Coming to Grips with Carpal Tunnel Syndrome
by Lisa Ladd, M.D.
Carpal tunnel
syndrome, a painful condition involving the wrist, affects hundreds
of thousands of Americans and costs employers billions of dollars
a year, according to the Bureau of Labor Statistics.
People will often experience tingling, numbness and
pain in their wrist, hand and fingers (including the thumb, index,
middle and the thumb side of the ring finger). If you are experiencing
these symptoms, you may have carpal tunnel syndrome (CTS).
Who's at Risk?
Occupational activities are associated with this syndrome.
Anyone who has a job or hobby that involves using the hands in repetitive
motions is potentially at risk, including computer users, carpenters,
musicians, assembly-line workers, meat packers and many others.
For the majority of patients, however, the cause of their carpal
tunnel syndrome is unknown.
You are also at a higher risk if you are pregnant,
though CTS will typically abate after delivery. Diabetes, hypothyroidism,
Raynaud's disease, menopause and obesity will also increase your
risk of developing CTS.
Watch for the Symptoms
Even though this pain may actually be tendonitis or
bursitis rather than CTS, if you are experiencing symptoms that
last for more than a week, it is recommended that you see a physician
for an evaluation.
CTS is often the result of a combination of factors
that increase pressure on the median nerve and tendons in the carpal
tunnel, rather than a problem with the nerve itself. The median
nerve, which runs from the forearm into the hand, becomes pressed
or squeezed at the wrist and reduces sensation and muscle control
to the thumb and fingers as noted above.
The result can be painful tingling during the night
and day, numbness, or burning in your hand; shooting pains in your
wrist; weakness of your thumb; stiffness or cramping of your hand;
frequent dropping of objects; and the inability to make a fist,
grasp small objects, or perform other manual tasks, such as tying
your shoes or picking up small objects. You may also experience
referred pain into the elbow and shoulder.
In chronic and/or untreated cases, the muscles at
the base of the thumb may waste away. Some people are unable to
tell between hot and cold by touch.
Time to Get Treatment
Professional medical treatment for carpal tunnel syndrome
should begin as early as possible, otherwise damage to the median
nerve can become permanent. You should see your doctor or visit
an Urgent Care Center if symptoms don't improve within a few weeks.
Applying cool packs can help reduce swelling and inflammation.
Initial medical treatment generally involves resting the affected
hand and wrist for at least two weeks and avoiding activities that
may worsen symptoms. The wrist is usually immobilized in a splint
to avoid further damage from twisting or bending. There are also
some therapeutic exercises that may be of benefit.
Often, your physician may prescribe anti-inflammatory
drugs. A cortisone injection may be of benefit not only for treatment,
but also for diagnosis. If nothing else works to relieve your pain,
you may need to have surgery and your doctor will make the appropriate
referral.
How to Prevent and Treat Carpal Tunnel Syndrome
Approximately one percent of individuals
with carpal tunnel syndrome develop permanent injury. The majority
recover completely and can avoid re-injury by changing the way they
work or play.
There are some things you can do to help prevent CTS,
or to treat it if you already have it.
- Take a break at least once an
hour when doing repetitive tasks involving your hands or wrists,
such as typing or needlework.
- If you work at a computer, make
sure that your desk, keyboard and chair are at the correct height
for comfortable keyboarding. Your keyboard should be at the height
of your hands when your elbows are bent and your forearms and
hands are parallel to the floor.
- If you are overweight, ask
your physician about a weight loss program.
- Get a handle on your stress.
Stress seems to make CTS worse.
- Ask your doctor to prescribe
a splint for you that will immobilize your wrist and take some
of the strain off the affected area. A splint allows you to continue
to work while allowing your wrist to heal.
- If you get pain in your hand, especially
if it awakens you at night, hang your hand over the side of your
bed and rub or shake your hand to relieve the pain. Wearing your
splint at night may help alleviate these symptoms.
- Clench your hand into a fist, then straighten
your fingers and stretch your hand as wide as possible; repeat
with your other hand.
See
your doctor or visit an Urgent Care Center, if your symptoms
persist despite remedies.
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