Does Carpal Tunnel Syndrome Have A Long Recovery
Surgery to repair carpal tunnel syndrome does not have a particularly long recovery. The bandage that covers the stitches after surgery can be removed in a few days. The hand can then be used for light activities. Making a fist is encouraged. Full range of finger motion and early symptom relief is usually seen within two weeks after the stitches have been removed. You can usually return to most activities by six weeks. Your return to work depends on factors such as type of work, how much control you have over your work and workplace equipment.
How To Treat Carpal Tunnel Syndrome Without Surgery
Im writing this article for people who want to avoid carpal tunnel surgery. Yes, I am a hand surgeon but Im also a physician, and part of our jobs as physicians is to educate patients about prevention of disease. Hopefully I can teach people about ways to reduce the risk of carpal tunnel syndrome and provide options for treatment prior to requiring surgery.;As a disclaimer, patients who have severe carpal tunnel syndrome should be evaluated promptly and not delay treatment unnecessarily. Constant numbness in the hand and loss of muscle mass at the base of the thumb are signs of nerve damage and severe CTS. Surgery is the best way to prevent the nerve from being damaged irreversibly. If people wait too long before having surgery, some of the hand numbness can be permanent.;Also, not all hand pain, numbness, and tingling are caused by CTS. If your symptoms are progressive, severe, or not responding to treatment, get an evaluation by a hand specialist or primary care physician sooner rather than later. The recommendations below are intended for patients with mild to moderate CTS symptoms, or in people who want to prevent the symptoms from occurring in the first place. There are some things we cant change about our health, such as our family history, age and anatomy, but there are many things which we can modify.Helpful things to do other than surgery for carpal tunnel syndrome:
;Treatments which are NOT helpful for CTS:
How Is It Diagnosed And Treated
Did you ever wake up and your hand is still asleep all numb and giving you pins and needles? Sometimes, with CTS this tingling starts in the palm of the hands and fingers, especially the thumb, and;the index and middle fingers.
A brace or splint can help mild cases of CTS. It is usually worn at night and keeps a person’s wrists from bending. Keeping the wrist straight opens the carpal tunnel so the nerve has as much room as possible. Resting the wrist will allow the swollen tendons to shrink. Medicines like ibuprofen can also help reduce the swelling.
In more severe cases, your doctor may recommend cortisone to reduce inflammation and swelling in the carpal tunnel. This medicine is given by a shot, or injection. When the symptoms of CTS have improved, the doctor may suggest the person do wrist exercises and make changes that can prevent further problems, such as repositioning the computer and keyboard.
If none of these treatments help, the person may need surgery to release the pressure on the median nerve. This surgery takes less than an hour and usually doesn’t require a stay overnight in the hospital. Very few people are permanently injured by CTS. Most can get better and take steps to prevent the symptoms from returning.
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Carpal Tunnel And Tendonitis
Years ago, it was thought in general by patients that carpal tunnel was caused by typing too much. Studies have shown that this is not true. What most are suffering from is tendonitis, and its getting worse from the tiny handheld computers that most of now have; as a result, the cases of wrist and thumb tendonitis are on the rise.
We can understand the confusion that patients have self-diagnosing themselves with carpal tunnel syndrome since carpal tunnel syndrome and wrist and thumb tendonitis has such similar symptoms.
What are the differences between carpal tunnel syndrome and tendonitis?
Can Carpal Tunnel Syndrome Be Prevented Or Avoided
You can take steps to prevent carpal tunnel syndrome. The following actions may help to prevent it:
- Lose weight if youre overweight.
- Get treatment for any disease you have that may cause carpal tunnel syndrome.
- If you do the same tasks over and over with your hands, try not to bend, extend, or twist your hands for long periods of time.
- Dont work with your arms too close or too far from your body.
- Dont rest your wrists on hard surfaces for long periods of time.
- Switch hands during work tasks.
- Make sure the tools you use arent too big for your hands.
- Take regular breaks from repeated hand movements to give your hands and wrists time to rest.
- If you use a keyboard a lot, adjust the height of your chair so that your forearms are level with your keyboard, and you dont have to flex your wrists to type.
