CARPAL TUNNEL SYNDROME

 

Carpal tunnel syndrome is an arm and hand condition that causes tingling, numbness, pain and other symptoms. It is caused by a pinched nerve in the wrist.

The condition is generally more common in women. A number of factors can contribute to this condition, including the anatomy, certain underlying health problems and lifestyle (diet, nutritional deficiencies, toxins, stress, side effects f using medication, etc.).Bound by ligaments and bones, the carpal tunnel is a narrow passageway located on the palm side of the wrist. It protects the main nerve going through the hand. Compression of this nerve which can be caused by different factors produces the numbness, pain, tingling slowly leading to hand weakness and the carpal tunnel syndrome.

Fortunately, proper treatment usually leads to the recovery from this condition.

SYMPTOMS

Carpal tunnel syndrome usually starts gradually with numbness or tingling in your thumb, index and middle fingers that comes and goes. This may be associated with discomfort in your wrist and hand. Common carpal tunnel syndrome symptoms include:

Tingling or numbness. You may experience tingling and numbness in your fingers or hand, especially your thumb and index, middle or ring fingers, but not your little finger. This sensation often occurs while holding a steering wheel, phone or newspaper or, commonly, waking you from sleeping. The sensation may extend from your wrist up your arm.

Many people “shake out” their hands to try to relieve their symptoms. As the disorder progresses, the numb feeling may become constant.

Weakness. You may experience weakness in your hand and a tendency to drop objects. This may be due to the numbness in your hand or weakness of the thumb’s pinching muscles, which are controlled by the median nerve.

CAUSES
Usually an inflammation such as arthritis or anything that irritates or compresses the median nerve going through the carpal tunnel  can lead to the condition.
 Some chronic illnesses, such as diabetes, increase your risk of nerve damage, including damage to the median nerve. Inflammatory conditions. Illnesses that are characterized by inflammation, such as rheumatoid arthritis, can affect the tendons in your wrist, exerting pressure on your median nerve. Alterations in the balance of body fluids. Fluid retention may increase the pressure within your carpal tunnel, irritating the median nerve. Other medical conditions. Certain conditions, such as menopause, obesity, thyroid disorders and kidney failure, may increase your chances of CTS. Workplace factors. It’s possible that working with vibrating tools or on an assembly line that requires prolonged or repetitive flexing of the wrist may create harmful pressure on the median nerve or worsen existing nerve damage.
However, in many cases, no single cause can be identified. It may be that a combination of many risk factors contributes to the development of CTS.

TREATMENT

Carpal tunnel syndrome should be treated as early as possible after you begin to experience symptoms.

Some people with mild symptoms of carpal tunnel syndrome can ease their discomfort by taking more frequent breaks to rest their hands, avoiding activities that worsen symptoms and applying cold packs to reduce occasional swelling.

If these techniques don’t offer relief within a few weeks, additional treatment options include wrist splinting, medications and surgery. Splinting and other conservative treatments are more likely to help you if you’ve had only mild to moderate symptoms for less than 10 months.

If the condition is diagnosed early, non-surgical methods may help improve carpal tunnel syndrome. Methods may include:

Wrist splinting. A splint that holds your wrist still while you sleep can help relieve night-time symptoms of tingling and numbness. Nocturnal splinting may be a good option if you’re pregnant and have carpal tunnel syndrome.

There isn’t evidence, however, that these drugs improve carpal tunnel syndrome.

Corticosteroids. Your doctor may inject your carpal tunnel with a corticosteroid such as cortisone to relieve your pain.

Corticosteroids decrease inflammation and swelling, which relieves pressure on the median nerve. Oral corticosteroids aren’t considered as effective as corticosteroid injections for treating carpal tunnel syndrome.

If carpal tunnel syndrome results from an inflammatory arthritis, such as rheumatoid arthritis, then treating the arthritis may reduce symptoms of carpal tunnel syndrome, but this hasn’t been proved.

If your symptoms are severe or persist after trying non-surgical therapy, surgery may be the most appropriate option.

The goal of carpal tunnel surgery is to relieve pressure on your median nerve by cutting the ligament pressing on the nerve.

The surgery may be performed with two different techniques. Discuss the risks and benefits of each technique with your surgeon before surgery. Surgery risks may include incomplete release of the ligament, wound infections, scar formation, and nerve or vascular injuries. The final results of endoscopic and open surgery are similar.

Endoscopic surgery. In endoscopic surgery, your surgeon uses a telescope-like device with a tiny camera attached to it (endoscope) to see inside your carpal tunnel and cut the ligament through one or two small incisions in your hand or wrist.

Endoscopic surgery may result in less pain than does open surgery in the first few days or weeks after surgery.

Open surgery. In open surgery, your surgeon makes a larger incision in the palm of your hand over the carpal tunnel and cuts through the ligament to free the nerve. This procedure may also be conducted using a smaller incision, which may reduce the risk of complications.
During the healing process after the surgery, the ligament tissues gradually grow back together while allowing more room for the nerve than existed before.

In general, your doctor will encourage you to use your hand after surgery, gradually working back to normal use of your hand while avoiding forceful hand motions or extreme wrist positions.

Soreness or weakness may take from several weeks to a few months to resolve after surgery. If your symptoms were very severe before surgery, symptoms may not go away completely after surgery.

LIFESTYLE AND HOME REMEDIES

There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on your hands and wrists by taking the following precautions:

Reduce your force and relax your grip. Most people use more force than needed to perform many manual tasks. If your work involves a cash register, for instance, hit the keys softly. For prolonged handwriting, use a big pen with an oversized, soft grip adapter and free-flowing ink. This way you won’t have to grip the pen tightly or press as hard on the paper.
Take frequent breaks. Give your hands and wrists a break by gently stretching and bending them periodically. Alternate tasks when possible. If you use equipment that vibrates or that requires you to exert a great amount of force, taking breaks is even more important.
Watch your form. Avoid bending your wrist all the way up or down. A relaxed middle position is best. If you use a keyboard, keep it at elbow height or slightly lower.
Improve your posture. Incorrect posture can cause your shoulders to roll forward. When your shoulders are in this position, your neck and shoulder muscles are shortened, compressing nerves in your neck. This can affect your wrists, fingers and hands.
Keep your hands warm. You’re more likely to develop hand pain and stiffness if you work in a cold environment. If you can’t control the temperature at work, put on fingerless gloves that keep your hands and wrists warm.