When To See A Healthcare Provider
You should see a healthcare provider if your symptoms have been continuing for two weeks or more. At first, the symptoms may come and go. Once they are persistent, waking you up at night, or interfering with everyday tasks, you should seek care. If the symptoms are due to CTS, allowing them to go on for too long increases the risk of muscle atrophy and permanent nerve damage.
Early treatment can also help avoid the need for surgery.
Visit your primary care provider for an assessment and general health check. If you don’t have a primary care provider, you can see an internal medicine physician or an occupational medicine specialist. You may be referred to an orthopedic surgeon, neurologist, hand surgeon, rheumatologist, or physiatrist for further testing or treatment.
Carpal Tunnel Syndrome Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
Your healthcare provider will consider other possible causes of the symptoms, including other nerve conditions and arthritis. In addition, carpal tunnel syndrome is seen more frequently in people with underlying conditions such as hypothyroidism, diabetes, and rheumatoid arthritis which you may not be aware that you have. Seeing your healthcare provider will allow you to get a diagnosis and appropriate treatment for both carpal tunnel and any other conditions.
How Do I Know If I Have Carpal Tunnel Or Tendonitis
Carpal tunnel syndrome, often known as CTS, does not include inflammation of the tendons like tendinitis does.Instead, carpal tunnel syndrome is brought on by compression of the median nerve, which is the nerve that travels through your wrist.Your thumb, index finger, middle finger, hand, and wrist may all experience numbness or tingling as a result of a pinched nerve.Nighttime is frequently when CTS symptoms manifest in patients.
Causes Of Carpal Tunnel Syndrome
As we mentioned, carpal tunnel syndrome is named after the carpal tunnel, which is a passageway that runs from your hand up your arm. The median nerve runs through this passageway and, when compressed, can cause the symptoms of carpal tunnel syndrome.
Theres no one root cause of carpal tunnel syndrome, but its likely the combination of several underlying factors, which well discuss more in-depth below. Carpal tunnel is caused by anything that irritates the median nerve of the wrist. In some cases, trauma such as a break or sprain from a sports injury or car accident can contribute to additional, ongoing issues like carpal tunnel syndrome.
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Treatment Similarities And Differences
- Physical therapy exercises to relieve pressure and strengthen the affected area
- Changing your environment or activities to compensate for pain or loss of function
In some cases, however, carpal tunnel syndrome becomes so severe that surgery is necessary to treat the problem. An outpatient surgery is performed, usually under local anesthesia, to increase the size of the space within the carpal tunnel and relieve the pressure on the median nerve by cutting the transverse carpal ligament at the base of the palm. This surgery usually relieves all symptoms of carpal tunnel syndrome once the incision is healedabout 10 to 14 days.
Arthritis may also become severe enough to warrant surgery, but the procedure is very different. Reconstructive surgery is sometimes required when deformity is severe in osteoarthritis, and joint replacement may be required for people with severe rheumatoid arthritis. Rheumatoid arthritis may also be treated with medications like disease-modifying anti-rheumatic drugs . Methotrexate is a DMARD commonly used to treat rheumatoid arthritis. Biologics like adalimumab , etanercept , and infliximab can also be used for this condition. These medications suppress the immune system to prevent further damage.
How Do I Know If My Wrist Pain Is Carpal Tunnel
The wrist flexion test is another name for this particular examination.The physician will instruct you to push the palms of your hands and the tips of your fingers together while flexing your wrists and pointing the tips of your fingers downward.Youre going to remain in that position for the next minute or two.Carpal tunnel syndrome might be diagnosed if you experience tingling or numbness in your fingers.
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What Are Carpal Tunnel Syndrome Symptoms
Five of the main symptoms of carpal tunnel syndrome include:
- Numbness, tingling, burning, and pain
- Especially in the thumb and the index, middle, and ring fingers
Other symptoms of carpal tunnel syndrome may include:
- Stiff fingers
- Inability to make a fist
- Fingers feel swollen even though little or no swelling is apparent
- Itchy palms
- Changes in hand temperature
- Changes in skin color of the affected hand
- Untreated, the muscles at the base of the thumb may waste away
- Inability to determine between hot and cold by touch
What Aggravates Carpal Tunnel
Diabetes, high blood pressure, and arthritis are just some of the illnesses that might put you at an increased risk for having it. Smoking, consuming a lot of salt, leading a sedentary lifestyle, and having a high body mass index are all lifestyle variables that have been linked to an increased risk of carpal tunnel syndrome .
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Standard Conservative Treatments Offered By Physical Therapists
Now that you have learned about the non-operative techniques used to treat carpal tunnel syndrome among those that experience the symptom of shoulder pain, it is time to learn about the standard conservative treatments that most physical therapists engage in.
