Treatment For Carpal Tunnel Syndrome
Thankfully, carpal tunnel syndrome is very treatable. Its important to see a doctor for an exam, to rule out other issues and to learn what you can do to comply with treatments. While a doctor may prescribe pain relievers, administer cortisone shots, or even recommend surgery, there are many complementary steps that you can take to help ease discomfort as you heal. Whether the root cause is rheumatoid arthritis, diabetes, or something else, theres a lot you can do to help relieve the symptoms of carpal tunnel syndrome.
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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
Carpal Tunnel Syndrome Treatment
If carpal tunnel syndrome is caused by a medical problem , your doctor should treat that problem first. Your doctor may ask you to rest your wrist or change how you use your hand. He or she may also ask you to wear a splint on your wrist. The splint keeps your wrist from moving but lets your hand do most of what it normally does. A splint can help ease the pain of carpal tunnel syndrome, especially at night.
Putting ice on your wrist to reduce swelling, massaging the area, and doing stretching exercises may also help. An over-the-counter non-steroidal anti-inflammatory drug can relieve swelling and pain. These medicines include aspirin, ibuprofen , and naproxen . In more severe cases, your doctor might inject your wrist with a corticosteroid, which reduces inflammation and pain.
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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.
Hand And Wrist Stretches
A physical therapist, occupational therapist, or certified hand therapist can teach you exercises which you can learn to do on your own. Nerve and tendon gliding exercises have been shown to be helpful in carpal tunnel syndrome. Simple exercises I have found helpful are stretches which involve the fingers and wrist, pulling them back into extension and holding the stretch for 20 seconds, then relaxing. This can be repeated for up to 5 minutes per session, 2-3 times per day. This stretch shouldnt be painful or done with excessive force. Therapists can also do therapeutic ultrasound and iontophoresis treatments which can help reduce symptoms.
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Treatment Of Carpal Tunnel Syndrome
Your health care provider will figure out the best treatment for you based on:
Your overall health and medical history
How bad your wrist is right now
How well you tolerate specific medications, procedures, or therapies
How bad the disease is expected to get
Your opinion or preference
Treatment may include:
Splinting your hand. This helps keep your wrist from moving. It also eases the compression of the nerves inside the tunnel.
Anti-inflammatory medication. These may be oral or injected into the carpal tunnel space. These reduce the swelling.
Surgery. This eases compression on the nerves in the carpal tunnel.
Worksite changes. Changing position of your computer keyboard or making other ergonomic changes can help ease symptoms.
Exercise. Stretching and strengthening exercises can be helpful in people whose symptoms have gotten better. These exercises may be supervised by a physical or occupational therapist.
Management Of Carpal Tunnel Syndrome
ANTHONY J. VIERA, LCDR, MC, USNR, Naval Hospital, Jacksonville, Florida
Am Fam Physician. 2003 Jul 15 68:265-272.
Carpal tunnel syndrome affects approximately 3 percent of adults in the United States. Pain and pares-thesias in the distribution of the median nerve are the classic symptoms. While Tinel’s sign and a positive Phalen’s maneuver are classic clinical signs of the syndrome, hypalgesia and weak thumb abduction are more predictive of abnormal nerve conduction studies. Conservative treatment options include splinting the wrist in a neutral position and ultrasound therapy. Orally administered corticosteroids can be effective for short-term management , but local corticosteroid injections may improve symptoms for a longer period. A recent systematic review demonstrated that nonsteroidal anti-inflammatory drugs, pyridoxine, and diuretics are no more effective than placebo in relieving the symptoms of carpal tunnel syndrome. If symptoms are refractory to conservative measures or if nerve conduction studies show severe entrapment, open or endoscopic carpal tunnel release may be necessary. Carpal tunnel syndrome should be treated conservatively in pregnant women because spontaneous postpartum resolution is common.
Family physicians frequently encounter patients who may have carpal tunnel syndrome. This article reviews the clinical features, diagnosis, and treatment of this relatively common condition.
