Time Course Of Symptoms
Most doctors classify carpal tunnel syndrome’s severity in 3 distinct stages:
Within each of these stages, you can have one or more of the following symptoms:
Carpal tunnel symptoms most frequently begin on the palm side of the index and middle fingers . Also, half of the ring finger has symptoms .
In most people, the thumb and forefinger are more severe than the other fingers. However, symptoms never appear on the fifth finger.
The remarkable thing about carpal tunnel it that it can get extremely bad. But it always starts off without your noticing anything at all.
As symptoms start to show up more and more often, patients usually attribute it to overworked or tired hands. And it’s hare to tell in the beginning! In fact, it’s hard to tell the difference between carpal tunnel and simplewrist tendinitis.
Unlike simple tired hands or even tendinitis, carpal tunnel symptomsfirst happen at rest. In other words, they begin to appear when you’re sleeping or sitting quietly. In contrast, overworked hands or wrist tendonitis symptoms usually appear while actually using your hands.
The time it takes for carpal tunnel to progress from mild to severe is different from one person to another. But generally, it takes about 6 months.
Without Treatment Carpal Tunnel Usually Worsens
Carpal tunnel syndrome is aprogressive disorder.That means italmost alwaysworsenswithout treatment in the majority of people who get it.
If you let it advance to thesevere stageit’s much more difficult to treat. Beyond that point, your hand may turn into a nearly useless appendage with only a fraction of its former function.
When you allow carpal tunnel to go that far, there’s little chance anyone can fix the problem. That’s because your median nerve is so damaged that it’s too far gone for any repair- even with surgery.The median nerve is so damaged that it’s essentially dead so surgeons know any chance of repair is slight, at best.
Treatment For Severe Symptoms
If symptoms persist for more than 6 months and are interfering with your daily life and work activities, despite self-care and treatment, you may need surgery. Surgery relieves pressure on the trapped nerve and aims to prevent any permanent nerve damage. Your doctor will be able to discuss the most suitable method of surgery with you.
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Types Of Painful Feelings
As describe above, theplacewhere carpal tunnel pain hurts the most is easy to define. But describing the actualtypeof pain patients feel is more difficult.
The types of pain reported have a wide range. They can be anywhere fromannoying or bothersometocrushing or punishing. The specificqualitiesof pain sensations usually described are:
Note that you can have only one or all of these pain sensations at the same time. Usually having more than one type of pain sensation is relative to the stage of carpal tunnel syndrome.More advanced stages produce additional types of pain sensations.
Thumb Knuckle Pain: The Top 6 Possible Causes
If you have persistent pain at the base of the thumb, right at the knuckle joint, or in your thumb pad, you might be worried about what it could mean. Did you sprain your thumb, somehow sleep on it wrong, or could it be a sign of rheumatoid arthritis? This article reviews a few thumb knuckle pain culprits, and what you can do to help treat the cause of this discomfort.
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Coldness And Colour Change
The hands may feel subjectively cold , but as with many of the symptoms described here measurement of the hand temperature usually does not reveal dramatic coldness. There have been studies of thermography as an aid to diagnosis in CTS which suggest that there are slight changes in temperature but this has not taken off as a diagnostic method . Marked coldness of the fingertips combined with colour change is sometimes a clue to the presence of Raynaud’s disease, which is essentially a disorder of the small blood vessels. As with trigger finger, there may be an association between Raynaud’s and carpal tunnel syndrome .
Basal Joint Arthritis Or Osteoarthritis
Basal joint arthritis could be causing your joint pain. The basal joint lies at the base of your thumb, just above the wrist. A wearing away of the cartilage in this joint is commonly called “thumb arthritis,” and comes not only with pain but also the loss of thumb mobility and the possible loss of thumb grip strength.
Our joint cartilage provides a cushion at the spot where two bones would otherwise meet and grind together. Cartilage cannot heal on its own, because, unlike other forms of tissue in the body, it has no blood supply to provide a healing pathway. Becoming aware of cartilage damage as soon as possible is important so you can ask your doctor how to prevent further breakdown.
Cartilage breakdown in the joints is also known as osteoarthritis, and it’s the most common form of arthritis worldwide.
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The Difference Between Arthritis And Carpal Tunnel
You rely on the use of your hands for almost everything you do on a daily basis. But when you have constant pain and discomfort in your hands and wrists, these simple tasks become more difficult and uncomfortable.
Two big culprits of this type of pain are carpal tunnel syndrome and rheumatoid arthritis conditions infamous for the pain and discomfort they cause in hands and wrists. Because they both lead to a similar type of pain, they can be easily confused. However, these conditions arent related. Carpal tunnel syndrome and RA are distinctly different when it comes to their causes and how theyre treated.
What To Expect After Surgery
There may be some swelling and stiffness right after surgery, which can be relieved by elevating your hand over your heart and moving your fingers frequently. You may need to wear a wrist brace for a few weeks while you heal, but will still be able to use your hands. Pain and weakness usually resolve within two months after surgery, but it may take six months to a year to recover completely.
