Research And Possible Risk Factors
Researchers have found that a previous wrist fracture and the use of insulin, metformin, and sulphonylureas are associated with a higher chance of CTS. Smoking, hormone replacement therapy , the combined oral contraceptive pill, and oral corticosteroids did not appear to be not linked to a higher risk of CTS.
One study has suggested that obesity, combined with a square-shaped wrist shape, may increase the likelihood of CTS developing. However, the team concluded that obesity was probably not the cause, because when participants with obesity lost weight, they continued to have CTS.
The same team concluded in other research that the age of women at the menopause might be a factor, and that pregnancy-related hormones may increase the risk of CTS in women at the time of the menopause.
Apart from work-related factors, the main risk for CTS is inflammatory arthritis, but hypothyroidism and diabetes also appear to increase the chance of developing it, according to research published in the Journal of General Internal Medicine.
The National Institute of Neurological Disorders and Stroke says that CTS is three times more likely to occur among people working in assembly operations than in data-entry personnel.
The Canadian Centre for Occupational Health and Safety list the following occupations as risk factors for CTS:
According to the National Library of Medicine, there is
What Is Carpal Tunnel
Carpal tunnel is a syndrome that often causes severe pain to radiate from your inner wrist to your elbow.
This pain can also travel down the nerve into the palm of your hand and into your fingers. Besides the pain, the carpal tunnel might cause weakness, numbness, or a tingly, prickly sensation in your fingers and hand.
In addition, you might notice your inner forearm is tender to the touch.
If you continue to irritate the ulnar and median nerve, you could have difficulty grasping and holding onto things.
You will have difficulty closing your hand, making a fist. It will also be difficult to pinch your pinkie and thumb together.
In addition, the numbness, tingling could become permanent and you could have atrophied, wasting of the muscles, which will cause claw-like hands.
Carpal tunnel is usually caused by either soft tissue, bone, inflammation, cyst, or a tumor pressing on the nerve. A Wrist injury and diseases like hypothyroidism, diabetes, obesity, and tendonitis can also cause this to occur.
Radial Tunnel Syndrome: Causes And Symptoms
Radial tunnel syndrome is caused by increased pressure on the radial nerve, which runs by the bones and muscles of the forearm and elbow. Causes include:
- Inflammation of surrounding tissue
Symptoms of radial tunnel syndrome include:
- Cutting, piercing, or stabbing pain at the top of the forearm or back of the hand, especially when you try to straighten your wrist and fingers.
In contrast to cubital tunnel syndrome and carpal tunnel syndrome, radial tunnel syndrome rarely causes numbness or tingling, because the radial nerve principally affects the muscles.
Just as with cubital tunnel syndrome, if you have any of these symptoms, your doctor may be able to diagnose radial tunnel syndrome by physical examination alone. They also may order electromyography to confirm the diagnosis, identify the area of nerve damage, and stage the severity of the condition.
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If You Have Rotator Cuff/shoulder Issues Frozen Shoulder Neck Pain/stiff Neck Headaches Or Carpal Tunnel Syndrome
Ahhh I hate my computer.
In geek speak, upper crossed syndrome means your neck is poking out and your shoulders are hunched over.
Its increasingly the posture that a lot of young kids are having because they spend hours on a computer a day, which naturally results in a couple things:
A head that pokes out. The neck goes into flexion and starts poking out, meaning the traps and neck muscles go into overdrive to still hold it up . Some of you probably cant get comfortable while sleeping , or have been suffering from headaches if so, your head position throughout the day should be the first thing you evaluate.
Sternocleidomastoid One of the tightened, shortened muscles. From Wikipedia.
The shoulders meanwhile roll forward and get hunched limiting their ability to rotate outwards. This is part of the reason why youre probably getting lots of rotator cuff injuries or elbow injuries like tennis elbow.
Youre also probably getting burning between the shoulder blades, and/or numbness in one arm, hand or fingers.
If youre a weightlifter, you most likely have experienced biceps tendonitis or repeated shoulder issues.
Whats going on:
Whats going on here is that the neck muscles are in overdrive because they are sticking out and trying to fight gravity imagine trying to hold a 10lb ball over your head!
Its easy when its straight up, but try holding it at a 45 degree angle. Hard.
Priority: Return the shoulder and neck alignment to normal.
How to fix it
For your neck:
What Are The Symptoms
The most common early symptom of cubital tunnel syndrome is pins and needles in the littleand ring finger of the affected arm. There can also be an electric or shooting type pain from the elbow to the fingers, down the inside of the forearm. This is due to damage to the sensory fibres of the nerve. The brain perceives the pain like pins and needles at the site where the nerve supplies, not at the site of compression, so there is rarely elbow pain associated with cubital tunnel syndrome, although the problem is in the elbow.Early on, the symptoms are intermittent and often depend on the position of the elbow. Having the elbows bent for long periods of time, such as when sleeping, can result in the symptoms that often wake patients at night. Symptoms can often be caused by reading and holding the book with the elbow bent or driving with the elbow bent for a long period of time. Intermittent sensory symptoms are reversible with treatment. When sensory symptoms become permanent, the reversibility is less predictable and can take a long time for the symptoms to resolve.As the condition progresses, the motor part of the nerve becomes damaged and the small muscles of the hand which affect the strength of grip lose their nerve supply, become weak and eventually atrophy resulting in the muscle wasting away. Muscle wasting is permanent.
