If you've been bothered lately by an ache in your hand or wrist, or if you have numbness
in your fingers, you may be feeling the effects of carpal tunnel syndrome. Carpal
tunnel syndrome (CTS) affects millions of Americans, particularly those who use
the same hand or wrist motions repeatedly in their work or other activities. Carpal
tunnel syndrome can be painful and, in some cases, disabling. The good news is, the
disorder is preventable and treatable, especially if the right steps are taken early.Your wrists are among your body's hardest working
joints. They help you perform most of your daily tasks. Located in the center
of your wrist is a narrow passageway about 1½"
long, called the carpal tunnel. Within this narrow opening a major
nerve (the median nerve) and several flexor tendons fit
snugly together as they pass from the forearm into the hand. Much of the movement
and sensation you enjoy with your hands is made possible by these tendons and the median
nerve.
 The wrist (carpal) bones form the bottom and two
sides of the carpal tunnel.
The top of the tunnel is formed by the transverse carpal
ligament, a tough band of
tissue which lies across the heel of the wrist. It connects
the wrist bones and helps
stabilize the wrist joint.
The median nerve carries sensations from the
thumb, the first two fingers and half of
the ring finger, to the brain.
Nine flexor tendons connect muscles to bone,
allowing you to bend the fingers and
grasp objects. They are covered with a lubricating tissue
which lets them move
smoothly as the fingers or wrist bend and extend.
Cross Section View
Showing Anatomy of the Wrist and the Carpal Tunnel |
Carpal tunnel problems are typically caused when
heavy demands are placed on the hand or wrist through repeated, forceful movements.
Over time, repeated motions lead to wear and tear and swelling of the tendons. As
the tendons swell, they press against the median nerve, squeezing it between the wrist
bones and the transverse carpal ligament. The nerve responds to this excess
pressure by sending pain and other sensory signals to the brain.
A wide variety of conditions can cause swelling in
the wrist, or make wrist structures take up extra space. Any of these conditions can
result in pressure on the median nerve and related CTS symptoms:
Wear and tear (repeated motion causing swelling
resulting in increased nerve pressure)
Wrist fractures or injuries (narrowing the tunnel as the
bones change position)
Fluid retention (hormone changes at menopause or
pregnancy, obesity, birth control
pills, increased salt intake)
Other underlying medical conditions (diabetes,
rheumatoid arthritis, thyroid
imbalance)
Carpal tunnel symptoms usually develop gradually and
vary from person to person. Generally, patients feel pain, numbness, burning or
tingling (like "pins and needles") in the hand, wrist, or fingers (especially
the thumb, index, and middle fingers). Pain may radiate up the arm to the elbow,
neck or shoulder. Symptoms can be constant or come and go. They often get
worse at night or after strenuous activity involving the hands. One or both hands
may be affected.
Without treatment, CTS symptoms may continue to get
worse. You may have increased pain, decreased feeling in the hand, and gradual loss
of grip strength. Simple tasks like grasping a handle or utensil may prove
difficult. If you're experiencing CTS symptoms, getting help early can bring prompt
relief while reducing the risk of permanent nerve damage.
A variety of treatments is available to help relieve
or eliminate carpal tunnel symptoms. Each is designed to reduce swelling and
pressure on the median nerve. Non-surgical treatments may be al that's needed to
control your symptoms. But if it continues, or the threat of nerve damage exists,
effective surgical treatment is available.
Wrist Splints. Since flexing the wrist can
worsen symptoms, a rigid splint device may
be used to keep the wrist straight and restrict movement.
Splints may be worn at night,
during the day, or both.
Medications. To reduce the symptoms of pain,
swelling or fluid retention.
Cortisone Injections. To reduce inflammation
within the wrist.
Surgical Treatment. The transverse
ligament is surgically cut to "release" the carpal
tunnel and relieve nerve pressure. The procedure is
performed as outpatient surgery
(usually under local anesthesia) and normally takes 30 - 60
minutes.
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This news
letter does not replace professional medical care.
See your physician for diagnosis and treatment of medical
problems.
Reprinted with permission of Evergreen Publications. |
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