Wednesday, October 20, 2021

How To Reduce Carpal Tunnel Syndrome

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Carpal Tunnel Syndrome Stretching

You can help relieve pressure on the median nerve and prevent symptoms by combining carpal tunnel exercises and stretches with other treatments, like wearing a splint. You may wish to speak with your doctor before trying a new stretch or exercise. If you notice pain as you stretch, stop what youre doing and let your doctor know.

 

You can easily complete this stretch at your desk. Heres what youll do:

  • Press your palms together and place them in front of your chest below your chin.
  • Keeping your hands pressed together and near your stomach, slowly lower them toward your waistline until you feel stretching under your forearms.
  • Hold the position for 15 to 30 seconds and repeat two to four times.

Can You Avoid Carpal Tunnel Syndrome

Physical therapy, splinting, and corticosteroid injections may relieve symptoms temporarily.

You may suspect that you have carpal tunnel syndrome if you experience numbness, tingling, and weakness in your hand. CTS is a common condition that doesn’t go away on its own. “The longer you wait to get help, the less likely you will respond completely to treatment, if the process has progressed beyond a certain point,” says Dr. Chaitanya Mudgal, a Harvard Medical School assistant professor.

Wearing A Brace At Night

 Most people, including myself, sleep with the wrist bent. When the wrist is not kept straight, the pressure within the carpal tunnel increases. Therefore, when the wrist is bent for a long period of time, such as during sleep, the nerve is compressed. This can cause symptoms at night. The simplest treatment is to use an over-the-counter wrist brace to keep the wrist straight and train yourself not to keep the wrist bent during sleep. Otherwise youll wake up with the hand numb/tingly and have to reposition your arm and shake out the numbness to get the feeling back.

Why Does Carpal Tunnel Hurt More At Night

Its not uncommon for carpal tunnel symptoms to start while youre sleeping and there are two main reasons why carpal tunnel syndrome can be worse at nighttime.

  • Sleeping with your wrists bent.

    Flexing your wrists puts more pressure on the median nerve, in turn causing carpal tunnel pain. Ideally, you would sleep with your wrists in a neutral position with your hands slightly elevated.

  • Lying down and moving minimally

    This can cause fluid to accumulate within your body. If fluid builds up within the wrist it can compress the median nerve.     

  • Apply Pressure To Wrists

    Preventing Carpal Tunnel Syndrome

    Wrist pain, numbness, and tingling can be treated with gentle pressure to the wrists. You can wear a splint or compression gloves to provide that pressure and prevent nighttime swelling. Applying pressure with self massage is another way to relieve pain. Combined with elevating your hands, pressure is an excellent way to get pain relief from carpal tunnel.

    Conventional Treatments For Carpal Tunnel Syndrome

    After youve been diagnosed with carpal tunnel syndrome, your doctor will likely recommend that you immediately take a break from doing anything that puts added pressure on the hands. Resting the hands and wrists gives them time to heal while swelling reduces. You might need to avoid certain tasks at work, or find modifications if they are making symptoms worse.

    There are several ways to lower pain in your hands and wrists while you heal. These include:

    What Is Carpal Tunnel Syndrome

    Carpal tunnel syndrome is a fairly common condition that affects the hand and wrist, says hand, wrist, elbow and shoulder surgeon William Seitz, MD.

    Symptoms include numbness, tingling and pain, usually in your thumb and the first three fingers of your hand, Dr. Seitz says.

    Carpal tunnel syndrome happens when the median nerve, which runs from your forearm to your hand through a narrow space called the carpal tunnel, is compressed or pinched, Dr. Seitz says.

    Nine tendons that flex the first three fingers and thumb also run through the carpal tunnel.

    Anything that makes the carpal tunnel smaller and pinches the median nerve can result in carpal tunnel syndrome, Dr. Seitz says. These can include:

    • Medical conditions such as hypothyroidism, rheumatoid arthritis, and diabetes
    • Repetitive hand movements, especially if the wrist is bent so that your hands are lower than your wrists
    • Pregnancy

    Ergonomic Mice And Wrist Position

    There is a wide range of ergonomic mice on the market that can assist in providing support for your wrist.  Often these involve holding your mouse slightly differently, putting pressure on the base of the hand rather than the wrist.  We will be doing a review of the best ergonomic mice so stay tuned for that.

