What You Need To Know
- Carpal tunnel release is one of the most common hand conditions requiring surgery.
- Symptoms may include tingling, pain, numbness or weakness in the thumb through ring fingers of the affected hand.
- Women get carpal tunnel syndrome three times more often than men.
- Carpal tunnel syndrome is a progressive condition that can worsen without proper care.
- Symptoms of carpal tunnel syndrome often occur during pregnancy and can be alleviated with nonsurgical treatments. Symptoms often improve after delivery, but such patients are at higher risk of developing carpal tunnel syndrome later in life.
What Is Carpal Tunnel Syndrome And How Does It Affect Your Overall Life
Carpal tunnel syndrome occurs when the median nerve in your wrist becomes pressed or squeezed. The carpal tunnel refers to ligament and bone at the base of your hand that lines the median nerve and tendons. This nerve goes from the forearm into the palm of your hand, providing movement and feeling to your thumb and your first three fingers.
When your median nerve is compressed, it can cause tingling, numbness, and pain in your hand, forearm, wrist, or elbow. Gripping objects or performing activities that cause you to bend your wrist can make the pain and other symptoms worse. Everyday tasks may become harder as you find it more difficult to hold objects such as a fork or use your thumb to perform simple tasks such as opening a jar.
A Note About Carpal Tunnel Release Surgery
You’ll note that I didn’t mentioncarpal tunnel release surgeryas a permanent pain treatment. That’s because it isn’t. Surgery doesn’t eliminate the cause of the problem, which is tendon swelling.
Surgery merely un-swells the area temporarily. And that’s why pain relief is temporary. In fact, where carpal tunnel pain was the main symptom,about 50%of post-surgical patients saw pain return by 2 years after their hand operation.
Why? Because surgery doesn’t eliminate the source of the pain.
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Carpal Tunnel Syndrome Daily Exercises To Help Pain Management
Until the symptoms improve, stop doing activities that may be contributing to carpal tunnel symptoms. If the self-care treatment plan does not bring enough relief, physical therapy sessions often help. Surgery is always an option it brings relief in 90 % of the cases.
What Are The Early Signs
Typically, the symptoms start out slowly, with burning, numbness, tingling, or pain. You might feel it in your thumb and any of your fingers, but not your pinkie. The strange feeling may also travel up your forearm.
Often, symptoms start at night. Thatâs because most people sleep with their wrists bent, which causes pressure on the median nerve. You might wake up feeling like you need to shake your hands out.
As your condition gets worse, you may notice symptoms during the day, as well. This often happens when youâre doing something where your wrist is bent up or down for a long time, like driving a car, reading a newspaper, or holding your phone.
At first, symptoms tend to come and go. But over time, they occur more often and become worse.
You might also notice other symptoms:
- Your fingers feel swollen, even though they donât look like it.
- Pain and tingling travel up your forearm to your shoulder.
- âShocksâ come and go in your thumb and fingers.
Over time, carpal tunnel can also affect your grip and ability to pinch. Here are some things that could be happening:
- You drop things more often .
- Youâre having a hard time working with small objects, like the buttons on your shirt.
- Itâs harder to make a fist than it used to be.
In more severe cases, you can lose muscle at the base of your thumb. Or you may no longer be able to tell hot from cold just by touch.
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Where Carpal Tunnel Pain Ismost Intense
For most people who suffer with this condition, the location where carpal tunnel pain is most intense is the palm of the hand and the first three fingers.The image above illustrates this pattern.
Note that the little finger is never involved. Nor is the pinky-side of fourth finger.
The location where carpal tunnel pain is usually most intense is thethumbandforefinger. Most times, the base of the thumb also hurts more than the rest of the palm.
As carpal tunnel syndrome starts out, there are 2 key symptoms to look for. In fact, these symptoms distinguish carpal tunnel syndrome from other disorders likewrist tendonitis.The early carpal tunnel symptoms to look for are:
- Pain never occurs during the day, as you’re using your hand. Instead, symptoms appear only when your hand is resting. In contrast, tendonitis for example, only hurts when your hand is working.
- In the beginning stages, carpal tunnel symptoms usually appear only at night. When you’re trying to sleep, you might be awakened with the need to rub out the pain or shake out the numbness.
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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Carpal Tunnel Syndrome Explained
Carpal tunnel syndrome is a direct result of pressure on the nerve that is located at the base of the palm of the hand. This is medically termed as the median nerve.
The carpal tunnel is a narrow region located in the wrist, on the side of the palm. It is an area that aids in the protection of the tendons that are responsible for bending the fingers, as well as the median nerve.
If pressure builds in this area, it can result in the development of weakness and pain in the wrist and the hand. It may also result in a numb or a tingling sensation in one or more fingers.
The overall functionality of the arm may be detrimentally impacted. Additionally, many individuals experience extreme bouts of shoulder pain with carpal tunnel syndrome.
Where Can I Get More Information
For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network at:
Office of Communications and Public LiaisonNational Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.
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Treating Carpal Tunnel Syndrome
Chances are you’re less concerned with where carpal tunnel pain is located than how to treat it. But don’t worry, you can treat it effectively – with or without surgery.
