What Is Carpal Tunnel
Carpal tunnel syndrome is a wrist condition where the median nerve is exposed to increase pressure, causing a numbing, painful sensation. The median nerve runs from the forearm to the hand into an area called the carpal tunnel. It is here that the nerve is exposed to pressure which causes carpal tunnel syndrome.
What Is Carpal Tunnel Syndrome
Carpal tunnel syndrome is a medical condition in the hand, wrist and fingers that is caused when excessive pressure is put on the median nerve in the wrist. The median nerve runs down the forearm and through the wrist on the palm side through the carpal tunnel.
When there is swelling and the tunnel is compressed, the patient may feel numbness, weakness or pain that radiates up the arm.
Treating Moderate Carpal Tunnel Syndrome
Most patients finally see a carpal tunnel doctor in themoderate stage.The doctor will usually recommend non-surgical remedies first, and then monitor your progress.
As with treating the mild stage, moderate stage carpal tunnel syndrome is first approached conservatively. However, the doctor is more likely to start with steroid injections at this stage. The injections are about45% effectivewhen administered during the moderate stage.
Usually, and at the same time, the doctor will also prescribenight bracing, stretching exercises,andmassage.They are the same techniques used during the mild stage .
Most non-surgical treatments will resolve symptoms in approximately 80-90% of patients in this stage. It will also take approximately 2 months to see good results.
Surgery will resolve symptoms inapproximately 60%of patients in the moderate stage. Recent studies show that when either massage or surgery are performed during this stage,the results are equivalentat 2 years.
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Treating Mild Carpal Tunnel Syndrome
If your carpal tunnel doctor diagnoses you withmild carpal tunnel syndrome,your treatment plan will be relatively simple. TheAmerican Academy of Orthopedic Surgeonsrecommends all mild cases of carpal tunnel syndrome be managed conservatively. That means usingnon-surgical therapies.
Conservative management techniques include resting and avoiding the activity that brought on the disorder. Since carpal tunnel syndrome is usually directly related to youroccupation,it might mean changing jobs.
Daily application of these treatments should allowall symptomsto resolve within 4-6 weeks. If they don’t, then more aggressive treatments are required .
What Can A Hand Specialist Do For My Carpal Tunnel
An orthopedic hand specialist will examine your hand and wrist to diagnose the cause of the unwanted symptoms you have been experiencing. The hand specialist will not only do a physical examination, but they will also review your medical history and ask for details on your daily activities involving your hands.
For example, the specialist may ask for details about your office job, any hobbies you participate in, and your lifestyle. The hand physician will also examine the severity of the condition in order to determine what kind of treatment is necessary. This will give the physician an understanding of what could be causing the carpal tunnel syndrome.
Depending on the cause of your carpal tunnel syndrome, the hand specialist may make different recommendations for treatment. For example, if the cause is overuse or improper positioning of your hands and wrists while you work at your desk job, the physician may recommend that you start using ergonomic office equipment. The doctor may also suggest using splints to help prevent pressure on the median nerve.
For serious cases, more invasive treatments may be recommended for adequate improvements to your symptoms. This may include surgery.
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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.
How Is Carpal Tunnel Syndrome Diagnosed
Your doctor will do a medical exam and a few simple in-office tests to study the way your hand and wrist are working. Its helpful if you can tell us how long youve had carpal tunnel symptoms and when they occur.
Most of the time, we diagnose carpal tunnel syndrome through a physical exam. Well order additional tests like X-ray or magnetic resonance imaging if we need more information. These tests help us look for fractures, arthritis or other complications.
In some cases, we order electrodiagnostic tests like electromyography to check your nerve pathways. These tests measure how nerve messages travel in your body.
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The Best Carpal Tunnel Doctor Hasexperience
The differences between carpal tunnel syndrome and anotherhand pain conditionare not usually clear-cut to most patients. But theyre obvious to anybody who truly understands disorders of the hand. Since symptoms can vary from one patient to another, an appropriate physical exam is necessary.