    When using your mouse you should move your entire forearm and not twist your wrist.  Often gamers use their wrist for snapping and aiming in FPS games.  Over time this can cause real problems for the wrist.  Try to get in the habit of using your whole forearm to move your mouse if you are experiencing pain.  You may not be as accurate but it will reduce your pain!

    Treating Carpal Tunnel Syndrome

    For mild cases of carpal tunnel syndrome, resting your hand and wearing a splint at night might be all it takes to relieve symptoms. Symptoms of carpal tunnel syndrome often occur at night, causing people to wake up and shake or move their hand around until the numbness resolves and it feels better, says Dr. Rozental. Medications, such as aspirin and ibuprofen aren’t a cure, but can help relieve pain. Your doctor may also want to try giving you steroid injections to help relieve symptoms.

    If these carpal tunnel treatments aren’t effective, however, it may be time to consider surgery to release the ligament that is placing pressure on the median nerve.

    How To Deal With Carpal Tunnel Syndrome

    This article was co-authored by Karen Litzy, PT, DPT. Dr. Karen Litzy, PT, DPT is a licensed physical therapist, international speaker, owner of Karen Litzy Physical Therapy, PLLC, and the host of the Healthy Wealthy & Smart podcast. With over 20 years of experience, she specializes in a comprehensive approach to practicing physical therapy utilizing therapeutic exercises, manual therapy, pain education, and home exercise programs. Karen holds a Master of Science in Physical Therapy and a Doctor of Physical Therapy from Misericordia University. Karen is a member of the American Physical Therapy Association and is an official spokesperson for the APTA as a member of their media corps. She lives and works in New York City.There are 8 references cited in this article, which can be found at the bottom of the page.wikiHow marks an article as reader-approved once it receives enough positive feedback. In this case, 100% of readers who voted found the article helpful, earning it our reader-approved status. This article has been viewed 60,324 times.

    When Its Time To See The Doctor

    If these home treatments dont ease your pain in one or two weeks, it might be time to see an orthopaedic physician, who specializes in treatment of bones, joints and muscles.

    Your doctor may recommend surgery if theres severe damage to your median nerve or to prevent permanent sensory or functional loss, Dr. Seitz says.

    The surgery involves cutting the band of tissue in the wrist that crosses the median nerve to lessen the pressure.

    Over time, surgery may be the best route to permanent relief, Dr. Seitz says.

    Carpal Tunnel Syndrome Treatment

    If youre experiencing pain in your wrist or hand, its best to have your doctor check it out. Untreated carpal tunnel syndrome could lead to weakness in your fingers and make it challenging to coordinate movements. It can also become more painful over time.

    If you have mild CTS, there are many things you can do to relieve symptoms and stop it from progressing. Often, treatment can eliminate mild CTS symptoms. If you have severe CTS that interferes with daily activities, your doctor may recommend surgery. Heres what treatment typically entails.

    • Wrist brace: The first form of treatment for CTS usually involves wearing a wrist brace or splint. Your doctor might recommend a brace, especially if your symptoms cause pain at night that keeps you from sleeping. For individuals with mild CTS, wearing a wrist brace and taking frequent breaks can be enough to resolve symptoms.
    • Corticosteroid injection: Your doctor might administer a corticosteroid injection in addition to recommending a splint. This injection can reduce swelling and inflammation in the carpal tunnel, which reduces the pressure on the median nerve.
    • Surgery: If treatments do not relieve symptoms, your doctor might suggest surgery. During surgery for CTS, the surgeon will cut the ligament that is pressing on the median nerve. The surgeon will also check for other conditions that may be causing nerve issues during the procedure. For most patients, surgery is an effective treatment for CTS.

    Hand Movements Contribute To Carpal Tunnel Syndrome

    Prevent Carpal Tunnel Syndrome

    Certain hand movements and positions increase pressure on the median nerve in the carpal tunnel. Although typing, texting, and playing video games are frequently associated with an increased risk of carpal tunnel syndrome, they arent the only activities that affect the nerve.

    Holding a phone and hand movements typically performed by cooks, painters, metal workers, housekeepers, and mechanics are a few examples of other high-risk activities.

    Three key factors increase your risk of carpal tunnel syndrome:

    Does Magnesium Help Carpal Tunnel

    Magnesium, which is well known for its anti-inflammatory properties, provides much needed reduction of swelling in the carpal tunnel, as well as muscle relaxing properties. It also stabilizes the body’s natural level of cortisol production, which is what gives it such great anti-inflammation characteristics.

