Carpal Tunnel Syndrome
10
Jun
Carpal Tunnel Syndrome
Wrist Pain and Weakness Carpal Tunnel Syndrome Median nerve dysfunction; Median nerve entrapment Carpal tunnel syndrome is pressure on the median nerve -- the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.
What Causes It?
The area in your wrist where the nerve enters the hand is called the carpal tunnel, a series of ligaments and structures that are normally narrow. Through activities or trauma an inflammation process can occur which cause swelling and lead to a compress of the median nerve which will cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome. Long-term swelling eventually leads to calcification of ligamentous structures which can cause long-term debilitating pain from the constriction.
Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel. Other causes include:
Sewing, Driving, Assembly line work, Painting, Writing, Use of tools (especially hand tools or tools that vibrate, Sports such as racquetball or handball, Playing some musical instruments.
The condition occurs most often in people 30 to 60 years old, and is more common in women than men.
Symptoms
- Numbnessor tingling in the thumb and next two or three fingers of one or both hands
- Numbness or tingling of the palm of the hand
- Pain extending to the elbow
- Pain in wrist or hand in one or both hands
- Problems with fine finger movements (coordination) in one or both hands
- Wasting away of the muscle under the thumb (in advanced or long-term cases)
- Weak grip or difficulty carrying bags (a common complaint)
- Weaknessin one or both hands
Sign:
Physical examination:
- Numbness in the palm, thumb, index finger, middle finger, and thumb side of the ring finger
- Weak hand grip
- Tapping over the median nerve at the wrist may cause pain to shoot from the wrist to the hand (this is called Tinel’s sign)
- Bending the wrist forward all the way for 60 seconds will usually result in numbness, tingling, or weakness (this is called Phalen’s test)
Tests:
- Electromyography
- Nerve conduction velocity
- Wrist x-rays
- should be done to rule out other problems (such as wrist arthritis)
Treatment:
There are a number of approaches to treating carpal tunnel syndrome. The first line of defense is avoidance of the activity that is causing the condition. The primary cause of carpal tunnel is a repetitive motion which causes micro-trauma to ligamentous structures resulting in inflammatory response which leads to constriction of the structures. Typing on a keyboard is the most common cause of carpal tunnel in our society today. While it might be impractical to stop using a keyboard, the position in which we use the keyboard can be modified so as to reduce the amount of pressure placed on the surrounding structures, and this in turn, will reduce the amount of trauma and thereby avoiding/reducing the condition. There are many changes you can make in the workplace/home to reduce the stress on your wrist:
- Special devices include keyboards, different types of mouses, cushioned mouse pads, and keyboard drawers.
- Someone should review the position you are in when performing your work activities. For example, make sure the keyboard is low enough so that your wrists aren’t bent upward while typing.
- You may also need to make changes in your work duties or recreational activities. Some of the jobs associated with carpal tunnel syndrome include those that involve typing and vibrating tools.
- You may try wearing a splint at night for several weeks. If this does not help, you may need to try wearing the splint during the day. Avoid sleeping on your wrists.
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