Carpal Tunnel Syndrome
Carpal tunnel syndrome typically occurs in adults, when the median nerve, which runs from the forearm into the palm side of the thumb and fingers, excluding the little finger, is pressed or squeezed at the wrist. The median nerve also goes along the smaller muscles within in the hand that provides movement to the fingers and thumb. The carpal tunnel of the hand is a narrow, rigid pathway for the bones and ligament that is at the base of the hand, where the nerves and tendons live. Occasionally the tendons become irritated and become thicker and swell; which will narrow the rigid pathway and causes the median nerve to compress. This can result in weakness, pain or numbness in the hand and wrist, radiating up the arm. Painful sensations may mean that other conditions; carpal tunnel syndrome is the most common and highly recognized known of the entrapment neurosciences in which the body’s peripheral nerves are compressed or traumatized.
Symptoms of Carpal Tunnel Syndrome
Symptoms can start slowly with frequent tingling, burning, numbness and itching in the palm of the hand, fingers, specifically thumb and the index and middle fingers. Some individuals with carpal tunnel described as the fingers feeling useless and swollen, even when no swelling is evident. Symptoms often appear in the hands during the night, since many people sleep with their rest fixed. A person with carpal tunnel syndrome may wake up feeling the need to shake their hand. As symptoms become worst, people may feel tingling during the day; the ability to decrease the grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/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.
Carpal tunnel syndrome can be the result of many different factors that can cause increase pressure on the median nerve, and tendons within the carpal tunnel rather than the nerve itself. The disorder is due to the congenital predisposition – the carpal tunnel is smaller in some people hands rather than others. Other contributing factors include trauma or injury to the wrist that causes swelling, like a fracture or a sprain; overactivity or the purity gland; hypothyroidism and rheumatoid arthritis; mechanical problems in the wrist joint; work stress and repeat use of vibrating hand tools. Carpal tunnel can also be caused fluid retention during pregnancy or menopause; or development of a cyst or tumor in he canal. In other cases, there is no cause identified.
There is not enough evidence to indicate whether repetitive or forceful movements of the hand and wrists activities can cause carpal tunnel syndrome. There are disorders such as tendonitis and bursitis that are related to motions performed in the course of normal work or other activities. Repetitive activities may also cause writers cramp.
Women are three times as likely to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than men. The dominant hand is usually the first affected by carpal tunnel syndrome and will produce the most severe pain. People with diabetes or metabolic disorders that directly affect the body’s nerves and make them more at risk for compression.
What is the Risk of Developing Carpal Tunnel Syndrome?
The risk of developing carpal tunnel syndrome is not limited to certain people within specific industries. Everyone can be affected. However, there is a higher risk for people who work in manufacturing, finishing, cleaning, meat packing, and those who work on computers are three times more likely to develop carpal tunnel.
Early diagnosis and treatment can be essential in avoiding permanent damage to the median nerve. A physical examination of the hand, arms, shoulders, and neck can help determine if the patient’s complaints are related to daily activities or an underlying disorder, and can rule out other conditions that can mimic carpal tunnel syndrome. The wrist is examined for tenderness, discoloration, swelling, warmth. Each finger should be tested for sensation, and the muscles at the base of the should be examined for strength and signs of atrophy. An X-ray and real arthritis, diabetes, and fractures.
Doctors may use a specific test to produce the symptoms of capable tunnel syndrome. IN the final test, the doctor will tap or press against the median nerve in the patient’s wrist. If the test is positive for carpal tunnel, there can be a sensation. The Phalen, or wrist-flexion, test involve having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together.
There may be a need for the electrodiagnostic test, in which electrodes are placed on the hand and the wrist. Small electric shocks are applied and in the speed of the nerve, the reaction is measured. In an electromyography, a fine needle is entered into a muscle. Electrical activity viewed on a screen can determine the severity of the damage to the median nerve. Ultrasound imaging can show the abnormal size of the median nerve, through magnetic resonance imaging (MRI) can show the anatomy of the wrist but to date has not been especially useful in diagnosing carpal tunnel syndrome.
Treatment for Carpal Tunnel Syndrome
Treatments for carpal tunnel syndromes should begin as soon as possible based on the underlying cause. Initial treatment involves resting the affected hand for at least two weeks. Avoiding activities that would word symptoms. Avoiding activities can worsen the symptoms, and immobilizing the wrist in a splint to prevent fetch damage from twisting or bending. If there is inflammation, applying cool ice can help reduce swelling.
Medical In certain circumstances, different drugs can ease the pain and bleeding that is linked to carpal tunnel syndromes. NSAID drugs such as ibuprofen, and aspirin, and other prescription pain relievers may ease symptoms, that have been present for a short time can cause by strenuous activity. Diuretics, water pills can become decrease swelling. Corticosteroids ( such as prednisone ) or the drug lidocaine can be injected directly into the wrist or taken into the mouth. People with diabetes or be predisposed to diabetes should note the prologned use of corticosteroids, can make it difficult to regulate insulin levels. Corticosteroids should not be taken without a doctor’s prescription. Some studies show vitamin B6 pyridoxine supplements
Exercise – such as stretching and strengthening exercise can be helpful in people whose symptoms have abated. These exercises can be supervised by a physical therapist.
Alternative therapies, such as acupuncture and chiropractic care have benefited some patients, but their effectiveness is not proven.
Surgery is an option
Carpal tunnel release is a surgical procedure that is common in the United States. Surgery is recommended for individuals who have six months of the symptom. In the surgery a band of tissue around the wrist is severed to reduce the pressure on the median nerve. Local anesthesia is used and does not require overnight care in the hospital. Many patients will have surgery on both hands.
There are several types of surgery:
Open release surgery is a procedure that helps correct carpal tunnel syndrome, which consist of making an incision that is 2 inches or less in size, and the carpal ligament is to enlarge the carpal tunnel. This procedure is complete under local anesthetic and is usually done on an outpatient basis.
Endoscopic surgery can allow faster functional recovery and less postoperative discomfort than one release surgery. The surgeon makes two incisions about 1/2 inch each in the wrist and palm, inserts a camera attached to a tube, observes the tissue on a screen, and cuts the carpal ligament *the tissue that holds joints together). The two portal endoscopic surgery is normally performed under local anesthesia. With Endoscopic surgery, there is less scarring and tenderness from scaring. Single portal endoscopic surgery for carpal tunnel syndrome is also an option can result in a post -operative pain and minimize scarring.
After surgery symptoms full recovery from carpal tunnel surgery can take months. Some patients may have complications and produce some infection, stiffness, pain at the scar or nerve damage. Occasional the wrist does lose strength due toe the carpal ligament being cut. Patients may need to undergo physical therapy after surgery to restore wrist strength. Some patients may need to adjust job duties or even change jobs after recovery from surgery.
Carpal tunnel syndrome prevention
Carpal tunnel sufferers, can perform stretching exercises, take frequent rest breaks, where splints to keep wrists and use correct posture and wrist position. Wearing fingerless gloves can help keep hands warm and flexible. There are workstation tools and handles that can be redesign to enable the workers wires to maintain position naturally during work.