    Carpal Tunnel Syndrome Surgery

    If your CTS is getting worse and other treatments have not worked, the GP might refer you to a specialist to discuss surgery.

    Surgery usually cures CTS. You and your specialist will decide together if it’s the right treatment for you.

    An injection numbs your wrist so you do not feel pain and a small cut is made in your hand. The carpal tunnel inside your wrist is cut so it no longer puts pressure on the nerve.

    The operation takes around 20 minutes and you do not have to stay in hospital overnight.

    It can take a month after the operation to get back to normal activities.

    How Do I Protect My Wrists When Typing

    Using your keyboard

  • The back of the wrists should be flat or only slightly bent back.
  • Don’t rest your arms on chair arm rests while keyboarding; adjust or remove them if necessary.
  • Do not use wrist or palm rests. …
  • The keyboard position should be adjusted to allow for the elbow and wrist positioning described above.
  • What Can I Do To Prevent Carpal Tunnel Syndrome From Getting Worse

    This will depend on the cause, but some general tips for stopping progression of carpal tunnel syndrome include:

    • Taking regular breaks from activities that require repetitive use of your hands, such as typing, piano playing, and playing video games.
    • Wearing a splint to keep your wrist straight, especially at night.
    • Trying a different type of keyboard or computer mouse. A mouse that is flat and symmetrical in shape usually is best, as is a larger mouse that encourages moving the entire arm rather than just the wrist.

    Mild Stage Carpal Tunnel

    Symptoms of carpal tunnel from guitar playing begin to show up in the mild stage.Unfortunately, this is when patients should do something about it, but they usually dont. 

    When caught and treated in this stage, mild symptoms will resolve 50% of the time with simple rest and some night bracing. But in cases where mild symptoms are ignored, they willalmost certainly worsen.

    During themild stage,pain, numbness, and tingling are only just beginning. They creep up extremely slowly. In fact, many people dont even notice a problem unless theyre thinking about it. 

    Also in the beginning, theres usually a stress delay when the symptoms show up. In other words, some people might feel the symptoms immediately after playing. Other times symptoms show up a few hours after playing, perhaps while holding a steering wheel or a phone. 

    In almost every case, initial symptoms will occur at night while youre trying to sleep. Many say they have to wake up and shake out a numb hand or rub painful fingers.

    How To Prevent Carpal Tunnel With Stretching Exercises

    I often tell patients,Do these stretches and youll never see carpal tunnel syndrome.Its absolutely true. If youre at high risk, and symptoms of carpal tunnel didnt start yet, you can completely avoid them with regular hand and finger stretches.

    There are 4 key stretches everyone at high risk must do. These are calledcore exercises.Theyre designed to stretch your flexor tendons so you can avoid carpal tunnel syndrome altogether.

    These stretches are designed to lubricate the flexor tendons. They also break apart any adhesions on the tendons. Suchare responsible for causing carpal tunnel syndrome.

    Best of all, each stretching exercise can be done quickly. In total, all four exercises take no more than 2 minutes to complete.

    Do these stretching exercisesat least three times per day.More is always better.

    Prayer stretch

    The prayer stretch is designed to lubricate the entire length of your flexor tendons. Place both palms together as in a prayer position, with fingers pointing upward. Keep your hands close to your body and at the level of your breastbone. 

    While holding your hands at the same level, slowly elevate both elbows as high as you can. Hold the stretch for 10 seconds and then relax. Drop your hands to your sides and shake them out for a few seconds.

    Stop stretch

    This stretch concentrates on the flexor tendons inside the wrist joint. Hold one hand out in front of you as if youre saying Stop!. 

    Finger interlace stretch

    Thumb stretch 

    How Is Carpal Tunnel Pain Treated

    If you are already experiencing carpal tunnel pain in Atlanta, GA, it is crucial that you seek treatment as soon as possible to avoid long-term symptoms and complications. At-home stretches and exercises, anti-inflammatory medications, and behavioral modifications can all be effective in relieving carpal tunnel pain, but, in some cases, you may need more formal treatment for persistent or severe symptoms.

    During your appointment with Dr. Williams, he will examine your hand and wrist and possibly perform diagnostic tests to further elucidate the cause of your symptoms. He may then recommend corticosteroid injections or even surgery if your condition has progressed beyond what can be treated with behavioral modification alone.