Many products you can buy, such as wrist rests for a computer keyboard, are supposed to ease symptoms of carpal tunnel syndrome. No one has proven that these products really prevent wrist problems. Some people may have less pain and numbness after using these products, but other people may have increased pain and numbness.
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Could Your Job Be To Blame
Its a common belief that frequent typing can lead to carpal tunnel syndrome. But its 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.
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.
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What Is The Outlook After Treatment For Radial Tunnel Syndrome
Most patients recover completely with medical treatment if they follow instructions carefully and avoid future injury to the nerve. Surgery improves symptoms for patients who did not respond to medical treatment, but some patients continue to have mild pain after surgery.
Preventing re-injury to the radial nerve is the most important goal after recovery.
Other Medical Issues That Cause Hand Numbness
Compressed nerves arent the only reason you may wake up with numbness in your hands. These other medical disorders can also cause numbness:
- Cervical Spondylosis: ;A chronic degenerative disease that impacts neck muscles, tendons, and bones, cervical spondylosis is fairly common. It is more often seen in older adults. Common symptoms include neck pain and stiffness, as well as pain and numbness in the arms, shoulders, and fingers.
- Thoracic Outlet Syndrome: This disorder involves compression or irritation of blood vessels in the upper chest due to anatomical variations of the muscles in that region. Most cases of thoracic outlet syndrome are caused by whiplash or other neck trauma. Sometimes the disorder is caused by repetitive motions or, less commonly, by having an extra rib.
- Diabetes Mellitus: More commonly known as type 2 diabetes, this disorder is characterized by an inability of the body to use or create insulin adequately and can result in nerve damage. Nerve damage can cause numbness and tingling sensations in the hands and feet.
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If You Think You Might Have Carpal Tunnel Syndrome Here Are A Few Tips That Can Help You With Your Self
If you have one of the symptoms listed on our Carpal Tunnel Syndrome Symptoms page above, then you have a 70 80% chance of having Carpal Tunnel Syndrome.
If you have two of the Carpal Tunnel Syndrome Symptoms listed on the above page then you have a 80 -90% chance of having Carpal Tunnel Syndrome.
If you have three or more of the Carpal Tunnel Symptoms listed on our Carpal Tunnel Syndrome Symptoms page above then you have a greater than 95% surety that you have this chronic hand / wrist condition.
There are hundreds of possible permutations and different combinations of Carpal Tunnel 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 Carpal Tunnel self-diagnosis approach in your efforts to clearly identify what your collection of symptoms might be.
As you go through this self-diagnosis process, 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 through the wrist, forearm, elbow, bicep, shoulder and neck to the cortex of the brain and can affect any muscle, joint or other parts of the anatomy along this nerve path.
It is always good to get a back-up professional diagnosis when you can fit it in, but there is no reason to wait to start getting these potentially devastating symptoms under control.
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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During Rem Sleep The Body Goes Into A State Of Semi
Many people are not aware that during REM sleep the body goes into a state of semi-paralysis. This state of semi-paralysis prevents a person from moving, so we dont act out our dreams. However, with no muscle movement, the lymphatic system does not disperse lymphatic fluid like it normally does during the day.
How Is Radial Tunnel Syndrome Diagnosed
Pain in the forearm and hand are usually the symptoms that send a person to the doctor. However, there are no tests to prove a person has radial tunnel syndrome. This makes the diagnosis difficult. The doctor must depend on the patients physical exam and the type and location of the pain. As part of the exam, the patient is asked to turn his or her palm up with a straight elbow while the doctor restricts arm and hand movement. If the patient feels pain while trying to move the arm or hands against resistance; it is a sign of radial tunnel syndrome. In another test, the patient is asked to point with his or her middle finger against resistance. Pain with this movement is another sign of radial tunnel syndrome.
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Early Diagnosis Is Crucial
An early diagnosis of carpal tunnel syndrome is important to prevent permanent damage to the median nerve. In acarpal tunnel testthe doctor performs a physical examination of the hands, arms, shoulders and neck. This is important because it can rule out other painful conditions such asarthritis. Sometimes doctors will;misdiagnosecarpal tunnel syndrome as some other condition, likewrist tendonitisor muscle strain.