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What Is Radial Tunnel Syndrome
Radial tunnel syndrome is a set of symptoms that include fatigue or a dull, aching pain at the top of the forearm with use. Although less common, symptoms can also occur at the back of the hand or wrist.
The symptoms are caused by pressure on the radial nerve, usually at the elbow. The radial nerve is one of the three main nerves in the arm. It runs from the neck to the back of the upper arm. Next, it crosses the outside of the elbow and goes down to the forearm and hand. At the elbow, the radial nerve enters a narrow tunnel formed by muscles, tendon, and bone. This is called the radial tunnel.
Why Youre Suffering From Chronic Pain
In my own experience these are mostly side effects of sedentary life.
Being sedentary does two major things:
The result? These two things lead to poor bodily alignment.
Poor bodily alignment leads us to a few things:
These all lead us down the road to chronic pain.
Just check out my Why Cavemen Never Had Backpain post. Look at the pictures of peoples posture in the 1800s and 1900s compared to now. Its scary.
A lot has changed in the last hundred years. We really do need to treat health as modern health. The requirements for modern humans to get healthy, fix pain, or lose weight are far different from someone 100 years ago.
Anyway, try those out and let me know how it goes!
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What If I Have Surgery
While surgery is an option for carpal tunnel syndrome, most physical therapists do not recommend it however, there are some instances in which a medical professional will deem surgery necessary. If this ends up being the case, you will likely be referred to us following your surgery for rehabilitation therapy. Then, there are very rare cases where we may refer you for surgical consultation.
If surgery is performed, you will have a post-operative physical therapy treatment regimen that includes one or all of the following:
- First, you will be encouraged to participate in exercises that are designed to improve the overall strength of the muscles located in the hand and in the wrist area. As the strength of the muscles in this area improves, the functionality of the muscles will also improve.
- Your physical therapist will encourage you to do carpal tunnel exercises that stretch out the muscles. This aids in optimizing the overall mobility associated with the area, which in turn improves function.
- All surgeries result in some degree of skin scarring. Once you complete the carpal tunnel surgery, you will quickly discover that the skin develops a mark. Carpal tunnel physical therapy includes scar management. This aids in ensuring that the skin remains flexible and is considered to be supple.
- You will be provided with information regarding how to properly position the wrist and the right posture. This will help in reducing compression and issues, such as shoulder pain.
Acute Vs Chronic Finger Numbness
Another key factor for diagnosing the underlying problem of finger numbness is the duration of the numbness. Acute or sudden on and off numbness may be due to a transient injury. Again, leaning on your funny bone is a good example.
Another example of temporary finger numbness may be when it occurs while working. Typing on a keyboard or swinging a hammer may cause finger numbness. But if it disappears with rest, then its a transient problem directly related toyour occupation.It means the work itself is causing the nerve injury because of how you use your hand.
Chronic finger numbness can be more serious. It means the nerve is sufficiently damaged that simple rest wont help. It could also be a sign that a more serious condition is lurking which causes finger numbness.
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Can Carpal Tunnel Syndrome Affect Your Elbow
Although you may think of this syndrome as affecting your hands, fingers, and wrist, the pain can also extend to your elbow. A similar condition called cubital tunnel syndrome can also cause pain or tingling in your elbow when your ulnar nerve is irritated or damaged.
If youre experiencing pain or tingling in your hand, fingers, wrist, or elbow, make an appointment today with Mirza Orthopedics. Well diagnose the cause of your symptoms and recommend the most effective treatment possible to help you return to your active life, free of pain. If surgery to correct carpal tunnel syndrome is needed, we offer a cutting-edge, minimally invasive procedure that was developed by Dr. Ather Mirza. It results in a better outcome with less pain, a smaller scar, and quicker recovery.
What Happens In Severe Cases Of Carpal Tunnel Syndrome
In severe cases of carpal tunnel syndrome, you may have less grip strength because the muscles in your hand shrink. Pain and muscle cramping may also become worse, and the median nerve begins to lose function due to irritation or pressure around it. As a result, this may lead to:
- Slower nerve impulses
- Loss of feeling in the fingers
- A loss of strength and coordination
- A loss of ability to use your thumb to pinch
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Conditions With Symptoms Similar To Carpal Tunnel Syndrome
Other conditions, including different types of nerve compression, can look like carpal tunnel syndrome. Some of these are:
- Arthritis.Arthritis of the wrist can cause many of the same symptoms. One key difference is that arthritis may cause visible swelling and redness.