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How Often Is Hand Pain Caused By Carpal Tunnel Syndrome
While carpal tunnel syndrome is a common condition, it has a different set of symptoms from many other sources of hand pain. There are actually several similar conditions that cause hand pain. These include:
- De Quervains tendinosis: A condition where swelling affects the wrist and base of the thumb. In this condition, you will feel pain when you make a fist and simulate shaking someones hand.
- Trigger finger: This condition causes soreness at the base of the finger or thumb. Trigger finger also causes pain, locking and stiffness when bending the fingers and thumb.
- Arthritis: This is a general term for many conditions that cause stiffness and swelling in your joints. Arthritis can impact many joints in your body and ranges from causing small amounts of discomfort to breaking down the joint over time .
Can You Tell Which Condition You Have
Joint swelling in arthritis may also cause compression of the nerves in the hand or wrist, which can then cause numbness, tingling, and pain. Your healthcare provider will perform a few specific tests to pinpoint the problem.
- Reduced muscle mass in the fleshy part of the hand at the base of the thumb
- A positive Tinel’s Sign, or a burning or tingling sensation when the median nerve is tapped lightly
- A positive Phalen’s sign, a test that assesses for pain when your arms are held vertically and your wrists are flexed 90 degrees for 60 seconds
- Weakness or poor dexterity with pinching movements
- Pain that is worse at night or wakes your from your sleep
- Asymmetric patterns of joint involvement
- Swelling of other joints outside of the hands and wrists
- Systemic involvement with inflammatory arthritis, including fevers, malaise, or rash
- Antibodies or inflammatory markers present in blood testing
- Pain that goes away after a few hours in the morning
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Is Burning Hand Pain A Symptom Of Carpal Tunnel Syndrome
Question by Silvia
Answer by Doctors at First Hand Medical
It seems a bit dramatic, to some, but many people do describe the nerve pain associated with Carpal Tunnel Syndrome as an intense burning sensation, saying their hands feel like they are on fire. No pain in the human body can be as intense and unpredictable as nerve pain.
With Carpal Tunnel Syndrome the Median Nerve gets pinched in the Carpal Tunnel. The pinching in the beginning usually causes hand numbness or loss of feeling at the tips of the fingers. One of the most classic symptoms is to have your hands wake you up at night tingling and aching when you fall into deep into REM sleep.
As Carpal Tunnel progresses other symptoms often present themselves. Some of these include what patients describe as shooting electrical shocks up their forearms. Some describe odd symptoms like itchy palms or an aching neck.
There are hundreds of possible combinations of symptoms, which can make it difficult for the average General Practice Doctor to make a solid diagnosis with confidence. You can rely on the following simple self-diagnosis approach in your efforts to clearly identify what your collection of symptoms might be.
Do not rule out or ignore any symptoms that follow the nerve path of the Median Nerve which runs from the tips of the fingers to the cortex of the brain and can affect any muscle, joint or other parts of the anatomy along this nerve path.
Differences Between Carpal Tunnel & Arthritis
We’ve seen that carpal tunnel & arthritis share similar symptoms. Pain sensations in the wrist, hand or fingers are nearly identical — especially in the early stagesof rheumatoid arthritis. So that’s when it’s most difficult to diagnose.
Usually, both conditions cause throbbing or dull pain in the joints. It occurs for most of the day. Also, both conditions give you the feeling of tenderness. These symptoms even wake you up at night.
Both carpal tunnel & arthritis will give you pain symptoms. And in both conditions, pain medicines likeNSAIDs temporarily relieve the pain.
As time goes on, the systemic effects of rheumatoid arthritis begin to happen. Thats when you know carpal tunnel will not cause those symptoms. They includefatigue, fever or loss of appetite.
In contrast, carpal tunnel symptoms remain in the fingers, hand and wrist. Sometimes with carpal tunnel syndrome, the pain shoots up the arm to the elbow.
You can perform “provocative” self-tests for carpal tunnel syndrome byThey are composed of the Tinel, Phalen and Durkan tests. The results normally cannot be confused with arthritis.
Whether you have carpal tunnel, arthritis or even another disorder, your doctor will prescribe a treatment program that’s right for you.
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How To Relieve Carpal Tunnel Pain
For most people, it doesn’t matter where carpal tunnel pain is as long as they can treat it. But it may surprise you that treating the pain symptoms is only slightly helpful. But treating thecauseof the pain is far more effective and lasting. In other words:
If you treatonly the painit will come back. But if you treat thecause of the painit will eliminate symptoms forever.
Therefore, where carpal tunnelpainis your main symptom, there are 2 approaches to treating it:
- temporary pain treatmentswhich just treat pain for the time being
- permanent pain treatmentswhich treat & eliminate the source of the pain
I highly recommendyou use thepermanent pain treatmentsfor obvious reasons. I list the temporary ones below because you’ve probably tried them – with no long-term effects.