    Dont suffer from recurrent carpal tunnel syndrome any longer. Call Interventional Orthopedics of Atlanta to schedule your consultation with Dr. Christopher Williams today, and learn more about how you can prevent future symptoms and get the much-needed relief from your current carpal tunnel pain sooner than you think!

    Which Symptom May Be Helpful In Identifying Carpal Tunnel Syndrome

    Prevent Carpal Tunnel

    People often confuse carpal tunnel syndrome with conditions that cause similar symptoms, like arthritis, for example. However, arthritis, which is inflammation of the joints, can affect all the fingers, whereas CTS typically does not impact the pinky finger. Your doctor may perform the following tests to determine if you have CTS or another ailment:

    • Tap on your median nerve to watch if it causes pain
    • Bend your wrist forward for 60 seconds to see if it causes tingling, numbness or weakness

    Either of these tests may show signs of CTS.

    Reasons For Carpal Tunnel Release

    Carpal tunnel release surgery is not for everyone. In fact, some people are able to treat their carpal tunnel symptoms with nonsurgical methods. You can take over-the-counter anti-inflammatory drugs, such as ibuprofen or aspirin, or prescription pain medications. Doctors may recommend a steroid injection and inject medication directly into your arm or hand.

    Other types of nonsurgical methods include:

    • cold or ice compress
    • splints to keep the wrist straight so that there is less tension on the nerve
    • physical therapy

    Repetitive activities, such as typing, can also trigger or worsen carpal tunnel syndrome. Taking frequent breaks and resting your hands can reduce symptoms and alleviate the need for a surgical procedure.

    However, if pain, numbness, or weakness continues or worsens even after experimenting with nonsurgical methods, your doctor may recommend carpal tunnel release. Before scheduling your procedure, your doctor may perform a nerve conduction test and electromyogram test to check for abnormal muscle electrical activity, which is common in carpal tunnel syndrome.

    Traditional Treatments For Carpal Tunnel Syndrome

    More serious cases of carpal tunnel syndrome may require your doctors help.

    Your doctor may recommend corticosteroids to lessen your pain and inflammation. These drugs reduce the amount of swelling and pressure placed on the median nerve. Injections are more effective than oral steroids. This therapy may be particularly effective if your CTS is caused by inflammatory conditions, such as rheumatoid arthritis.

    Your doctor may also recommend surgery to relieve pressure on the nerve. This typically involves making one or two incisions in the area affected and cutting the ligament involved. This will release the nerve and increase the space around the nerve.

    The ligament will eventually grow back, allowing more space for your nerve than there was before. If your CTS is severe, surgery may not clear up your symptoms completely, but it should help you feel better and help prevent any further damage to the nerve.

    Preparing For Carpal Tunnel Release

    Tell your doctor about all the medicines and supplements youre currently taking. Your doctor may instruct you to stop taking some of your medications one week before your scheduled surgery. Tell your doctor if youre experiencing any illnesses, such as cold, fever, or virus before surgery. Have someone drive you to the hospital and arrange for a ride back home. Do not eat for six to 12 hours before carpal tunnel release surgery.

    There are two ways to perform carpal tunnel release: open carpal tunnel release and endoscopic carpal tunnel release.

    Preventing Carpal Tunnel Syndrome In The Workplace

    If your job requires you to use your hands for a long time in an unnatural position or while using force, youre at higher risk of developing carpal tunnel syndrome. However, CTS doesnt only affect employees with manufacturing jobs. Many different occupations, from grocery store jobs to administrative positions, could put an employee at risk of developing CTS. By adjusting the way you work, you may be able to avoid carpal tunnel syndrome, reduce the severity of symptoms or make them disappear completely. Consider these tips.

    What To Do If You Think You Have Carpal Tunnel Syndrome

    Dr. Fitzmaurice advises patients to make an appointment at the Fitzmaurice Hand Institute in Phoenix for persistent pain or numbness in the hands, fingers, or wrists. If left untreated, some injuries and conditions could result in permanent nerve damage, causing pain and mobility problems. Depending on the severity and cause of symptoms, many cases of carpal tunnel syndrome and other nerve injuries to the upper extremities can be treated with minimally invasive outpatient surgery, which has significantly lower risk of side effects and complications and faster healing and recovery rates than traditional open surgery.

    Learn more about carpal tunnel exercises by visiting WebMD.com.

    Who Is At Risk For Carpal Tunnel Syndrome

    While anyone can get CTS, there are specific risk factors associated with the condition.