- Cubital tunnel syndrome. Also called ulnar tunnel syndrome, this condition is due to compression, or squeezing, of the ulnar nerve in the elbow. Symptoms are more likely to affect the pinkie, ring finger, and inside of the hand.
- Pronator syndrome.Pronator syndrome is a condition in which the median nerve in the arm is compressed. Pain is typically felt in the arm but can extend to the palm, making it difficult to make the OK sign.
- Radial tunnel syndrome.Radial tunnel syndrome is due to compression of the radial nerve, which runs from the neck through the arm. It rarely causes the numbness or tingling of carpal tunnel syndrome. Pain is more likely to occur in the forearm or back of the hand.
- Tendonitis.Tendonitis of the wrist is due to inflammation of the tendons. Unlike carpal tunnel syndrome, tendonitis may cause swelling, and the pain tends to improve with rest.
Causes Of Shoulder Elbow And Wrist Pain
Although many disorders can cause pain, the most common cause of shoulder pain is rotator cuff tendinitis. The most common elbow disorder is epicondylitis , and common wrist disorder is usually Carpal Tunnel Syndrome. These disorders can be from acute injuries but are more commonly from overuse or repetitive use. These conditions can also include other causes including:
- Repetitive stress injuries
- Frozen shoulder
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Treatment For Carpal Tunnel And Tendonitis
1- The doctor might suggest you take an over the counter pain reliever like Tylenol.
2- He might suggest a Non-steroid anti-inflammatory agent. This will reduce the swelling and the pain.
3- Another suggestion is an NSAID topical sports cream that contains menthol.
4- Ice packs to the affected area for 20 minutes is another suggestion. Be sure not to put the ice directly on the skin. Leave the ice off for half an hour in between. Its suggested to apply ice after youve used the affected extremity.
5- Heat also helps relieve some of the pain. You can use a hot water bottle, a heating pad, or warmed up a towel in the microwave. Perhaps you can try a long hot bath.
6- Some doctors suggest Corticosteroid shots. This will decrease swelling and inflammation, which will decrease the pain. For carpal tunnel, it will relieve enough swelling to release the pinched nerve.
7- The doctor might suggest you use a splint, to immobilize the area, and reduce some of the pressure. This will speed up your healing.
8- The doctor will also ask you not to use the affected extremity until its properly healed. When you move it around you could cause further damage.
10- Another option you might consider is acupuncture. This has shown to help alleviate a lot of pain.
Sometimes when the above options dont work the doctor might suggest surgery.
Ease Up On Your Elbow
Cubital tunnel syndrome is treated by avoiding elbow flexion during activities and while sleeping, says Dr. Evans. Wearing an elbow splint at night will prevent you from bending your elbow while youre asleep.
Other things to avoid include resting your elbow on armrests, keeping your elbow bent for extended periods of time, leaning on your elbow, or sitting in a low chair while using a computer. If you talk on the phone a lot, Dr. Evans recommends using a headset instead of holding your phone to your ear.
Early on, nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen , may be taken to reduce swelling around the nerve. Surgery is reserved for severe cases in which compression has caused muscle weakness or damage. It is usually performed as an outpatient procedure with generally good results.
Treatment is aimed at preventing progression, which can be functionally devastating. If treated early, however, cubital tunnel syndrome can be reversed almost fully, says Dr. Evans.
This article originally appeared in Cleveland Clinic Arthritis Advisor.
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Immediately After Surgery For Carpal Tunnel Syndrome
After the operation, you can expect that:
- If you had a general anaesthetic, nurses will check your temperature, pulse, breathing, blood pressure and wound site frequently.
- You should not eat anything for at least four hours after the operation.
- Your wrist may be placed in a sling to help reduce swelling.
- Your wrist may be quite painful or uncomfortable for a couple of days. Your doctor will order analgesia .
- You should exercise your hand and wrist as soon as possible, following your doctors advice.
Enhancing Healthcare Team Outcomes
Median nerve injury and the associated pain, paraesthesias, and upper extremity weakness that occurs require prompt treatment ranging from night splints to surgery. The cause of median nerve injury may be due to a myriad of diagnoses, including idiopathic, injury, overuse, and type two diabetes. The history and physical exam may usually reveal nerve impairment without imaging studies.
It is crucial to consult with an interprofessional team of specialists that include a primary care provider, neurologist, and a hand surgeon. Physical and occupational therapists are also vital members of the interprofessional group during the healing process both for conservative management of median nerve injury and postoperative recovery after median nerve decompression. Orthopedic nurses are involved in patient education, arranging follow up visits, and informing the team of patient issues. In cases where evidence is minimal or not definitive, expert opinion from the specialist may help to recommend the type of imaging or treatment. If the clinician first attempts steroid injections to ward off surgery, the pharmacist can assist with the dosing and preparation of the drug.
A team approach is an ideal way to limit the complications of this procedure. Before surgery, the patient should have the following done:
The earlier signs and symptoms of a complication get identified, the better is the prognosis and outcome.
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