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“Oh, my aching hands!” Do you have carpal tunnel syndrome?

Betty Jean Randy, 59, is a writer who is on her computer day and night but lately, she can barely stand to type on the keyboard because of the radiating pain in her hands.  “My hands hurt so badly right down to my fingertips!  Sometimes, I am barely able to hold a pen!”  We use our hands and wrists to do everything but when pain or weakness strikes them, the culprit just might be carpal tunnel syndrome.

What is carpal tunnel syndrome?

The carpal tunnel is a small passageway in the hand. The median nerve, which sends sensory information to the fingers, runs through the carpal tunnel. When tendons and ligaments in the carpal tunnel become swollen, they put pressure on the median nerve and may cause carpal tunnel syndrome.   

Symptoms

The symptoms of carpal tunnel will often worsen over time.  The main sensation is pain in the palm, wrist or forearm, especially along the side of the thumb. A sufferer might also feel numbness, tingling, or pins and needles in their hands, and have difficulty gripping items.

Arthritis can also mimic carpal tunnel syndrome somewhat except that numbness and tingling are exclusive to carpal tunnel syndrome, whereas swelling is exclusive to arthritis.

Causes

The most common cause of carpal tunnel is repetition, using your hands to do the same thing day in and day out like typing or using a computer mouse. Seniors seem to be experiencing more carpal tunnel symptoms because of constant computer use.  If someone was born with a small carpal tunnel or has fractured a wrist, they will probably suffer from carpal tunnel. In addition, diabetics and rheumatoid arthritis sufferers are also at high risk for developing carpal tunnel. The syndrome is also very common in women around the time of the menopause and in women treated with certain breast cancer drugs.

People who are obese also tend to experience carpal tunnel, as do musicians, and workers who use vibrating hand-held tools. Carpal tunnel also tends to run in families. About one in four people with the syndrome have a close relative, such as a parent, brother or sister, who also has the condition. It is not fully understood how and why the condition is passed on through families.

Diagnosis

A physician can typically diagnose carpal tunnel by asking you a series of questions and then examining your hand. If there is some question as to whether or not your symptoms are carpal tunnel related, you may be referred to a facility for imaging studies like an X-ray and/or ultrasound. A nerve conduction study is a test that a doctor might also recommend and this measures how fast signals are transmitted through your nerves.

Treatment

A physician’s course of treatment for carpal tunnel will depend on the severity of the condition. In a few cases, the carpal tunnel’s symptoms may disappear without any form of treatment. If the syndrome’s symptoms are constant, however, there are several non-surgical and surgical remedies that aim to relieve the pressure on the median nerve.

In those patients who have a milder form of carpal tunnel, a physician might recommend a wrist splint to support the wrist. The splint prevents the wrist from bending, which can place pressure on the median nerve and aggravate your symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin) might also offer some relief in a few cases. Corticosteroids, a type of steroid medication can help reduce inflammation and can be administered via injection which is the most preferred method or in tablet form.

If the carpal tunnel is severe and other treatments have failed, surgery is probably the best course of action. Surgery for CTS is known as carpal tunnel decompression or carpal tunnel release surgery and is performed on an outpatient basis, which means you will not have to stay in a hospital overnight. During surgery, the roof of the carpal tunnel, known as the carpal ligament, is cut to reduce pressure on the median nerve in the wrist. In most cases, carpal tunnel release surgery provides a complete and permanent cure. However, as with all surgical procedures, there is always some form of risk involved like infection, nerve injury, or a new pain that differs from the original one.

 

 

For more info about carpal tunnel syndrome contact the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), www.niams.nih.gov

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