How a better understanding of carpal tunnel syndrome can help you avoid it


carpal tunnel syndrome

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Carpal tunnel syndrome (CTS) can seriously affect your ability to perform the simplest of manual tasks. According to the American College of Rheumatology, CTS affects anywhere between 4 and 10 million Americans, yet its causes and effects are often misunderstood. Just what is CTS and how do you know if you're at risk?


Knowing the causes


According to the National Institutes of Health (NIH), the syndrome occurs as a result of compression of the median nerve — a group of long fibers that travel down the arm and through a narrow gap (called the carpal tunnel) on the palm side of the wrist. It's the median nerve that sends sensations from the first two fingers and thumb to the brain and which, in return, also controls the motor function of those same digits. Any damage to or compression of the nerve in this particular area can result in CTS — a broken wrist or swollen tissue can narrow the gap while a repetitive strain of the nerve can cause irritation and inflammation.

CTS is more common in women than men, possibly because they tend to have narrower carpal tunnels. This is particularly true during pregnancy when fluid retention in the limbs can lead to compression of the nerve. Certain illnesses can also result in the condition. Anything, in fact, that adversely affects the motor or sensory nerves — autoimmune disease, motor neuron disease, obesity, arthritis, hyperthyroidism and (most commonly) diabetes — can contribute to the problem. Despite persistent common preconception, the NIH report that there is, as yet, not enough evidence to connect CTS with typing or the use of vibrating machinery. Cramps or spasms in the hand (or anywhere else) are instead usually due to forms of focal dystonia like writers' cramp.


Seeing the symptoms


Carpal tunnel syndrome is a little different. It can begin with mild discomfort in the thumb, index and middle fingers. A slight tingling or numbness in the first three digits — but not the pinky finger — as well as in the hand and wrist can be the first signs that you are at risk for CTS. Sufferers often report weakness in the hand which, as it progresses, causes them to fumble or drop objects. You may have difficulty making a fist or being able to grasp objects.

Those affected may experience pain or numbness in the hand and wrist especially when gripping objects (like cell phones or books) that require a "pinching" action. The pain might even be intense or persistent enough to wake them at night. The first solution for many is to shake out the tingling or numbness much as you would when your foot goes to sleep. As the condition progresses, however, this becomes more difficult to achieve and the sensation can become permanent.


Asking for help


Untreated, carpal tunnel syndrome can cause permanent damage to the nerve. With the right treatment delivered promptly, however, there's no reason why most cases should be anything more than temporary. Your doctor will check your medical history to check if any other conditions are causing the problem and then perform a physical examination of the affected area using blood tests, X-rays or a nerve conduction velocity test (NCV). The NCV involves sending a tiny electrical impulse through the nerve to see if the signal slows in the carpal tunnel — if it does, it's a pretty good indication that the patient has CTS. 

Depending on the cause and extent of the condition, treatment can vary from patient to patient. Wrist splinting along with corticosteroid tablets or injections can provide initial relief by reducing inflammation. A doctor may recommend a visit to a neurologist who will check the condition of the patient's nervous system to ensure that the CTS or its symptoms do not have more serious, underlying causes. In some cases, it may be necessary to use corrective endoscopic or open surgery. The National Institute of Neurological Disorders describes the treatment for CTS as "one of the most common surgical procedures in the United States." It is performed under local anesthetic as an out-patient procedure and, though full recovery may take a few months, the majority of patients recover completely.


Getting it right


If you suspect you might be developing problems with your dexterity, make sure you get checked out by a health professional. Some of the symptoms of carpal tunnel syndrome can be signs of other things so it's much better to play safe. If you're experiencing mild discomfort, try ice to bring down swelling and ease pain and always rest your hands when you can. And if you're worried about treatment, it's worth remembering that invasive methods like surgery tend to be a last option.

Aside from keeping a general eye on your health, there are ways you can help prevent both CTS and focal dystonia. HealthCommunities has some great ideas for dealing with CTS that are — if you'll forgive us — right here at your fingertips.