Carpal Tunnel Syndrome-What, Why?
Tingling and numbness in your wrist and hand. You have had it for months, it’s getting worse. It keeps you awake at night and making your work day painful and long. Welcome to Carpal Tunnel Syndrome – probably one of the most common syndromes affecting thousands and thousands of individuals from virtually every occupation and walk of life.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a painful and progressive condition caused by compression of the median nerve travelling through the carpal tunnel. The median nerve along with nice flexor tendons pass through the carpal tunnel that is surrounded on three sides by carpal bones.
The finger and wrist flexor muscles including their tendons original in the forearm at the medial epicondyle of the elbow joint and attach to the thumb and fingers. The median nerve controls sensations to the palm side of the thumb and fingers, but not the little finger. The nerve also controls impulses to small muscles in the hand.
Symptoms of Carpal Tunnel:
The median nerve can be compressed by a decrease in the size of the carpal tunnel or swelling of the tendons. Thr resulting compression of the median nerve may be pain, weakness or numbness in the hand and wrist, also radiating up the arm. The symptoms may be worsened at night due to different sleeping positions.
The symptoms can range from mild to extreme. These worsen over time and besides pain in the fingers and wrist, loss of grip strength may also develop. Pain may also radiate to the arm and shoulder, along with swelling of the hand.
Causes of Carpal Tunnel:
Repetitive movements and hand manipulating activities may be the culprit. Poor ergonomics in the workplace and flexing the wrist at 90 degrees also could be the cause.
Prevention of Carpal Tunnel:
Stretching: stretching exercises of the wrist, hand and fingers is essential to allay the pain and numbness caused by repetitive movements. Also range of motion exercises for the fingers is important – clenching your fist tighting for 3-5 seconds, then release and straighten the fingers holding the extension for 3-5 seconds – repeating for 5 times on each hand.
A rigid split helps limit the wrist flexion thereby helping to reduce the numbness. Wearing braces at night and during the activities that cause stress to the wrist will help. Splits should also be worn at night.
Massage is one of the most overlooked methods of treatment. Myofascial release and active stretching may help to erase symptoms of pain, numbness and tingling. Always follow massage with stretches.
Surgery is generally recommended if symptoms last for 6 months. Open release surgery involves a 2″ incision in the wrist which allow the carpal ligament to be cut to enlarge the tunnel. Usually done under a local anesthesia.
Recovery may take several months and physio therapy is essential to restore wrist strength. Recurrence is rare after surgery and the majority of patients recover completely.
Carpal tunnel is a painful and progressive condition. Treatment should be agressive and immediate. Do not try and suffer through the symptoms. Treat them immediately and take all necessary steps: adjust the workplace conditions if possible, use range of motion and stretching exercises daily, enlist the services of a registered massage therapist to work through deep tissue work and stretching exercises. Finally, surgery may be a necessity if all other modes of treatment are not relieving the symptoms.
Till next time,
“Monitoring, Mentoring, Motivation”
National Institute of Neurological Disorders and Stroke