"acf":[],"yoast_head":"\n