Carpal Tunnel Syndrome

WHAT CAUSES CARPAL TUNNEL SYNDROME?

Carpal tunnel syndrome is a common, painful disorder of the wrist and hand and produces numbness, tingling in the fingers and pain in the wrist and hand. Carpal tunnel syndrome is caused by pressure on the median nerve in your wrist. People who use their hands and wrists repeatedly in the same way (for example, illustrators, carpenters, and assembly-line workers) tend to develop carpal tunnel syndrome symptoms. Pressure on the nerve may also be caused by a fracture or other injury, which may cause inflammation and swelling. In addition, pressure may be caused by inflammation and swelling associated with arthritis, diabetes, and hypothyroidism. Carpal tunnel syndrome can also occur during pregnancy.

WHAT ARE THE SYMPTOMS OF CARPAL TUNNEL SYNDROME?

Symptoms include:

• 1. Pain, numbness, or tingling in your hand and wrist, especially in the thumb and index and middle fingers; pain may radiate up into the forearm.
• 2. Increased pain with the increased use of your hand, such as when you are driving or reading the newspaper.
• 3. Increased pain at night.
• 4. Weak grip and tendency to drop objects held in the hand.
• 5. Sensitivity to cold.
• 6. Muscle deterioration especially in the thumb (in later stages).

HOW IS IT DIAGNOSED?

Your doctor will review your symptoms, conduct a physical exam, and discuss the ways you use your hands. He or she may also do the following tests:

• 1. Tinel Sign: The doctor may tap the inside middle of your wrist over the median nerve. You may feel pain or a sensation like an electric shock
• 2. You may be asked to bend your wrist down for one minute to see if this causes symptoms.
• 3. Nerve Conduction Study:  The doctor may arrange to test the response of your nerves and muscles to electrical stimulation.

TREATMENT FOR CARPAL TUNNEL SYNDROME

 Other treatment focuses on relieving irritation and pressure on the median nerve in your wrist. To relieve pressure your doctor may suggest:

• 1. Restricting use of your hand or changing the way you use it.
• 2. Wearing a carpal tunnel brace during the day and night.

 Your doctor may prescribe a cortisone-like medicine or a nonsteroidal anti-inflammatory medicine, such as ibuprofen. Your doctor may recommend a cortisone-like medicine to rub into the carpal tunnel area. In some cases surgery may be necessary. If you have a disease that is causing carpal tunnel syndrome (such as rheumatoid arthritis), treatment of the disease may relieve your symptoms.

How Long Will The Effects Last? How long the symptoms of carpal tunnel syndrome last depends on the cause and your response tor treatment. Sometimes the symptoms disappear without any treatment, or they may be relieved by nonsurgical treatment. Surgery may be necessary to relieve the symptoms if they do not respond to treatment or they get worse. Surgery usually relieves the symptoms, especially if there is no permanent damage to the nerve.

Symptoms of carpal tunnel syndrome that occur during pregnancy usually disappear following delivery.

How Can I Take Care Of Myself? Follow your doctor's recommendations. Also, try the following:

• 1. Elevate your arm with pillows when you lie down.
• 2. Avoid activities that overuse your hand.
• 3. Find a different way to use your hand by using another tool or try to use the other hand.
• 4. Avoid bending your wrists down for long periods.

 When Can I Return To My Sport Or Activity? The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport will be determined by how soon your wrist recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may return to your sport or activity when you are able to painlessly grip objects like a tennis racquet, bat, golf club, or bicycle handlebars. In sports such as gymnastics, it is important that you can bear weight on your wrist without pain. You must have full range of motion and strength of your wrist.

HOW TO PREVENT CARPAL TUNNEL SYNDROME

 If you perform repetitive work with your hands, make sure that your hands and wrists are comfortable when you are using them. Take regular breaks from the repetitive motion. Avoid resting your wrists on hard or ridged surfaces for prolonged periods. If you have a disease that is associated with carpal tunnel syndrome, effective treatment of the disease might help prevent this condition. In some cases, the cause is not known and carpal tunnel syndrome cannot be prevented.

Carpal Tunnel Rehabilitation Exercises: You may do all of these exercises right away.

1. Active range of motion

A. Flexion: Gently bend your wrist forward. Hold for 5 seconds. Repeat 10 times. Do 3 sets.

B. Extension: Gently bend your wrist backward. Hold this position 5 seconds. Repeat 10 times. Do 3 sets.

2. Stretching

A. Place both palms on a desk or table. Gently lean your body forward over your wrists and hold for 15-30 seconds. Repeat 3 times.

B. With your uninjured hand, help to bed the injured wrist down by pressing the back of your hand and holding ti down for 15 to 30 seconds. Do this twice.

3. Tendon glides: Start with the fingers of your injured hand held out straight. Gently bend the middle joint of your fingers down toward your upper palm. Hold for 5 seconds. Repeat 10 times. Do 3 sets.

4. Wrist flexion: Hold a can or hammer handle with your palm up. Bend your wrist upward. Hold this position for 5 seconds. Repeat 10 times. Do 3 sets. Gradually increase the weight of the object you are holding.

5. Wrist extension: Holding a can or similar object with the palm down, bend the wrist up. Hold this position for 5 seconds. Repeat 10 times. Do 3 sets.

6. Grip strengthening: Squeeze a rubber ball and hold for 5 seconds. Repeat 10 times.

All material provided is designed for information purposes only and should not be used to replace the care of a health care professional. Do not rely on any of the information for diagnosis or treatment. It is recommended that you visit a qualified health care professional for individual and personal attention.