 |
 |
 |
|
Rebecca Willard is returning to do some hours in the clinic in December - please call or e-mail to book an appointment for your pre-Christmas check up!
What is carpal tunnel syndrome?
The carpal tunnel is a channel in the palm side of the wrist. The bones of the wrist are arranged in a semi-circle, a tough ligament called the transverse carpal ligament forms a roof over them creating a passageway - the carpal tunnel. Running through the carpal tunnel are the tendons that are used to bend the fingers and wrist and the median nerve. The median nerve is one of three nerves that connect to the hand and also controls some of the muscles that move your thumb. Carpal tunnel syndrome can occur if there is too much pressure on the median nerve. Carpal tunnel syndrome is a fairly common condition. About 3 in 100 men and 11 in 100 women develop carpal tunnel syndrome at some point in their life.
What are the symptoms of carpal tunnel syndrome?
Symptoms usually start gradually, with frequent burning, tingling, or an itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell between hot and cold by touch.
|
|
 |
Causes of carpal tunnel syndrome
Because there isn't much room in the carpal tunnel, any swelling around it can press on the median nerve, causing the symptoms of carpal tunnel syndrome. Carpal tunnel syndrome can also occur if you:
- start doing a manual job you aren't used to, such as house painting
- have rheumatoid arthritis in your wrist joint have osteoarthritis in your wrist as a result of an old fracture
- are pregnant
- have thyroid problems
- have acromegaly, a condition caused by too much growth hormone (a chemical produced naturally by your body)
- have diabetes
- have cysts in your carpal tunnel
- take certain medicines, such as the oral contraceptive
For many people, it isn't known why carpal tunnel syndrome develops. Other nerve and tendon disorders may produce similar symptoms.
|
|
 |
Who is at risk of developing carpal tunnel syndrome?
Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain. People with diabetes or other metabolic disorders that directly affect the body's nerves and make them more susceptible to compression are also at high risk. Carpal tunnel syndrome usually occurs only in adults.
The risk of developing carpal tunnel syndrome is not confined to people in a single industry or job, but is especially common in those performing assembly line work e.g. manufacturing, sewing, finishing, cleaning and meat packing. In fact, carpal tunnel syndrome is three times more common among assemblers than among data-entry personnel.
How is carpal tunnel syndrome diagnosed?
Early diagnosis and treatment are important to avoid permanent damage to the median nerve. A physical examination of the hands, arms, shoulders and neck can help determine if the patient's complaints are related to daily activities or to an underlying disorder and can rule out other painful conditions that mimic carpal tunnel syndrome. The wrist is examined for tenderness, swelling, warmth and discoloration. Each finger is tested for sensation and the muscles at the base of the hand are examined for strength and signs of atrophy. Routine laboratory tests and X-rays can reveal diabetes, arthritis and fractures.
|
|
 |
Treatment of carpal tunnel syndrome
Carpal tunnel syndrome treatment aims to relieve the symptoms by reducing the pressure on the median nerve. Treatment should be started as early as possible.
- Self-help
If the condition is linked to the way the hands are used, it is important to try to change how you do things. Changing repetitive movements, reducing how often they are done and increasing the amount of rest between periods of activity should help.
Stretching exercises can help to relieve the symptoms and keep the area mobile. Mild symptoms can be relieved by resting the hands and wrists regularly and by applying a cold pack, such as ice or a bag of frozen peas, wrapped in a towel. Ice should not be applied directly to the skin as it can damage your skin.
- Complementary therapies
Chiropractic treatment and acupuncture may help to relieve symptoms of carpal tunnel syndrome.
- Non-surgical treatments
Wrist splints are often recommended for use either at night, or both day and night although they can get in the way whilst doing daily activities. These help to keep your wrist straight and reduce pressure on the compressed nerve. Research indicates that ultrasound treatment can help reduce the symptoms of carpal tunnel syndrome.
- Medicines
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen don't seem to have much effect on carpal tunnel syndrome symptoms unless it's caused by an inflammatory condition. Diuretics (water tablets) have also been prescribed for carpal tunnel syndrome but recent studies do not show much benefit. There are other medicines available for carpal tunnel syndrome that your GP may prescribe for you. Corticosteroid tablets can provide relief of the symptoms in the short term but they have side-effects if they are taken for too long. GP's may suggest steroid injections (for example hydrocortisone) into the carpal tunnel.
- Surgery
If the symptoms are severe, Surgery may be suggested which releases the carpal tunnel. This operation involves cutting the carpal ligament to make more space for the nerves and tendons in the carpal tunnel. It’s usually done as day-case surgery under a local anaesthetic.
|
|
|
 |
to unsubscribe click here
if this email doesn't display correctly, view
the online version
|
|