An experienced carpal tunnel doctor will perform a physical exam immediately. Then he or she will be able to pick up on what’s causing your problem with precision, not guesswork.
What Is A Hand Specialist
A hand specialist is an orthopedic doctor who specializes in diagnosing, treating, and preventing disorders in the hand, wrist, and forearm. They have a profound understanding of the complex networks of blood vessels, nerves, muscles, ligaments, tendons, and bones that make up the hand and fingers. They can work with individuals of all ages who have a hand injury or condition, are experiencing problems with mobility and function, or who have ongoing pain.
Some hand conditions and injuries are short-term and will go away on their own with rest, but others may require further treatment. Contact your hand specialist if you experience the following symptoms:
- Pain or discomfort, even while resting the hand
- Ongoing pain and/or stiffness when you start an activity
- A reduced range of motion in the hand, wrist, and/or fingers
- A weak grip or difficulty when holding an item
- Pain, redness, or swelling that gets worse with activity
- Pain that extends to the elbow
- Tingling or numbness in your fingers or hand
- Loss of muscle tone in the hand
- Everyday activities like brushing your hair or preparing meals cause pain or become difficult to do
- Your symptoms dont improve with rest
Some symptoms can indicate a serious condition, such as a fracture or dislocation, and require urgent treatment. This can include severe pain, swelling, bruising, an obvious deformity, and an inability to move your hand, wrist, or finger normally.
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Be Wary Of Doctors Relying On The Emg
Doctors who rely solely on electrodiagnostic testing for carpal tunnel syndrome are gravely mistaken. According to the American Academy of Orthopedic Surgeons, in a large percentage of cases,EMG tests are not reliable.
That means the best diagnosis comes from the knowledge and experience. The best carpal tunnel doctor knows that, and willnotrely on EMG testing for a diagnosis.
Finding The Right Doctor For Carpal Tunnel Release Surgery
A hand doctor or other surgeon with experience and expertise in carpal tunnel surgery should meet these requirements: Is board certified and who specializes in hand surgery (this can be a hand surgeon, dont hesitate to make an appointment with one of the dedicated hand doctors at Atlanta Hand Specialist, 17 Accompanying the surgeon will be an operating nurse and, The incision is about two inches long, and see the doctor within 24 hours, unless local anesthesia is being used, it is best to start with a primary care physician when the symptoms of carpal tunnel are firstEstimated Reading Time: 1 minThe carpal tunnel is a small passageway approximately the size of the thumb located on the palm side of the wrist, muscles, Nerve entrapment
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Whats Your Doctors Reasonable Expectation Of The Surgery
Remember that carpal tunnel syndrome is a disease with no cure. Symptoms may lessen after the surgery, at least for some time. But in50% of patientssymptoms return within two years. What happens then another operation that will likely fail?Discuss what might be the next step in case your surgery fails.
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Wrist & Hand Fracture
If you have shooting pain in your hand or wrist, you may have a wrist or hand fracture. Fracturing, or breaking, the bones in the wrist or hand is extremely easy because of their size and structure. Read on to learn how wrist and hand fractures are treated by Dr. Patel and the Atlanta Hand Specialists.
Treating Carpal Tunnel Syndrome
Carpal tunnel treatment options can ease pain, numbness, and symptoms and help prevent permanent nerve damage.
Your treatment may be fairly simple if you caught carpal tunnel syndrome early. The first steps of treatment are:
Changing your habits. You may need to change specific aspects of your work or other activities that make your condition worse.
Taking medications. Nonsteroidal anti-inflammatory drugs can help. Examples are ibuprofen and naproxen. These drugs ease the pain and inflammation that cause symptoms. Putting ice on your wrists also helps with inflammation.
Wearing a brace. It helps to keep your wrist in a straight position. Wearing a brace at night or during the day, or both, relieves pressure in your wrist. This can help ease your .
Exercising. Your doctor can suggest exercises to stretch the muscles and ease pressure on the nerve in your wrist. Your doctor also may suggest that you work with a .
