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Carpal tunnel syndrome
Carpal tunnel syndrome is a specific group of symptoms including tingling, numbness, weakness, or pain in the fingers or hand and occasionally in the forearm and elbow. Bounded by bones and ligaments, the carpal tunnel is a narrow passageway - about as big around as your thumb - on the palm side of your wrist. This tunnel protects a main nerve (median nerve) to your hand and nine tendons that bend your fingers. Pressure placed on the nerve produces the numbness, pain and, eventually, hand weakness that characterize carpal tunnel syndrome. Fortunately, for most people who develop
carpal
tunnel syndrome, proper treatment usually can
relieve the pain and numbness and restore normal use
of the wrists and hands.
Treatment Conservative and
early treatments include nonsteroidal anti-inflammatory drugs (NSAIDs),
which can help control pain and may help if you have an associated
inflammatory condition. If no inflammatory condition is involved, NSAIDs
are unlikely to help relieve the symptoms of carpal tunnel syndrome. Simply taking more
frequent hand-rest breaks can help. And a splint that holds your wrist
still while you sleep can help relieve nighttime symptoms of tingling
and numbness. Applying cold packs can help reduce swelling if you have
inflammation. Your doctor might also inject the affected area with a
corticosteroid, a medication that suppresses inflammation and which may
provide some relief from symptoms. Or your doctor may have you take oral
corticosteroids. Generally, these
conservative treatments are more effective if you have only mild nerve
impairment. When the pain or
numbness of carpal tunnel syndrome persists, an operation may be the
best option. Your surgeon may use one of a few accepted techniques. But
in all accepted surgical procedures, your doctor cuts the ligament
pressing on your nerve. At times, surgery can be done using an
endoscope, a telescope-like device with a tiny television camera
attached to it that allows your doctor to see inside your carpal tunnel
and perform the surgery through small incisions in your hand or wrist.
In other cases, surgery involves making an incision in the palm of your
hand over the carpal tunnel and releasing the nerve. In most people
surgery results in marked improvement, but some residual numbness, pain,
stiffness or weakness may persist. After surgery,
your doctor may tell you that limited use of your hand and wrist is OK
within a few days. However, it may take from several weeks to as long as
a few months before you have unrestricted use of your hand and wrist. If
surgery appears to be the best alternative for relieving your symptoms
or preventing further muscle atrophy, be sure to talk with your surgeon
about the procedure that will work best for you and with your plans to
return to your previous activity levels, both at work and at home. If carpal tunnel
syndrome results from an inflammatory arthritis, such as rheumatoid
arthritis, then treating the underlying condition generally also reduces
the carpal tunnel syndrome symptoms. This may not be the case with all
underlying conditions, such as thyroid conditions or diabetes.
Prevention There are
no proven strategies to prevent carpal tunnel syndrome, but to protect
your hands from a variety of ailments, take the following precautions:
Reduce your force and relax your grip.
Most people use more force than needed to perform many tasks involving
the hands. 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.
Every 15 to 20 minutes give your hands and wrists a break by gently
stretching and bending them. 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 pains 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.
Carpal tunnel syndrome
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