The general rule in carpal tunnel therapy is that the more advanced your symptoms, the less likelihood your hand will be restored to normal. That goes for nonsurgical andsurgical interventions.
Treating carpal tunnel pain and other symptoms should begin with nonsurgical remedies first. In fact, theAmerican Academy of Orthopedic Surgeons recommend trying ALL nonsurgical therapies before considering hand surgery.
The 10 approved nonsurgical remedies are listed below.
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.
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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.
Carpal Tunnel Is It Causing Your Shoulder Pain
Carpal tunnel syndrome is a common but potentially debilitating condition of the wrist and hand. It can detrimentally impact the use of the entire arm, as well as the shoulder.
Excessive demands on the hands and wrists makes this is a very common issue. In fact, 1 out of every 20 people in the United States have Carpal Tunnel.
While surgery is often performed to correct the issue, it is not necessary.
Physical therapy and similar treatments have been found to be effective in alleviating the symptoms associated with the condition.
In this comprehensive guide, you will learn about carpal tunnel syndrome. If you have shoulder pain, limited use of your arm, or complications with your wrists and/or hands, continue to learn more.
The pain you feel today will be the strength that you feel tomorrow Unknown
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Diseases Of The Thyroid
People with improperly-managed thyroid conditions may retain excess fluid in their connective tissues. This contributes to inflammation within the wrist, which can cause CTS, especially if left untreated. Hypothyroidism is particularly linked to CTS, but people with hyperthyroidism are also more likely to develop CTS than the general population.
How To Relieve Carpal Tunnel Pain
For most people, it doesn’t matter where carpal tunnel pain is as long as they can treat it. But it may surprise you that treating the pain symptoms is only slightly helpful. But treating thecauseof the pain is far more effective and lasting. In other words:
If you treatonly the painit will come back. But if you treat thecause of the painit will eliminate symptoms forever.
Therefore, where carpal tunnelpainis your main symptom, there are 2 approaches to treating it:
- temporary pain treatmentswhich just treat pain for the time being
- permanent pain treatmentswhich treat & eliminate the source of the pain
I highly recommendyou use thepermanent pain treatmentsfor obvious reasons. I list the temporary ones below because you’ve probably tried them – with no long-term effects.
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Symptoms And Signs Of Carpal Tunnel Syndrome
Living with carpal tunnel syndrome is not easy because the hand and wrist are involved in most activities. It is often thought of as a repetitive motion condition, but can develop due to:
- repetitive movements
- inability to perform certain tasks requiring dexterity
- frequent dropping of items because of lack of feeling and weakness in the hand.
In severe cases, the muscles at the base of the thumb may shrink. The fingers affected are the ones served by the nerve running through the carpal tunnel: thumb, middle finger, ring finger and index finger.
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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Is My Hand Pain Caused By Arthritis Or Carpal Tunnel Syndrome
Before you can treat your hand pain, you need to know whats causing it. Two of the most common causes of hand pain are arthritis and carpal tunnel syndrome. How can you tell if you have oneor bothof these conditions?
Carpal tunnel syndrome is one of several conditions that either results from or shares symptoms with inflammatory arthritis.Conditions Related to Inflammatory Arthritis
Both arthritis and carpal tunnel syndrome can affect your ability to do everyday activities, such as getting dressed, driving, and using your phone and TV remote. Both can be triggered by activity or repetitive motion. To distinguish between the two conditions, doctors look for certain signs and symptoms.
Health Issues That May Cause Carpal Tunnel Problems
There are several unique health conditions that may lead to the onset of problems with the carpal tunnel region. These are as follows:
- Those that experience issues with the tendons in the wrist, such as swelling, inflammation, and other types of irritation are at a high risk for developing carpal tunnel problems.
- Changes with the hormones or the unique metabolic balance of the body such as pregnancy and/or issues with the thyroid could result in CTS.
- Injuries that directly impact the wrist like sprains, dislocations, and even fractures may place immense pressure on the carpal tunnel and cause hand, arm, and shoulder problems.
- Retaining fluid in the body due to other conditions, such as pregnancy, diabetes, and issues with the endocrine system may increase the pressure in the carpal tunnel.
- Arthritis and/or degenerative disorders in the body are known to cause carpal tunnel problems.
- In addition to the health issues that may lead to CTS, certain types of medications such as steroids may also result in severe pressure in the carpal tunnel in the wrist.
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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.
What Are The Symptoms Of Carpal Tunnel Syndrome
Symptoms usually begin slowly and can occur at any time. Early symptoms include:
- Numbness at night.
- Tingling and/or pain in the fingers .
In fact, because some people sleep with their wrists curled, nighttime symptoms are common and can wake people from sleep. These nighttime symptoms are often the first reported symptoms. Shaking the hands helps relieve symptoms in the early stage of the condition.
Common daytime symptoms can include:
- Tingling in the fingers.
As carpal tunnel syndrome worsens, symptoms become more constant. These symptoms can include:
- Weakness in the hand.
- Inability to perform tasks that require delicate motions .
- Dropping objects.
In the most severe condition, the muscles at the base of the thumb visibly shrink in size .
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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 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