Getting injections. Your doctor may inject a corticosteroid into the carpal tunnel. These drugs reduce inflammation and can ease your symptoms. However, the shots often work for only a short time. Your symptoms may come back.
Severe carpal tunnel syndrome may not improve with these steps. Some people need surgery.
Most people recover well from carpal tunnel syndrome surgery. It takes a few weeks to get back to normal activities. But, its very rare for symptoms to come back after surgery.
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Stages Of Carpal Tunnel Syndrome
When your carpal tunnel doctor confirms the diagnosis of carpal tunnel syndrome, he or she will determine which stage of the disorder you’re in. In other words, how far has carpal tunnel advancedaccording to your symptoms.Only then can the doctor formulate an appropriate treatment plan based on thestageof your condition.
There are are 4 basic stages of carpal tunnel syndrome:
- Mild Stage Carpal Tunnel Syndrome:This is whensymptoms begin to appearwhile you’re trying to sleep. Usually, pain or numbness will awaken you with the need to rub out or shake out your hand. Symptoms will generally not appear during the day.
- Moderate Stage Carpal Tunnel Syndrome:This stage is characterized by symptoms appearing during the day as well as at night while trying to sleep. The symptoms are more intense. Multiple symptoms usually occur . Loss of grip strengthis also generally noticed, as is hand clumsiness and loss of dexterity.
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.
- Tumors 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.
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What Kind Of Doctor Treats Carpal Tunnel
Carpal tunnel syndrome, depending on the cause of symptoms, can be treated by an orthopedic surgeon, a neurologist, a rheumatologist or other primary care physician specializing in hand, wrist and arm issues. Due to the fact that carpal tunnel syndrome can be caused by a number of factors, it is best to start with a primary care physician when the symptoms of carpal tunnel are first experienced. Once the underlying cause has been determined, then more precise care can be sought by going to a specialist.
The carpal tunnel is the passageway of ligaments and bones at the base of the wrist. This is also where the nerves and tendons connected to the wrist and hand are located. When pressure is placed on this passageway, the median nerve can become crushed, causing pain or weakness in the hand, wrist and arm. Tingling, burning, numbness and other nerve-type pain in the hand, wrist and arm are the first symptoms of carpal tunnel syndrome.
If the symptoms persist, and no action is taken to rectify the issue, the sufferer could experience difficulty gripping objects with their thumb and fingers. When visiting a primary care physician about pain in the hand, wrist and arm, certain tests can be performed to determine the cause and confirm or rule out carpal tunnel syndrome. There are both surgical and non-surgical treatment options available for carpal tunnel syndrome.
Common Conditions Affecting The Hand
Your hand can be vulnerable to many types of injuries and disorders. In some cases, pain, bruising, and swelling can develop immediately following injuries such a direct blow. Other conditions can get worse gradually over time and are often the result of overuse injuries or repetitive movements, which can place stress on tendons, nerves, and joints.
Arthritis can affect joints anywhere in the body. Arthritis of the hands is one of the most common causes of pain, stiffness, and loss of function and mobility in the hands. There are two types of arthritis that are common in the hands: osteoarthritis and rheumatoid arthritis. Osteoarthritis is often the result of wear and tear over time. It causes the cartilage that protects and cushions the ends of bones to breakdown, resulting in painful bone-on-bone rubbing. Rheumatoid arthritis is an autoimmune disease that causes severe inflammation in joints. It causes the bodys immune system to attack the membrane that protects and lines joints, resulting in inflammation and pain as well as a loss of function and mobility.
There are a number of other conditions and injuries that can affect the hands, leading to pain or limited function, which can include:
- Nerve problems
- Sports injuries of the hand and wrist
- Tendon disorders and injuries
- Hand nerve injury
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Determine Your Insurance Benefit
Your insurance coverage is a practical matter. To receive the most insurance benefits and pay the least out-of-pocket for your surgery, you need to choose a surgeon that participates in your plan.
But keep in mind, just because a doctor participates in your insurance plan doesnt mean he or she is a high-quality doctor. You still need to consider the doctors experience and expertise.