Tuesday, November 26, 2013

Carpal Tunnel Syndrome

Though commonly believed to be caused by repetitive motion such as typing and assembly work, there are a number of other surprising reasons individuals may suffer from carpal tunnel syndrome---or predispose them to experiencing carpal tunnel syndrome.


The carpal tunnel is a slender, rigid passageway constructed of bone and ligaments at the base of the hand where it joins the wrist. A key nerve---called the median nerve---which goes from your forearm down into your hand, runs through this passageway, sending impulses from the brain to the hand---specifically, the thumb, index and middle fingers. When something occurs to narrow the carpal tunnel passageway further---generally swelling of the area---the median nerve gets pinched or compressed and ceases to function properly. This narrowing and nerve compression is referred to as carpal tunnel syndrome.


The first symptoms of carpal tunnel syndrome may include the hand "falling asleep" during the night when you are sleeping, requiring you to "shake it out" to get full feeling back. During waking hours, tingling in the hand becomes more common and the hand may feel clumsy or swollen, even though it does not appear to be swollen upon examination. Numbness, tingling, itching, and/or burning in the fingers or the palm of the hand is also common. Left untreated, carpal tunnel syndrome symptoms may progress to where it is difficult to use the hand and the hand loses strength.


Resting and immobilizing the wrist so it is not moved in such a way that it compresses the median nerve is generally the first course of treatment for carpal tunnel syndrome, along with over-the-counter pain medications with anti-inflammatory properties. Ice or cold packs may also help reduce swelling. If unsuccessful, prescription drugs may provide relief of the pain and swelling, and some patients get relief with yoga, acupuncture or chiropractic care. If these treatments do not result in significant improvement, surgery to expand the carpal tunnel may be necessary---and is quite common in the United States.


Genetically, some people simply have a smaller carpal tunnel than others, and these people will have an increased likelihood of experiencing carpal tunnel syndrome, especially if other factors also contribute. Women are at higher risk than men, and people with metabolic disorders affecting the nerves or diabetes or arthritis are at increased risk of experiencing the condition. Other conditions such as hypothyroidism, an overactive pituitary gland or a cyst or tumor in the carpal tunnel can also cause carpal tunnel syndrome. Any condition that causes water retention or swelling---such as obesity or pregnancy---can also contribute to carpal tunnel syndrome. In addition, people who perform repetitive motions in assembly line jobs have a higher risk of injury to this area and a higher risk of developing carpal tunnel syndrome.


A physician will perform a patient history and possibly blood tests and/or X-rays to rule out any underlying cause for carpal tunnel syndrome. The hand, wrist and fingers will be carefully examined. Ultimately, nerve conduction studies and ultrasound have been the most conclusive means of positively identifying carpal tunnel syndrome.


If there is an underlying cause for carpal tunnel syndrome---such as arthritis or diabetes--a physician will treat the causal disease first and then treat the carpal tunnel syndrome symptoms.

Tags: carpal tunnel, carpal tunnel syndrome, tunnel syndrome, carpal tunnel, cause carpal, cause carpal tunnel, higher risk