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Ignoring Symptoms Of This Carpal Tunnel Syndrome Can Lead To Permanent Nerve Damage
First, you may notice tingling or numbness in your fingers that comes and goes. Over time, the sensations may get worse, lasting longer or even waking you up at night. Eventually the pain and numbness might even make it hard to grip things like a fork, a pen, or other objects.
If you’re having these symptoms, it could be carpal tunnel syndrome, which occurs when the median nerve which runs down your arm and into your hand is compressed by a ligament that crosses over it as it passes through a narrow space in the wrist known as the carpal tunnel.
“Carpal tunnel syndrome has classic symptoms, which include numbness and tingling in the thumb, index finger, middle finger, and half of the ring finger,” says Dr. Tamara Rozental, professor of orthopedic surgery at Harvard Medical School and chief of hand and upper extremity surgery at Beth Israel Deaconess Medical Center. Your little finger is typically not affected because a different nerve serves it.
Carpal Tunnel Syndrome Exercises
The right exercises are useful compliments to another CTS treatment. Exercises along with the right treatment, proper activity modification and wrist splinting can hasten the recovery process.
Here is a generic exercise that you can do anytime, anywhere. This exercise is developed by Dr. Housang Seradge at the University of Oklahoma Orthopaedic & Reconstructive Research Foundation.
Heres another set of exercises from University of Maryland Medical Center for carpal tunnel syndrome. These exercises work to strengthen the wrist, hands, arms and shoulders to help cure and avoid carpal tunnel syndrome.
Core Wrist Exercises
- Hold one hand straight up shoulder-high with your fingers together and palm facing outward.
- With the other hand, bend the hand you are exercising backward with the fingers still held together and hold for 5 seconds.
- Spread your fingers and thumb open while your hand is still bent back and hold for 5 seconds. Repeat five times with each hand.
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Pay Attention To Your Workstation
If you work at a desk job, its important to keep your hands in a neutral position, with your fingers in line with your forearms, says Dr. Sueno. If your wrist is in a neutral position, that really minimizes the risk of carpal tunnel syndrome, he says.
This might be easier with a desktop computer, since you can adjust them as needed. Frost is adamant that people shouldnt use laptops, while Sueno says that either is fine. The most important thing, he says, is to be careful not to overextend your wrists while typing.
Carpal Tunnel Syndrome Risk Factors
Carpal tunnel syndrome is three times more likely in females than in males. People are more likely to get carpal tunnel syndrome if they have diabetes, hypothyroidism, gout, rheumatoid arthritis or if they suffer a sprain or fracture of the wrist. Pregnancy and menopause also make the condition more likely.
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Perform Wrist Exercises And Therapy
Here are a few wrist exercises you can try to relieve pain:
- Shake It Out: Once an hour for one or two minutes, shake your hands as if youre trying to air dry them after washing them. By doing this, youre helping to keep your hand flexor muscles and the median nerve from becoming tight and cramped during the day. You may already be doing this just by washing your hands frequently throughout the day.
- Wrist Flex and Extend: For this exercise, youll hold your arm in front of you straight out, keeping your hand and wrist straight and palm facing down. Start bending your wrist down, so youre pointing your fingers toward the floor. Using your other hand, start pulling your fingers gently toward your body to help increase the stretch. Hold this position for up to 30 seconds. Now, return to a neutral, straight wrist position with palm still facing down. Begin bending your wrist up, so youre pointing your fingertips toward the ceiling. Gently pull your fingers with the other hand back toward you, holding the position for another 30 seconds. Repeat 10 times a few times a day.
- Stretch It Out: Whether youre sitting at your desk or standing in line at your local grocery store, you can perform this simple and quick wrist exercise. Make a fist and release, so your fingers are straight again. Continue performing this exercise up to 10 times to help relieve any pressure you may have in your wrist.
Massage For Carpal Tunnel
Massage can help relax, open up, and alleviate the pain. A knowledgeable and experienced massage therapist can guide you through this method. In this video, a massage therapist demonstrates a massage focusing on the symptoms of carpal tunnel syndrome, while describing her method.
