by Sanaz Majd, MD
Our hands are so important to everyday life. We write, eat, work, hold our children, and even talk with our hands. We generally take them for granted, until something happens and we are no longer able to use them as we did before.
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By far the most common ailment affecting my patients’ hands is carpal tunnel syndrome (CTS), which causes tingling and numbness in the fingers. It’s quite common, and can affect anyone at any age, but tends to occur more in women and in those who are overweight. Most of the time, it is triggered by our daily routine activities. Since it’s such a common medical issue, I’d like to give you some tips on its causes, symptoms, and treatments.
What is Carpal Tunnel Syndrome?
There is a band of tissues encircling our wrists that includes ligaments and tendons. Then there’s a nerve that runs through this band of tissues called the “median nerve.” The median nerve feeds the sensation in our first three and a half fingers, starting with the thumb. It does not affect our pinky finger.
When this band becomes inflamed and thickened, it compresses the median nerve and we start to experience tingling and numbness in those fingers.
What are the Symptoms of Carpal Tunnel Syndrome?
Initially, symptoms of tingling and numbness typically occur in the middle of the night. But if left untreated, they can progress into the daytime as well. When severe and chronic enough, some patients start to get weakness in the entire hand. They may no longer be able to open jars and drop objects held in the affected hand. As its severity progresses, the hand loses functioning.
Who Gets Carpal Tunnel Syndrome?
Any repetitive movements or prolonged inflammation of the wrist can cause CTS. For instance, CTS is very common in those who work with their hands. I see this commonly in patients who do a lot of typing, construction, or carpentry. In addition, those with hobbies requiring fine motor skills of the hands, such as beading or knitting, can also develop CTS. Pregnant women commonly get CTS as well, since the increase in fluid retention in the wrist can also compress the nerve.
How is Carpal Tunnel Syndrome Diagnosed?
If you are experiencing symptoms of CTS, your doctor will perform an exam to confirm it. This will involve holding your hands in certain positions, and typically this is sufficient. Sometimes a special test called a “nerve conduction study” is performed. During this test, special probes are placed on your arm and your nerves will be tested individually to confirm that indeed it is the median nerve causing all the chaos.
5 Tips to Treat Carpal Tunnel Syndrome
For most people, some simple measures are sufficient to help alleviate CTS once it’s diagnosed. Here are 5 Quick and Dirty Tips to halt your CTS in its tracks:
1. Use a Splint: A wrist splint designed for CTS (that can often be found in drug stores and sporting goods stores) is often the first line of defense. The splint keeps the wrist in a straight and neutral position. This is an important part of the healing process for the inflamed band surrounding the median nerve, since bending the wrist compresses the wrist and inflames the nerve. I tell my patients to wear this at least for a month, and even at bedtime, when symptoms are often worse.
2. Rest Your Wrist: Try to refrain from sleeping on your forearm and wrist, or engaging in the repetitive activities that initially caused your symptoms. If you bead or knit, give it a break for a couple of months. If you need to type for work, ask your Human Resources department to evaluate your work station and make sure you are using it properly.
3. Anti-inflammatories: Your doctor may prescribe a course of anti-inflammatories, such as ibuprofen, to help calm down the nerve for a specified time period. It can also help with the pain and swelling. Please be aware that people who have stomach ulcers or take blood thinners can’t take anti-inflammatories. Ask your doctor if it’s okay for you to take these.
4. Physical Therapy: If steps 1-3 aren’t working, your doctor may suggest physical or occupational therapy.
5. Cortisone Injections: Sometimes a cortisone injection can help alleviate CTS symptoms. That’s because cortisone is another type of anti-inflammatory that will help decrease inflammation, swelling, and pain.
Surgery for Carpal Tunnel Syndrome
Surgery isn’t right for everyone. In fact, it’s usually the last resort if all of the above measures fail. But once your symptoms are so severe that nothing else is working, it may be time to consider surgery. The surgeon will cut the thick band around the wrist, thereby relieving the pressure on the median nerve. Most people require some physical therapy or certain exercises to do at home after the procedure.
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Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
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