We specialize on natural techniques that will eliminate pain, optimize range of motion, and improve your general level of physical health without compromising other aspects of your health or encouraging you to participate in invasive procedures.
The following outlines one of the most productive strategies for helping our patients overcome carpal tunnel syndrome with shoulder pain:
What Does Nerve Pain Feel Like
Nerve pain often affects all people differently. Some patients feel just numbness and loose sensitivity in their finger tips. They start dropping things more regularly than normal and feeling clumsy and are unable to do simple tasks like buttoning a button or twisting a lid off a jar.
Other patients feel a pins and needles sensation like their hand or foot is falling asleep.
Still other patients describe an intense burning sensation like their hands or wrists are catching fire.
Some describe excruciating pain to the point that they feel the urge to cut off their arms.
Patients also describe shooting electrical-like shocks going up their arm or down their fingers that feel like they hit their funny bone on the edge of a door jam.
Some describe a dull achy feeling in their muscles, as if they have an injured the muscle. Often muscles control is lost and muscles dont respond in a normal way.
Different patients report different aspects of all of the above sensations in different parts of their body along the nerve path. In the case of Carpal Tunnel that nerve path starts at the finger tips and runs through the hands, wrists, arms, elbows, shoulders and even the neck.
One thing is consistent, the symptoms associated with a nerve condition are usually intense and can be extremely frustrating.
This behavior combined with the clumsiness can also affect the way people perceive you as a productive person at work.
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Carpal Tunnel Test Process
Many medical professionals work together in the carpal tunnel test process. Primary care physicians, physical therapists, ortho specialists, and others. The carpal tunnel test process is often comprehensive because its important that its diagnosed accurately to ensure proper treatment. Here are the steps included in the carpal tunnel test process. In some instances, only a few of these steps are performed. In others, all may be performed:
- A Thorough Neck and Back Examination
- Grip Strength Tests for Fingers and Hands
- Blood Tests
It is quite likely that you are experiencing shoulder pain that you believe could be caused by carpal tunnel syndrome. Is it carpal tunnel or is it a shoulder issue?
The truth of the matter is, it is probably both stemming from reversed median nerve pain resulting from compression. If you have shoulder pain, it is likely that you are suffering from carpal tunnel syndrome.
In years past, most doctors would not make this correlation. In todays medical landscape, its been found in approximately 75% of all cases of shoulder pain. The root cause is carpal tunnel syndrome. This is especially true among high risk groups.
How Can I Check Myself For Carpal Tunnel
You begin by standing with your arms extended in front of you. Next, you flex your wrists and let your hands to hang limp for approximately one minute. Its possible that you have carpal tunnel syndrome if you notice tingling, numbness, or discomfort in your fingers during the first sixty seconds of observation.
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Minimizing Stress With Carpal Tunnel Syndrome
As a carpal tunnel syndrome sufferer, there are many ways to minimize stress in the hand, wrist, arm, and shoulder. First, you should relax the grip that you have to reduce the amount of force you use when using the hands. By relaxing the grip, you will find that muscle fatigue and strain is avoided.
When using the hands, it is best to take frequent breaks. The wrists should be kept in a neutral position at all times. You may also work to improve your posture.
Additionally, there are many at home tools you can use to ease pain and heal your shoulder. This can aid in healing carpal tunnel syndrome.
What Happens Without Treatment
At first, symptoms of carpal tunnel syndrome come and go, but as the condition worsens, symptoms may become constant. Pain may radiate up the arm all the way to the shoulder. Over time, if untreated, carpal tunnel syndrome can cause the muscles on the thumb side of your hand to waste away . Even with treatment, strength and sensation may never be completely restored.
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How Does The Pain Start
For most people, carpal tunnel syndrome begins almost without notice.Maybe you feel some tingling at your fingertips when typing. Or if you tap your hand or wrist it tingles or causes a bit of pain in the fingers.
But as it advances, carpal tunnel syndrome becomes more and more unpleasant. Numbness and tingling usually get more intense. And if pain was only slight before, it getsmuch worsein a matter of weeks.Thats when life becomes truly miserable.
The remainder of this article is devoted to describing the 4 stages of carpal tunnel syndrome. Briefly, they are:
- Mild:This is just after symptoms become noticeable. They are worse when you’re relaxing or sleeping. Carpal tunnel pain or numbness keep you up at night. During the day, you may notice dropping things a lot. Your hands feel clumsy.
- Moderate:Symptoms start to bother you during the day. They’re more intense, and other symptoms also begin. You might feel shooting or radiating carpal tunnel pain. Tingling and numbness intensify. You lose more hand strength and dexterity.
- Severe:This is when symptoms are maximally intense. They are so bad they interfere with every aspect of your life. Pain, numbness, and tingling are almost unbearable. Hand weakness and dexterity loss is accompanied by loss of sensitivity to hot or cold.