How Arthritis Can Cause Carpal Tunnel Syndrome
Its very common to have carpal tunnel syndrome when you have rheumatoid arthritis, especially if you have rheumatoid arthritis of the wrist, says Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Florida, and medical advisor for CreakyJoints.
If you have rheumatoid arthritis, chances are it does affect your wrists research shows theyre the most common site for RA in the upper body and that 75 percent of people with RA have wrist involvement.
Though its impact isnt usually as great as RA, even osteoarthritis , the wear-and-tear type of arthritis, increases the risk of carpal tunnel too. OA in the wrist can cause swelling and bony changes that crowd the carpal tunnel.
The wrist is a very small area and if it gets inflamed for any reason, it can cause pressure on the nerve that leads to carpal tunnel syndrome, says Robert Gotlin, DO, a sports and spine physician in New York City and an associate professor of rehabilitation medicine and orthopedics at the Icahn School of Medicine at Mount Sinai.
Interestingly, carpal tunnel, like rheumatoid arthritis, is three times more likely to affect women than men, possibly because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain.
Like OA, carpal tunnel is more likely to occur with age more than three-quarters of people develop symptoms between the ages of 40 and 70.
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Carpal Tunnel Versus Arthritis
If you have ever had a hand or leg go to sleep because of pressure that temporarily cuts off the blood supply, you can get an idea of what carpal tunnel can feel like. The prickling, burning sensation can be similar to the numbness caused by compressing the median nerve, which runs in a narrow tunnel like structure formed by the bones and connective tissues from the elbow to the hand. The tendons and median nerve allow the fingers of your hand to flex and extend.
The median nerve carries impulses to and from the palm side of your hand to the index, middle, and ring fingers, as well as your thumb. If the tissues of the tunnel are irritated , they can swell and place pressure on the nerve.
Arthritis of the hand, however, is caused by a different mechanism, often showing up with a specific pattern in the way it attacks the joints. In the case of arthritis, the lining of the joint itself becomes inflamed. This can occur because of osteoarthritis , or other inflammatory processes caused by a defect in the immune response, in which the body attacks otherwise healthy tissue. The symptoms of arthritis include stiffness and soreness of the joint, and frequently starts with the smaller joints of the hands.
If you, or a loved one has carpal tunnel syndrome or any form of arthritis, or you would like more information about treatments for carpal tunnel or arthritis, or to schedule an appointment, please contact Orthopaedic Associates at 892-1440 today.
What Is The Carpal Tunnel
The carpal tunnel is a narrow canal or tube in the wrist. Similarly to a tunnel you could travel through by car, this part of the wrist allows the median nerve and tendons to connect the hand and forearm. The parts of this tunnel include:
- Carpal bones: These bones make up the bottom and sides of the tunnel. They are formed in a semi-circle.
- Ligament: The top of the tunnel, the ligament is a strong tissue that holds the tunnel together.
Inside the tunnel are the median nerve and tendons.
- Median nerve: This nerve provides feeling to most of the fingers in the hand . It also adds strength to the base of the thumb and index finger.
- Tendons: Rope-like structures, tendons connect muscles in the forearm to the bones in the hand. They allow the fingers and thumb to bend.
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Could Your Job Be To Blame
It’s a common belief that frequent typing can lead to carpal tunnel syndrome. But it’s actually three times more common among assembly line workers than it is among data-entry personnel — and frequent use of vibrating hand tools increases the risk. In contrast, one study found that even heavy computer use — up to seven hours a day — did not make people more likely to develop carpal tunnel syndrome.
How Is Carpal Tunnel Syndrome Diagnosed
First, your doctor will discuss your symptoms, medical history and examine you. Next, tests are performed, which may include:
- Tinels sign: In this test, the physician taps over the median nerve at the wrist to see if it produces a tingling sensation in the fingers.
- Wrist flexion test : In this test, the patient rests his or her elbows on a table and allows the wrist to fall forward freely. Individuals with carpal tunnel syndrome will experience numbness and tingling in the fingers within 60 seconds. The more quickly symptoms appear, the more severe the carpal tunnel syndrome.
- X-rays: X-rays of the wrist may be ordered if there is limited wrist motion, or evidence of arthritis or trauma.
- Electromyography and nerve conduction studies: These studies determine how well the median nerve itself is working and how well it controls muscle movement.
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When To See A Doctor
You should seek medical help immediately if you believe you have broken a bone in your thumb, your wrist, or any part of your hand. If you cannot move your thumb, or if it appears crooked after an injury, you should also seek emergency care.
If your symptoms are recurrent pain in your joints, knuckles, and wrist, you may have an underlying condition such as carpal tunnel syndrome or basal joint arthritis.
If you have joint pain that limits your daily activities, notice a decrease in your joint mobility, have trouble gripping objects, or live with pain that spikes each morning when you get out of bed, see your doctor to talk about your symptoms.