Chủ Nhật, 12 tháng 1, 2014

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome Carpel tunnel syndrome is a disorder that causes tingling pain in your hand due to the development of pressure on the wrist. Carpel tunnel is the name of portion that runs from forearm to your hand. There will be enough pressure created on the median nerve due to underlying medical conditions like hypothyroidism or due to inflammation. This area (carpel tunnel) is responsible for controlling movements and creating feeling in your thumb and three other fingers of your hand.


Causes :


The major cause of carpel tunnel syndrome is the pressure accumulated on the median nerve. Pressure can be caused due to many reasons like swelling, wrist injuries and obesity. Medical conditions like rheumatoid arthritis, hypothyroidism and diabetes can cause swelling on the wrist. Obese people and pregnant women are more inclined to develop this disorder. Making wrong movements with the wrist repeatedly, bone spurs can also cause fluid accumulation on the median nerve of the carpel.


Carpel is the narrow path which is about the size of your thumb found on the palm side of your hand. There are one main nerve and nine tendons that are responsible for bending the fingers. When this main nerve is pinched it can cause numbness and weakness eventually. Anything that irritates and compresses the carpel tunnel nerve can cause this tingling pain on the hand.


Formation of tumors and ganglion on the wrist can cause pressure on the carpel tunnel. Due to continuous usage there can be wear and tear of the tissues of the wrist which can be caused due to old age. Prolonged smoking habit can obstruct the normal blood flow causing carpel tunnel syndrome. It can occur as a workplace injury for many people whose job is to use their hands at the maximum for work. Finally there can be no apparent cause for this syndrome and combination of many factors can be a problem.


Symptoms :


Tingling sensation in your hands more particularly on your fingers (thumb and index fingers) are felt. You can feel this when you are holding your fingers for long like reading a newspaper or driving a car etc. There will be numbness in these fingers for some time which you can reduce it by shaking your fingers for a while.


There can be pain radiating towards your arm from the wrist area. Most of the symptoms like weakness, tingling sensation and numbness are felt only on middle finger, index finger and thumb and not on other two fingers, since these fingers are controlled by median nerve on the palm. Due to progressive weakness you may drop some objects while holding it for long.


Who are at risk?


Individuals with anatomic factors like dislocation of bones, wrist fracture etc is prone to develop carpel tunnel syndrome. This disorder is more common in women than men. People with chronic illness like diabetes or arthritis are under the risk of having nerve damage that leads to carpel tunnel syndrome. Certain infectious diseases can cause this problem.


Women who are pregnant or under the stage of menopause will have hormonal imbalance that will eventually lead to increased body fluids. This can cause this syndrome. Individuals who are working with tools all the time like in assembly line will have to use their wrist for extended time which can cause pressure on the median nerve or nerve damage.


Complications :


There is no serious complication with this disorder but carpel tunnel syndrome can cause constant damage to the median nerve. This may produce constant numbness in your fingers which may become weak after some time. Having this problem for long-term cause make you lose feeling in your hand and fingers. You may not be able to hold any objects with your fingers. It can affect the quality of life if you cannot perform your routine work at workplace.


Tests :


Your doctor will look for the above symptoms to detect carpel tunnel syndrome. He will test your fingers and muscle strength in your hand. He may order for X-ray of your wrist bone for knowing the correct position. Electromyogram can be done for measuring electrical discharge of muscles. He may conduct nerve conduction test in which two electrodes will be taped with your skin which will record the pulse when shock is sent through them. If the median nerve is affected your doctor may request for MRI scan for measuring the intensity of swelling.


Treatment :


The purpose of treatment is to reduce the inflammation of the tissues that surrounds the wrist median nerve and to address other symptoms of this syndrome. Your doctor will have to find out the cause and accordingly start with treatment. Carpel tunnel syndrome can be detected at early stages and can be cured completely without surgery. Mild to moderate types of symptoms will require medications combined with home treatment for 1-2 weeks. But if the signs are severe and your wrist or hand becomes incapable of performing simple movements, then surgery has to be done.


You can apply cold packs or wet compression on your hands to get relief from numbness and pain. You can rest your hands frequently by taking breaks in office to reduce swelling. Wrist splinting is a good option for most of the people affected with CTS with mild to moderate symptoms. The splint will help you holds the wrist tightly when you are asleep which will reduce the numbness and tingling sensation considerably.


To reduce inflammation and pain you can take anti-inflammatory drugs of type NSAID. For severe pain your doctor may inject a shot of corticosteroid on the fingers which will decrease swelling and relieve you from pain. For people with underlying medical issues like diabetes or arthritis (being root cause) your doctor will treat the underlying condition to reduce the symptoms.


Surgery is the only choice for individuals with severe nerve damage for long-term. The surgeon will cut down the ligaments and tissues that exert pressure on the median nerve. After healing process, the tissues will grow again thus providing more space for the median nerve. Endoscopic method is used in which a tiny telescope is inserted into the tube by making small incisions in your wrist portion. Then your surgeon will gently cut off the ligaments or tissues that build up pressure on the nerve.


During open surgery large incision is made for repairing the damaged nerve. You have to follow the instructions of your doctor by not making any forceful movements with your hand for some time after surgery. If you are a pregnant woman you can postpone the surgery till delivery. Most of the time, the symptoms will disappear after child-birth without wanting any treatment.


Home Remedies :


If you have symptoms of numbness or pain on your hand when you are working with your hands for long time, then you should take a break for relieving the symptoms. You can rotate the wrists gently and do stretching exercises for your fingers and palms.


For managing pain, you can take aspirin or ibuprofen. Wearing a splint is highly effective for reducing most of the symptoms. Wear it overnight so that you will not have any signs of numbness or pain next day. When you are sleeping you should not rest your head on your hands since it will exert constant pressure on your wrists. You can practice physiotherapy from a trained therapist to bring back the lost muscular strength on your hands.


Other Treatments :


Some people do acupuncture for getting quick relief from the ongoing symptoms like hand pain and numbness. Practice yoga regularly which will help in relieving pain from your fingers. You can also contact a chiropractor for massaging the hands and fingers to reduce swelling on the median nerve. Take vitamin B6 supplement in your daily diet to reduce the symptoms.


Prevention :


You can prevent getting carpel tunnel syndrome by monitoring your health and work related activities. Keep your finger muscles and hand strong. Observe whether there is any pain or numbness in your hand while you are working for long. Make uniform movements by your wrist and do not exert pressure on the median nerve that causes this syndrome.


Maintain your weight and stay healthily. Remain in the right posture and do not over-exert your hands or wrists for making awkward movements. Reduce the salt intake in your diet to reduce fluid accumulation and swelling. In case you feel that usage of particular tool causes intense pain and numbness on your hands you can request your manager to assign other job that involves less movements with your hands.


In case your work involves constant writing then you can use big pen that is equipped with soft adapter so that you will not exert more force for holding the pen. Take short breaks whenever possible to stretch your hands. Do not bend your wrists very much for reaching objects. Always stay in relaxed position when you are typing on keyboard. Make sure that you are seated in right posture so that your shoulder muscles and neck muscles are not strained. Individuals working in cold environment can wear hand gloves to keep their hands warm.


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