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• Joint Conditions/Injuries/Treatment

Coming To Grips With Carpal Tunnel Syndrome

Cooks get it. Meat packers get it. Construction workers and musicians get it. Computer operators get it, though not as often as assembly line workers. The fact is, just about any job or hobby that involves frequent, repetitive movements with the hands brings with it the risk of developing carpal tunnel syndrome, which can cause weakness, pain, and numbness in the hands and fingers. 

The carpal tunnel is a narrow passageway of ligament and bones at the base of the hand just at the wrist. This tunnel is a crowded and busy place. Through it pass the tendons that bend your fingers as well as the median nerve, which provides much of the feeling in your hand. 

Carpal tunnel syndrome develops over time as a result of pressure on the median nerve due to swelling of nearby tissues. Though anyone can get carpal tunnel syndrome, it’s usually found only in adults. “About 3 to 6 percent of people are diagnosed with carpal tunnel syndrome,” explains Michael Rymer, MD. “It’s slightly more common in women, and the median age for diagnosis is about 55.”

What Are the Symptoms Of Carpal Tunnel Syndrome?

Common symptoms include:

• Pain, tingling or numbness in the hands and fingers, sometimes interrupting sleep
• A weakening of the grip
• The feeling that the fingers are swollen
• A burning sensation in the fingers, especially the thumb, index, and middle finger

“These symptoms usually progress over months to years,” Dr. Rymer says. “Patients can actually get weakness in the thumb with advanced disease.”

What Causes Carpal Tunnel Syndrome?

Many times carpal tunnel syndrome can’t be traced to a specific cause, but some or all of the following could be contributing factors:

• Repetitive, frequent movements of the hand, as when you’re typing or practicing a musical instrument 
• Repeated and frequent grasping motions with the hands, as when playing certain sports
• Disease processes involving joints or bones, such as osteoarthritis or rheumatoid arthritis
• Hormonal or metabolic changes, such as menopause or a thyroid imbalance
• Blood sugar fluctuations
• Injuries such as wrist sprains, breaks, or inflammation
• A family history of carpal tunnel syndrome

Dr. Rymer discusses who might be at greater risk for carpal tunnel syndrome.

Click play to watch the video or read video transcript.

What Increases Your Risk For Developing Carpal Tunnel?

Patients are at a higher risk to develop carpal tunnel with certain co-morbidities which include diabetes, hypothyroidism, auto immune disease, advanced age, and obesity. There’s also a genetic predisposition in certain families for carpal tunnel syndrome. Dr. Rymer adds, “Women who are pregnant can also be at a higher risk because of excessive swelling in the extremities and weight gain.”

What Can You Do to Prevent It?

If you are engaged in work or play that, over time, can stress your wrists and compress the median nerve, it’s helpful to establish good habits that could protect you from developing carpal tunnel syndrome. Here are a few steps you can take:

• Keep your wrist straight. As much as possible, don’t use your wrist in a bent, extended or twisted position for long periods of time.
• Grip carefully. Don’t grasp or lift an object with just your thumb and index finger; use the entire hand and all your fingers.
• Keep repetition to a minimum.: Don’t move your arms or wrists, or hold an object in the same way, for long periods. If you must keep working, alternate tasks or switch hands.
• Rest your hands. Even a few minutes every hour can help
• Reduce speed and force. When you can, work at a slower pace while doing forceful, repetitive motions. If possible, use power tools to reduce the need for physical force.
• Strengthen the muscles. Exercising strengthens your hand and arm muscles, and it will help you keep them in a better position.

Just about any job or hobby that involves frequent, repetitive movements with the hands brings with it the risk of developing carpal tunnel syndrome.

How Is Carpal Tunnel Syndrome Treated?

Based on a combination of factors, including your personal preferences as well as your age, medical history, and the severity of your symptoms, treatments could include:

• A splint. A splint helps to keep your wrist from moving, easing the pressure on the median nerve.
• Anti-inflammatory medication.: These can reduce swelling that may be pressing on the median nerve. They can be taken orally or by injection.
• Surgery. The surgeon cuts the tissue that is pressing on the nerve in your wrist, effectively enlarging the tunnel and easing the pressure on the nerve. Carpal tunnel release surgery is one of the most common surgeries in the U.S.
• Positional changes at work. Changing the position of your computer keyboard or other equipment at work can help ease symptoms.
• Exercise. Stretching and strengthening exercises can be helpful. Ask your doctor or health care provider for recommendations. 

Dr. Rymer discusses common treatment options.

Click play to watch the video or read video transcript.

How Is Carpal Tunnel Syndrome Treated?

The treatment of carpal tunnel syndrome is a combination of nonoperative and operative measures. A lot depends on the severity of carpal tunnel and what has been tried before. Mild carpal tunnel or early stage carpal tunnel is often treated conservatively. That includes physical therapy, splinting, and anti-inflammatory medications, and activity modification. When carpal tunnel advances or doesn’t respond to these conservative measures, steroid injections or surgery are usually tried.

Some people with mild carpal tunnel, can be managed for the rest of their life with conservative treatments such as splinting, anti-inflammatories, activity modification, and hand therapy. In many cases, carpal tunnel progresses to requiring surgery.

Source: National Institute of Neurological Disorders and Stroke; Arthritis Foundation; Michael Rymer, MD, Hand and Reconstructive Surgeons and Associates