- End-stage:In this stage, much of your median nerve has died. It results in catastrophic loss loss of hand function. But carpal tunnel pain decreases . Numbness or tingling usually remain.
Arthritis Vs Carpal Tunnel Syndrome
While both arthritis and carpal tunnel can affect the wrists, hands, and fingers, the causes for the symptoms differ.
Rheumatoid arthritis is an autoimmune disease, which means your bodys own immune system attacks the joints, causing inflammation, pain, and swelling. Here are other common symptoms of rheumatoid arthritis.
Osteoarthritis is the wear-and-tear type that occurs when cartilage that cushions joints wears away. Here are other common osteoarthritis symptoms.
Carpal tunnel syndrome occurs when a major nerve in the hand the median nerve becomes compressed in the carpal tunnel, a narrow passageway on the palm side of your wrist that also houses the tendons that bend the fingers.
The floor and sides of this inch-wide tunnel are formed by small wrist bones called carpal bones, which are linked together by a ligament that overlies the top of the carpal tunnel.
Repetitive hand motions, such as those that occur when someone works on an assembly line, often contribute to carpal tunnel syndrome. With excessive motion, the tendons of the fingers can get swollen or inflamed and squeeze the median nerve. Despite common thinking that typing causes CTS, even heavy computer use did not make people more likely to develop it, according to one study.
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Does Carpal Tunnel Syndrome Only Happen To Office Workers Or Factory Workers
No. Many people with carpal tunnel syndrome have never done office work or worked on an assembly line. It affects people who use their wrists and hands repeatedly at work and at play. Anyone can get carpel tunnel syndrome, but it is unusual before age 20. The chance of getting carpal tunnel syndrome increases with age.
Other Conditions Which May Be Misdiagnosed As Cts
Carpal tunnel syndrome is frequently misdiagnosed due to the fact that it shares symptoms with several other conditions, including arthritis, wrist tendonitis, repetitive strain injury and thoracic outlet syndrome. Symptoms which CTS shares with other conditions include:
- Hot-and-cold sensations
- Difficulty grasping or using oneÃ¢â¬â¢s hand
It is important to be aware of the key differences between CTS and some other conditions which share its symptoms, in order to avoid a misdiagnosis. Other conditions which are commonly misdiagnosed as CTS include:
Arthritis can affect all the fingers in the hand, whereas CTS cannot affect the little finger. Whereas CTS is worse at night, arthritis is not affected by the time of day. The symptoms of CTS can be absent and then suddenly become triggered by a particular activity, whereas the pain associated with arthritis is usually constantly present but alters in intensity during activities which put strain on the hands and wrists.
Nerve compression due to conditions affecting the spine
Conditions such as spinal disc herniation and cervical stenosis can cause nerve compression that may result in similar sensations to those of CTS.
Thoracic outlet syndrome
Repetitive strain injury
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What Research Is Being Done
The mission of the National Institute of Neurological Disorders and Stroke is to seek fundamental knowledge of the brain and nervous system and to use that knowledge to reduce the burden of neurological disease. The NINDS is a component of the National Institutes of Health , the leading supporter of biomedical research in the world.
Scientists supported by the NINDS are studying the factors that lead to long-lasting neuropathies, and how the affected nerves are related to symptoms of pain, numbness, and functional loss. Researchers also are examining biomechanical stresses that contribute to the nerve damage responsible for symptoms of carpal tunnel syndrome in order to better understand, treat, and prevent this ailment. By quantifying the distinct biomechanical pressures from fluid and anatomical structures, researchers are finding ways to limit or prevent CTS in the workplace and decrease other costly and disabling occupational illnesses.
Scientists funded through NIHs National Center for Complementary and Integrative Health are investigating the effects of acupuncture on pain, loss of median nerve function, and changes in the brain associated with CTS. In addition, a randomized clinical trial designed to evaluate the effectiveness of osteopathic manipulative treatment in conjunction with standard medical care is underway. Evaluations of these therapies and other therapies will help to tailor individual treatment programs.
When Should I See A Doctor About Carpal Tunnel
If you have tingling, numbness, weakness, or pain in your fingers or hand and it keeps coming back or if it has not gone away after two weeks of home therapy, you should make an appointment with your primary care physician. Have lost most or all of the sensation in your fingers and hands over time. Cannot do even the most basic hand movements without dropping items.
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Injuries To The Wrist
It is possible for the median nerve to become compressed due to changes in the structure of the bones and muscles in the wrist that result from injuries. People who play a lot of sports are particularly at risk of hand and wrist injuries that can result in CTS. In injury-related CTS, ensuring that the injury heals properly and that the median nerve ceases to be entrapped will alleviate the condition.