CARPAL TUNNEL SYNDROME

 Basic information

description

Carpal tunnel syndrome is a common nerve disorder that affects the hands and wrists. The carpal tunnel is a tunnel-like passageway located on the palm side of the wrist. It is made up of ligaments and bones. It surrounds the median nerve and tendons that go to the thumb and first two fingers. It usually affects adults and occurs in women much more than men.

FREQUENT SIGNS & SYMPTOMS

• Symptoms usually start gradually and often affect the thumb and the index and middle fingers. The dominant hand is usually affected first.
• Tingling or numbness in part of the hand.
• Sharp pains that shoot from the wrist up the arm, especially at night.
• Burning sensations in the fingers.
• Morning stiffness or cramping of hands.
• Thumb weakness.
• Inability to make a fist.

causes

It is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel. The median nerve becomes irritated, which leads to the hand symptoms.

risk increases with

• Types of work that cause stress on the wrist (e.g., repetitive tasks, vibration, etc.) may increase risks. (Many people develop the condition regardless of the type of work they do.). Research is ongoing about the relationship of carpal tunnel syndrome and work.
• Women (possibly due to a smaller carpal tunnel).
• Certain medical or physical conditions may increase risk. These include arthritis, diabetes, hypothyroidism, alcoholism, obesity, menopause, pregnancy, or others.
• Wrist injury, fracture, dislocation, or other conditions that can cause inflammation in the wrist.

PREVENTIVE MEASURES

• There are no specific preventive measures.
• Get treatment for any medical risk factors.
• Seek medical care at the onset of any hand symptoms.
• Reduce the risk of hand injury at work. Take frequent breaks. Learn ways to do the work with less stress on the hands and wrists. Use good posture. Relax the grip. Keep hands warm. Perform hand and wrist exercises.

expected outcomes

With treatment and time, most people will recover completely.

possible complications

If the condition is severe and untreated, permanent damage in the hand may occur.

 diagnosis & treatment

general measures

• Your health care provider will examine your hand and wrist. Questions will be asked about your symptoms and daily activities. Medical tests may be done to see how well the median nerve is functioning or to check for an underlying disorder.
• Treatment for any underlying condition will be prescribed. Conservative treatment for the carpal tunnel symptoms is usually tried first. Surgery is an option.
• Activities that are causing your symptoms need to be changed or stopped if at all possible.
• Rest the affected hand and wrist for 2 weeks (or as advised). Use ice or warm and cold soaks if they help with symptoms.
• Wearing a splint on the affected wrist for 4 to 6 weeks may be advised. The splint can keep the wrist in a neutral position at rest. Splints may be worn at night, during the day, or both day and night.
• Surgery to free the pinched nerve may be needed. The procedure may be done as an outpatient. Physical therapy will then help rebuild wrist strength.

medications

• You may take aspirin or ibuprofen to reduce pain and inflammation.
• Anti-inflammatory drugs or cortisone injections at the wrist to reduce inflammation may be prescribed.

activity

Once symptoms get better, begin a routine of both aerobic and weight-training exercise to improve fitness.

diet

Eat a normal, well-balanced diet. A weight loss diet is recommended if overweight is a problem.

 notify our office if

• You or a family member has symptoms of carpal tunnel syndrome.
• Symptoms don't improve in 2 weeks after treatment.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

Special Notes: