Carpal Tunnel Syndrome
Carpal tunnel syndrome is as misunderstood as it is painful. While many people attribute the cause to long days at a keyboard, its origins are generally more difficult to define.
The carpal tunnel is formed by the carpal bones and transverse carpal ligament in the wrist. Within this tunnel are the flexor tendons that move your fingers and thumb and the median nerve, which transmits feeling in the index and long fingers and the underside of the thumb, and also controls the muscles around the thumb’s base.
Just as some people are smaller than others, some are also born with smaller carpal tunnels. These individuals are at higher risk for developing carpal tunnel syndrome because the median nerve has less room inside the tunnel and is more likely to be compressed. Other risk factors include hypothyroidism, fluid retention during pregnancy or menopause, a cyst developing in the tunnel, and trauma or injury that causes swelling. Often, the syndrome is caused by a combination of these factors.
Carpal tunnel syndrome is marked by the gradual appearance of a range of symptoms — including burning, numbness or an electric shock-like sensation that travels up the arm — that begin in the hand and fingers. Because people often sleep with their wrists flexed, symptoms can often be more severe at night, but symptoms can occur at any time. If you do not seek treatment, the pain may become constant.
Those who frequently work with their hands are at a higher risk of the condition. If computer work is typically part of your day, take frequent breaks and ensure you sit up straight and keep your wrists straight while typing.
Treatment for carpal tunnel syndrome begins with pinpointing the cause of your symptoms. Through X-rays and electrophysiological and manual exams that test the median nerve’s function, your doctor will be able to target the problem.
Conservative treatments aim to stop the syndrome’s progression by modifying exacerbating factors, such as repetitive motions.
Activity modification, if possible, is an easy way to stop the syndrome’s progression. If your daily activities are loaded with repetitive hand movements, find another way of getting the job done.
Anti-inflammatory medications, such as ibuprofen, or corticosteroid injections can give relief for a time, but symptoms may return.
Bracing or splinting — especially at night — can keep your wrist in a neutral position and prevent wrist movement from contributing to compression of the median nerve.
Minimally invasive surgical interventions can successfully reduce pressure on the median nerve by dividing the carpal ligament and increasing the size of the carpal tunnel.
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