Carpal Tunnel Syndrome is common in the workforce especially where repeative movements of the wrist are used. Understanding symptoms and prompt care is important. This article should help with this information and encourage prompt diagnosis.
Carpal Tunnel Syndrome
The median nerves running along the palm side of the wrist known as the “carpal tunnel region” serves the thumb side of the hand. The Bureau of Labor Statistics, report that of approximately 60% of workforce, cumulative trauma disorders the most recurrently reported is carpal tunnel.
Carpal Tunnel Syndrome is an ailment predominant in women and is not limited to only one hand. Extension of the wrist in repetitious movements is an inducement for carpal tunnel syndrome. Occupations involved in the routine use of a computer keyboard and workers who use small tools that require repetitive use of the wrist, are susceptible. The jarring of jackhammer tools or the constant vibrations of a lawn mower can be a cause of this syndrome. Other risks to develop carpal tunnel syndrome appear to be individuals who have rheumatoid arthritis, diabetes, a sluggish thyroid gland, and pregnancy.
CTS The Cause
Eight carpal bones in the wrist form a tunnel like configuration. This tunnel is filled with tendons called flexor tendons used to manage movements of the fingers. The median nerve has an avenue within this tunnel to reach sensory cells (feelings of sensation) in the hand. Damage to the wrist may cause the protective sheaths encompassing the tendon to grow thicker. These swollen sheaths create compression on the median nerve and carpal tunnel syndrome can be the result.
One early sign may be the first three fingers of the thumb side of the hand are as painful. Symptoms include a lack of feeling, tingling, a perception of rigidity as if the area is swollen.
The positioning of the hand in a flexed position while sleeping may initiate more intense pain. As symptoms of CTS continue, an inability to clasp or squeeze things will be noticed. Other indications may be loss of strength in the fingers and an inability to determine the difference in hot or cold by contact. Detailed intricate movements such as picking up small things, buttoning a shirt or blouse, will be altered. Over a period of time muscles in the hand, thumb side; can deteriorate from lack of use.
Early diagnosis is imperative in order to avoid ongoing damage to the median nerve A physician will evaluate for CT by physical examination of the affected hand and wrists, shoulders, arm, and neck. Feelings of sensation will be determined in each finger, and muscles at the inferior portion of the hand will need to be checked for diminishing function. Such factors as arthritis, diabetes, or fractures will be eliminated by x-ray.
The Tinel test is one in which the doctor tries to bring about the symptoms of CT by manipulation of the wrist as in, light tapping or applying pressure on the median nerve. The test may prove CT if a resulting painful, electrical shock like response occurs. Flexibility of the wrist is determined by the Phalen test that positions the forearms and hands together in such a way as to determine pain, tingling sensations, and numbness.
An Electrodiagonstic test is one that uses tiny electric shocks to determine any damage to the median nerve. Another method of diagnosing adversely affected motion or agility of the wrist can be found by using ultrasound imaging. MRI competently shows bone structure of the wrist however is not very useful in diagnosis of CT syndrome.
Avoidance of continued trauma-producing injury will be the first advice on the doctor’s agenda. Resting the injured wrist for a week or two is usually suggested. The use of a splint to secure and limit movement of the wrist will help to avoid the probability of further injury.
Anti-inflammatory drugs or cold packs may be used to reduce any current swelling of the area. Some choices of non-steroid over the counter medication to reduce inflammation may be aspirin, or ibuprofen. Injections with corticosteroids into the wrist, or oral medications containing steroids may be used for short term and prompt relief. A physical therapist may help with certain exercise that stretch and strengthen the muscles of the wrist area. These procedures are usually enacted after initial symptoms have lessened.
If intensive, continuing, pain remains, then surgery may be required. The surgery is usually done with local anesthesia, and as a rule does not require hospitalization. The “carpal tunnel release” will act to relieve pressure on the median nerve and is generally very successful and is consequently accountable for relief from pain and discomfort.
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