During the exam, the doctor looks for tenderness, swelling, warmth and discoloration. The doctor also tests finger sensitivity. The muscles at the base of your hand are tested for strength and signs of wasting. Routine lab tests and X-rays can show if you havediabetes, arthritis or fractures causing the symptoms.;
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 .
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How Is Finger Numbness Treated
Your doctor may recommend over-the-counter medication to reduce inflammation. Examples include nonsteroidal anti-inflammatory drugs, such as ibuprofen.
Another option is wearing a brace or splint. This will help you keep your elbow or wrist in a good position so that the nerve is less likely to be compressed.
In rare instances, your doctor may recommend more invasive treatments if OTC options dont work. Steroid injections can help relieve inflammation.
Surgery may decrease the nerve damage, or remove or reduce bones that are pressing on the nerve. These procedures include:
- cubital tunnel release
- ulnar nerve anterior transposition
- medial epicondylectomy
Resting your hand and wrist is usually one of the best ways to reduce inflammation when youre at home. You can also apply ice to the affected area.
When To Get Surgery
“The mistake that people often make is waiting too long to get surgery,” says Dr. Rozental. “I see a lot of people who say that their numbness was gradually worsening and now their hand is completely numb and has been for a year.” If the nerve is compressed long enough, the muscle atrophies and the nerve damage becomes permanent, she says.
So, if your carpal tunnel symptoms aren’t responding to other treatments, take action quickly.
The surgery takes 10 minutes under a local anesthetic. Unless you do a job that involves manual labor, you can typically go right back to normal activities, says Dr. Rozental.
“I tell my patients all the time that a carpal tunnel release done at the right time for the correct diagnosis is very successful,” she says.
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Two Basic Types Of Carpal Tunnel Surgery
Carpal tunnel release surgery can either beopenorendoscopic. Both aim to cut the ligament holding the wrist bones together.
Open carpal tunnel release surgerymeans the surgeon creates a 2-3 inch slit on the palm. The surgeon cuts the ligament, and then sutures the skin closed. This results in a significantly long scar on the palm.
- Theadvantageof this technique is that the surgeon can clearly see all of the structures in the hand. That means there’s less chance to accidentally lacerate an important structure like a nerve or blood vessel.
- Thedisadvantageof the open technique is that there’s much more hand trauma. This means more postsurgical pain and longerrecovery and aftercare.
Endoscopic carpal tunnel release surgeryis a little different. It means a surgeon uses an endoscope to see inside the carpal tunnel space rather than opening the skin over the palm. The surgery uses a thin, flexible tube containing a camera guided through a small incision in the wrist.;
Sometimes the surgeon makes two small holes; one in the wrist and one in the palm. This is calleddouble portal endoscopic carpal tunnel release surgery.
- Theadvantageof endoscopic surgery is that the surgeon cuts the ligament without having to make a large incision. This means less trauma. And less trauma means less postsurgical pain and faster recovery.
Questions To Ask Your Doctor
- How do you know that carpal tunnel syndrome is causing my symptoms?
- What can I do to relieve my pain?
- Are there any special exercises I can do to strengthen my hand and wrist?
- What is the best treatment option? Will I need surgery?
- How long will it take to recover?
- Is it likely that Ill experience this problem again, either in this hand/arm or in my other hand/arm?
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Myth: Any Hand Pain Or Tingling Is A Sign Of Carpal Tunnel Syndrome Especially If You Use A Computer All Day
At the first sign of pain, numbness, or tingling in the hand or wrist, people may assume its a sign of carpal tunnel syndromeespecially if they sit at a computer for most of the day. Just as with any repetitive motion thats done for long periods of time, typing on a keyboard or using a computer mouse all day can cause aches and stiffness in the hands and wrists. But this isnt necessarily carpal tunnel syndrome.
Carpal tunnel syndrome has specific symptoms that set it apart from other conditions that can cause pain and numbness in the hand. For example, carpal tunnel syndrome typically causes tingling and numbness in the thumb, index, and middle fingers, but not the ring or pinky fingers. Also, the pain of carpal tunnel syndrome is usually worse at night.