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Carpal Tunnel Syndrome


What is Carpal Tunnel Syndrome?


Carpal tunnel syndrome is an overuse injury.  Common causes of the disorder involve repetitive fine motor movements: knitting, crochet, stitchery, computer usage, and video games, for example.  The symptoms of carpal tunnel syndrome occur because the median nerve, which runs through the small bones of the wrist, becomes compressed by swollen tendons and the ligament that occupy the same passage between the hand and the arm.  Over time, the overuse causes  inflammation and eventually leads to nerve damage.


What are the symptoms of carpal tunnel syndrome?  


Early symptoms of carpal tunnel syndrome include burning, itching, numbness and/or tingling in the palm, the  thumb and first fingers of the hand. It is not uncommon to experience the sensation of hand(s) "falling asleep" during the night. Eventually the symptoms progress and this sensation may occur at other times of day; the patient's grip strength may weaken. It is possible for the muscles at the base of the thumb to waste away, loss of sensitivity to heat/cold may develop.       


How is carpal tunnel syndrome diagnosed and treated?





Physical examination is the first step in the diagnosis of carpal tunnel syndrome.  Nerve conduction and electromyography (EMG) may be ordered to confirm the diagnosis.  Ultrasound and MRI can also be used.

Treatment of carpal tunnel syndrome initially involves resting the involved hand(s) for a period of time. The wrist may be immobilized using a rigid wrist brace,splint or other suitable device.  Cool packs can be applied if swelling occurs.

Some pharmaceutical agents can be used to treat carpal tunnel syndrome, such as steroids and NSAIDs in select instances. 

Once swelling is reduced, stretching and strengthening exercises may be in order. An occupational therapist is a good resource for this type of treatment. 

Some patients report benefit from treatment via acupuncture or chiropractic medicine. Yoga has also been shown to reduce pain and improve grip strength for some patients.

Carpal tunnel surgery is one of the most common treatment modalities in the US. It is usually and outpatient procedure, meaning that no overnight stay in hospital is required.  There are a number of surgical procedures that can be used, the goal being to reduce the pressure on the median nerve






Some people feel immediate relief following these procedures, but a full recovery can take months.  Complications such as infection can occur, so one needs to be mindful.  That being said, once treated recurrence of carpal tunnel syndrome is extremely rare.



Sources:
http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm; wikimedia

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