    • Age: CTS is more common in adults over age 30 than other age groups.
    • Anatomy: Some individuals are born with small carpal tunnels in their wrists, which can increase the chance of getting CTS.
    • Sex: Women are much more likely to get CTS than men. Pregnancy can also be a risk factor for CTS, particularly in women who retain fluids.
    • Career: People who have jobs that involve repetitive movements or working with tools may face a higher risk of CTS.
    • Health conditions: Underlying conditions such as arthritis, gout, diabetes, alcoholism and hypothyroidism may make someone more susceptible to CTS.

    How Is Carpal Tunnel Syndrome Recognized

    People who suspect carpal tunnel syndrome often consult a doctor. The evaluation of occupational carpal tunnel syndrome includes identifying workplace risks. Evaluation begins with a discussion of the person’s employment and requires a detailed description of all the processes involved in a typical day’s work. It also requires consideration of the frequency, intensity, duration and regularity of each task performed at work. Diagnosis of carpal tunnel syndrome is confirmed by performing certain tests to detect damage to the median nerve.

    • Tinel’s test – The physician taps the median nerve at the wrist. A tingling response in one or more fingers indicates damage to the median nerve.
    • Phalen’s test – The patient puts the backs of the hands together and bends the wrists for one minute. Tingling of the fingers indicates damage to the median nerve.
    • Electromyography – Electrodes are placed on the forearm and electrical current is passed through the patient. Measurements on how fast and how well the median nerve transmits messages to muscles indicate if there is damage to this nerve.

    Position Your Keyboard Correctly

    How To Prevent Carpal Tunnel Syndrome In The Office

    Your keyboard should be directly in front of you and be around 30cm from the edge of your desk to provide adequate room to rest your arms.  If your keyboard sits high and you are having to arch your hands over it, try to find a padded wrist rest to provide you with some comfort and support.  Ensure that your wrists are resting at a natural angle, try not to twist them.

    How Do You Stop Carpal Tunnel From Progressing

    Carpal tunnel syndrome may continue to progress over time, but by taking frequent breaks with your hands, and stretching your hands, you can alleviate some pressure from your wrists. Be sure to avoid sleeping in positions that may bend your wrists or curl them in an awkward position. By sleeping with a splint, or even wearing a splint during the day, you are maintaining a neutral position with your wrists for an extended period of time. This neutral wrist position will help the nerves freely flow through the carpal tunnel, so the pain does not progress. An exercise to prevent carpal tunnel symptoms is to rotate your wrists in circles, and flex and extend your palms and fingers. This will help to decrease wrist numbness, tingling, and repetitive stress on your flexor tendons. 

    What Are The Occupational Factors Of Carpal Tunnel Syndrome

    The National Institute of Neurological Disorders and Stroke indicates that carpal tunnel syndrome is “often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself”.

    Carpal tunnel syndrome has been associated with certain tasks including:

    • Repetitive hand motions.
    • Mechanical stress on the palm.
    • Vibration.

    Those workers performing assembly line work – including manufacturing, finishing, cleaning, and meat/poultry/fish packaging – commonly report this injury. Cashiers, hairdressers, or knitters or sewers are examples of people whose work-related tasks involve the repetitive wrist movements associated with carpal tunnel syndrome. Bakers who flex or extend the wrist while kneading dough, and people who flex the fingers and wrist in tasks such as milking cows, using a spray paint gun, and hand-weeding are other examples. Excessive use of vibrating hand tools may also be related to carpal tunnel syndrome.

    A possible link between carpal tunnel syndrome and computer mouse use is uncertain. While keyboarding work is generally not a risk factor for developing carpal tunnel syndrome, it can cause pain and exacerbate symptoms for those who already have the condition.

    Note that the repetitive motions required for keyboard work and the use of a computer mouse may be related to the development of other injuries.

    Table 1
    • Use of oral contraceptives.
    • Menopause.

    How Can We Prevent Carpal Tunnel Syndrome

    Prevention of carpal tunnel syndrome may involve redesigning work stations, tools, or the job, and educating workers. Proper work station design reduces awkward wrist positions and minimizes the stressful effects of repetitive motions. Awkward positions can originate from unsuitable work station designs that do not take into account the size and proportions of the human body. Work stations should be adjustable and should accommodate a vast majority of people who work in that area.

    Redesigning work methods is important. For example, using an adjustable fixture to hold an electrical housing, as Figure 3 shows, reduces wrist flexion.

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