What Going on with Your Carpal Tunnel?
A common problem as we get older is tingling or numbness in our hands, or pain between the wrist and elbow. If such symptoms are great enough, it’s likely then that we have carpal tunnel syndrome, a condition in which the median nerve, nerve running from the forearm to wrist, becomes pressured (1). The carpal tunnel is the space that houses this nerve, so anything that causes that space to decrease, will lead to pressure on the nerve. Medical conditions that can cause this are obesity, arthritis, and pregnancy (ibid). However broken bones, bone spurs, and swelling from repeated hand motions can cause increased pressure on the nerve as well (ibid). So, jobs that focus on repeated hand motions for long periods of times could cause this, such as manufacturing, landscaping, and accounting.
The symptoms of carpal tunnel syndrome are gradual, so it won’t seem like much at first, but it progresses and become a problem if not taken care of. At first, people will feel a little numbness on your hand, wrist, or forearm (ibid). Possible stiffness in fingers in the morning or occasional pain in the forearm throughout the day (ibid). This is stuff people will just overlook, as a one time thing or something that will disappear with a little rest. However as it progresses, people will feel numbness when using their hands, difficulty doing simple hand movements, and over-reliance on the thumb. And if such symptoms persist without action, it’s possible to lose feeling or coordination on the hand, or permanent damage occurs to the median nerve (ibid). So, if you’ve begun to feel any of the symptoms above, visit a physiatrist, pain doctor, immediately.
Luckily, diagnosing carpal tunnel syndrome is not challenging for doctors. The doctor will look over your medical history and conduct a physical exam to determine hand strength (ibid). Using your history, the doctor will look for conditions that could cause pressure on the median nerve. To confirm this, doctor will usually send you for an EMG, nerve test, to check the median nerve or an MRI, which will find swelling of the median nerve.
Depending on your condition upon diagnosis, there are several treatment options. If it has been found that the condition is mild, you’ll be asked to rest your wrist for long periods between activities, icing hourly, and use of a wrist splint at night to prevent the numbness or tingling that is frequent of this condition (ibid). You’ll also be prescribed NSAIDS, non-steroid drugs, which can reduce pain or swelling (ibid). If the situation is serious, as in difficulty in carrying out simple hand movements, doctors will advise the use of corticosteroid injections. This will relieve the pressure on the median nerve for a period of time, so you’ll be advised to follow the treatment as those with mild symptoms to prevent it from coming back. If the injections don’t work, a surgical option, with much success, is carpal tunnel release. What is done is a ligament around the wrist is severed; relieving the pressure on the nerve and when the ligament grows back there is more space in the carpal tunnel than before (2). Relief of symptoms is immediate, however, strength in the wrist requires a couple months recovery time, so an adjustment in home life and jobs is required. Now, the thought of surgery is frightening for some, but this is a safe and effective procedure. It is done under local anesthesia and is relatively quick, no overnight stay is required. There is a low possibility of infection or pain at the scar, but other than that it is quick and successful procedure.
If you’ve undergone one of the treatment options above and have felt success, there are measures you should take to prevent symptoms from returning. First, don’t jump back into your way of life as before, because that was most likely the root cause of the symptoms in the first place. So, to prevent symptoms from returning, you would need to keep pressure off your wrists, so switch your hands when repeating movements and rest your hands (1). Also, it is imperative that you maintain a correct posture because this will keep from additional pressure on the wrists (ibid). Also, for the first couple of months after recovery, continue wearing a wrist splint at night to keep wrist at neutral position (ibid). Above all else, maintain a healthy diet and exercise regularly, because this will keep your wrists and forearms flexible.
So, carpal tunnel syndrome is a bothersome condition, especially since it usually occurs after an injury or is caused by a preexisting condition. Having to deal with one condition is quite taxing on people, and possibly leads them to ignore the early symptoms of carpal tunnel syndrome. However, if you have any of the symptoms mentioned above, it is imperative that you see a doctor because it will get worse. If caught in the early stages, it can be treated easily, but if it gets worse, surgery may be needed. However, surgery is quick and efficient and recovery is expected in all treatment options. So, the onus is on you to make the necessary lifestyle changes to prevent it from coming back.
References:
- "Carpal Tunnel Syndrome - Topic Overview." WebMD. WebMD, n.d. Web. 17 Mar. 2017. <http://www.webmd.com/pain-management/carpal-tunnel/carpal-tunnel-syndrome-topic-overview#1>.
- "Carpal Tunnel Syndrome Fact Sheet." National Institutes of Health. U.S. Department of Health and Human Services, n.d. Web. 17 Mar. 2017. <https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Carpal-Tunnel-Syndrome-Fact-Sheet>.
