AtoZ Diseases

What is this Condition?

Carpal tunnel syndrome is a pinched wrist nerve that affects the use of the hand. When the nerve is compressed together with blood vessels and tendons going to the fingers and thumb, it causes numbness and pain. Assembly-line workers and packers, computer users, and persons who use poorly designed tools are most likely to develop this disorder, especially women between ages 30 and 60. Any strenuous use of the hands - repetitive grasping, twisting, or flexing - aggravates the condition and interferes with work and everyday activities .

What Causes it?

The carpal tunnel is formed by the wrist bones and the band of ligament that holds them in place. Swelling or abnormal growths on the tendons that pass through the tunnel pinch the nerve. Besides repetitive motions, some familiar medical conditions that can cause the swelling include the following:

• rheumatoid arthritis

• inflammation from rheumatic disease

• pregnancy or menopause

• diabetes

• benign tumors

• a fracture, dislocation, or acute sprain of the wrist.

What are its Symptoms?

Carpal tunnel syndrome usually starts with feelings of weakness, pain, burning, numbness, or tingling in one or both hands. The discomfort affects the thumb, forefinger, middle finger, and half of the fourth finger, making it difficult to clench the hand into a fist. Fingernails may look dull; the skin, dry and shiny.

The symptoms are often worse at night or in the morning when circulation slows down. The pain may spread to the forearm and, in severe cases, as far as the shoulder. The person can usually relieve the pain by shaking the hands vigorously or dangling the arms at the sides.

How is it Diagnosed?

After people with carpal tunnel syndrome notice a loss of feeling in affected fingers (less reaction to a light touch or pinpricks), about half of them lose muscle strength as well. Other diagnostic indicators in­clude:

• a tap on the wrist that produces a tingling sensation in the hand

• holding the forearms vertically and allowing both hands to drop down at the wrists for 1 minute, reproducing the symptoms

• a blood pressure cuff, inflated on the forearm for 1 to 2 minutes, causing pain and tingling in the wrist

• electromyography, a test of nerve response that measures an abnor­mal delay in impulses to the hand.

How is it Treated?

The doctor may suggest conservative treatment first, including rest­ing the hands by splinting the wrists in a neutral position for 1 to 2 weeks. If there’s a definite link between the syndrome and the per­son’s work, the doctor may suggest that the person modifY his or her work or even change jobs. Effective treatment may also require correction of an underlying disorder.

If conservative treatment fails, the alternative is surgery. The most common procedures aim to remove pressure from the nerve byopening the carpal tunnel ligament or by using endoscopic surgical techniques. Neurolysis, the freeing of the nerve fibers by cutting them, may also be necessary.

What can a Person with Carpal Tunnel Syndrome do?

Take mild pain relievers and use your hands as much as possible. If the dominant hand is hurt, you may need help with eating and bathing.

After Surgery

Learn how to apply a splint and keep it loose enough for comfort. The nurse or therapist will show you how to remove the splint and gently exercise your hand, daily, perhaps while holding it in warm water. If your arm is in a sling, you’ll learn to remove it and do exercises for your elbow and shoulder.

No Comments yet »