What is carpal tunnel syndrome:There is a tunnel-like structure in the palm side of your wrist called the carpal tunnel. The median nerve that controls feeling in the palm side of the fingers passes through this tunnel. The nine flexor tendons that bend the fingers and thumb also travel through the carpal tunnel. Carpal tunnel syndrome occurs when pressure caused by swelling of tissues surrounding the flexor tendons puts pressure on the median nerve. This pressure on the nerve produces the numbness, pain and eventually the hand weakness that characterizes carpal tunnel syndrome.
What are the symptoms:Carpal tunnel symptoms normally increase very gradually and at the start may only be present during the night. You may get carpal tunnel in one or both wrists. Here are some of the normal symptoms: Numbness, burning or tingling in your hand or fingers. It usually occurs in your thumb, index, middle or ring finger (not your little finger). This sensation can often occur when holding the steering wheel, book, newspaper or phone. As the condition get's worse the numbness may become constant. Pain extending or radiating from the wrist up to the arm to the shoulder or down to your palm or fingers. These symptoms especially happen after repetitive or forceful use.You will usually notice this on the palm side of your forearm. Weakness in the fingers or hand.Eventually there may be a tendency to drop objects.
What are the risk factors:
- Tasks that involve repetitive, forceful, awkward or stressed motions of your hands and wrist can cause carpal tunnel. It's not surprising that working at a computer for long hours is suspected to be a major cause of carpal tunnel.
- A traumatic wrist injury like fractures and sprains
- Congenital - some people naturally have a narrower carpal tunnel. If your close relatives have had the condition, you may also have inherited the risk characteristics.
- Health conditions such as arthritis, diabetes, obesity or thyroid problems.
- Women are three times more likely to develop carpal tunnel syndrome. Women who are going through hormone changes because of pregnancy, oral contraceptives or menopause are at increased risk.
- The disease occurs more frequently in older people
Treatment Options:Most doctors will initially recommend a conservative treatment plan. The first period of treatment will include rest of the wrist and immobilization with a carpal tunnel splint as shown below. If there is evidence of inflammation or swelling a cold therapy wrap will help provide relief. In addition your doctor may prescribe ibuprofen or other non-steroidal anti-inflammatory medication. Diuretics (water pills) are sometimes prescribed to clear fluid retention. If appropriate, your doctor may inject cortisone into the carpal tunnel.
Helpful hints to prevent carpal tunnel syndrome:
- When using a keyboard keep it at elbow height or slightly lower.
- Use less force and relax your grip when using your hands in tasks like typing, handwriting or using tools.
- Give your hands and wrist a break by gently stretching and bending them every so often.
- Make sure you have good posture and don't let your neck and shoulders roll forward.
- Keep your hands warm, especially if you are in a cold environment.