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Carpal tunnel syndrome

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  • Carpal tunnel syndrome is a condition in which the median nerve becomes compressed.
  • The median nerve is the nerve that travels down the arm into the hand. With carpal tunnel syndrome the nerve is squeezed as it passes through the narrow path (or tunnel) at the wrist.
  • The pressure on the wrist can cause the fingers and thumb to feel tingly and numb. They may feel paralyzed, or unable to move.

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.

 

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 


 



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