Although carpal tunnel syndrome can be a frustrating and painful experience, there is an abundance of stretches and exercises that can help. From yoga and pilates to massage therapy and acupressure, you are bound to find a method that works for you. Exercises and stretches such as these help the body to strengthen and heal from the ravages of carpal tunnel syndrome. While these exercises can offer short-term relief, with ongoing practice many of these methods can eliminate and completely heal carpal tunnel syndrome.
This content is accurate and true to the best of the authors knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
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Carpal Tunnel Syndrome: Wrist Splints And Hand Exercises
Many people who have carpal tunnel syndrome have mild or moderate symptoms that come and go. In those cases, wearing a splint and avoiding too much stress on the joint may be enough to provide relief.
The main symptoms of carpal tunnel syndrome are tingling, numbness or pain in parts of the hand. Sometimes it’s difficult to move your thumb or first two fingers properly too. This is caused by too much pressure on the median nerve, which runs through the carpal tunnel in the wrist.
Sometimes these symptoms disappear again without treatment. A wrist splint can be worn for support. Splints don’t always offer enough relief from symptoms, but have hardly any side effects compared with other treatment options, like corticosteroid therapy or surgery.
What Are The Causes Of Carpal Tunnel Syndrome
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. Contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture an overactive pituitary gland an underactive thyroid gland and rheumatoid arthritis. Other factors that may contribute to the compression include mechanical problems in the wrist joint, repeated use of vibrating hand tools, fluid retention during pregnancy or menopause, or the development of a cyst or tumor in the canal. Often, no single cause can be identified.
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What Increases Your Risk
Things that put you at risk for carpal tunnel syndrome include:
- Health problems or illnesses that can cause arm pain or swelling in the joints and soft tissues in the arm, or reduce the blood flow to the hands. These include obesity, rheumatoid arthritis, diabetes, lupus, hypothyroidism, and multiple sclerosis.
- Being female. Women between the ages of 40 and 60 have the highest risk. Pregnant women near the end of their pregnancies often have short-term symptoms. Women taking birth control pills, going through menopause, or taking estrogen are also thought to be at risk.
- Hand and wrist movements and activities that require repeated motions, especially in awkward positions.
- Smoking. It may contribute to carpal tunnel syndrome by affecting the blood flow to the median nerve.
- Broken wrist bones, dislocated bones, new bone growth from healing bones, or bone spurs. These can take up space in the carpal tunnel and put more pressure on the median nerve.
- Tumours and other growths . These uncommon causes of carpal tunnel syndrome are usually benign.
- Normal wear and tear of the tissues in the hand and wrist caused by aging.
Physical Therapy Guide To Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common condition that causes pain, numbness, and weakness in the wrist and hand. CTS can affect the use of the entire arm. It is caused by pressure on the nerve at the base of the palm . Because of the constant demands people place on their hands and wrists, surgery may be needed when symptoms are severe. For many people with CTS, however, physical therapy treatment can relieve pain and numbness. It often can help restore normal hand, wrist, and arm use without the need for surgery.
Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation. To find a physical therapist in your area, visit Find a PT.
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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 .
Helpful Life Hacks For Carpal Tunnel Pain
When you have the wrist or hand pain and tingling of carpal tunnel syndrome, it may seem like surgery is the only answer. But there are measures you can take to either avoid or postpone surgery and still have good quality of life.
2.Use a wrist braceBracing the wrist is one of the most reliable ways to stabilize the wrist and ease carpal tunnel pain. When selecting a brace, choose a structured, firm option that will immobilize the wrist, as opposed a flexible one made of neoprene or elastic.
3.Elevate hands, especially during sleepElevating the hands and wrists can help ease inflammation, particularly at night. This can be done by sleeping on your back and propping your wrists up on pillows. Since keeping your arms straight can also help, try wrapping a towel or ace bandage around your elbows.
5.Ask about job rotationIf your job involves activities such as repetitive assembly line work, talk with your employer about the possibility of rotating tasks to give your wrists and hands a rest.
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