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 Doctors have written about carpal tunnel syndrome (CTS) for more than 100 years, but it took the emergence of computer keyboards for the condition to achieve national prominence. In fact, any activity that constantly strains the wrist, from guitar playing to rowing, from assembly line work to knitting, can bring it on. Sometimes, however, carpal tunnel syndrome can begin without any apparent cause at all.
Carpal tunnel syndrome usually starts as repeated local irritations swell the tendons and ligaments in the wrist. This then compresses the median nerve, which passes through a "tunnel" from the forearm to the hand. The combination of the inflamed tendons and the squeezed median nerve are responsible for the pain, tingling, numbness and weakness of the thumb and index and middle fingers characteristic of CTS. In addition, any of the following have been associated with this painful condition: an underactive thyroid, diabetes, rheumatoid arthritis, obesity, pregnancy, premenstrual syndrome (PMS), birth control pills, and menopause.
Although conventional medicine can be very helpful, we believe one of its options, namely surgery, should be the last resort. As many physicians are unaware of alternative therapies, let's see if our MyHealth suggestions can help keep you out of the operating room. No guarantees, of course, but nothing ventured . . .
What is Carpal Tunnel Syndrome? Carpal tunnel syndrome is a painful disorder of the wrist and hand that affects some 5 million Americans. Carpal tunnel refers to a passageway in the wrist, composed of bones and ligaments, through which a major nerve system passes from the forearm into the hand.
For a variety of reasons--repetitive strain, arthritis, bone dislocation or fracture, fluid retention, or a variety of systemic changes affecting the entire body, such as diabetes--the carpal tunnel can become narrowed. When this occurs, the median nerve, which controls feeling and movement in the hand, is compressed by surrounding tissue or excess fluid. As the nerve is constricted, it causes numbness, weakness, or pain. Often affecting the dominant hand (though possible in both hands), these symptoms may appear suddenly or gradually, and may last for only a few days at a time or persist for several months.
Women are far more susceptible than men are to carpal tunnel syndrome, in large part because more women perform the types of hand-intensive tasks (especially typing on computer keyboards) that put them at risk. The condition is also common among overweight women between ages 30 and 60 who have been pregnant. The sooner carpal tunnel syndrome is diagnosed, the easier it is to treat--and the better the prognosis. Left untreated, however, the condition can lead to a weakened grip and severe chronic pain in the forearm or shoulder.
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What Causes Carpal Tunnel Syndrome? Carpal tunnel syndrome is often considered a modern-day ailment, a stress injury caused by too many tense hours spent at a keyboard. In fact, it was first diagnosed in the 1880s, long before computers reigned, and its rise has been attributed to several factors, including:
- Prolonged repeated movements of the hands or fingers or bending of the wrist.
- Injury or trauma that causes nerve damage in the wrist.
- Hormonal changes due to pregnancy, birth control pills or menopause.
- Diseases such as diabetes, hypothyroidism, rheumatoid arthritis, or Raynaud's disease.
Treatment and Prevention For carpal tunnel, acting quickly at the first hint of a symptom can often head off a full-blown irritation. The natural position of the working hand is with the wrist held straight or slightly bent and the thumb in a continuous line with the forearm. Using your hand with the wrist bent, either forward or back, places a stress on the nerves as they pass through the carpal tunnel. So to prevent CTS, your best bet is learning to work with your wrist and hand held straight.
If you must perform repetitive movements, like those required by a keyboard, take a break every hour and exercise both your hands and your wrists. In addition, always adjust the height of your chair until you're positioned with your wrists in a straight line.
Conventional treatment usually begins with recommendations for rest, cold compresses, and wrist splints. The splints are usually worn for two to three weeks--especially at night when you may bend your wrist in your sleep. At the workplace, a good wrist splint allows you to continue your usual hand-related tasks. However, you may just have to discontinue certain troublesome actions for a week or two in order to allow time for the swelling to go down.
Unfortunately, the ultimate conventional remedy, surgery, provides relief for troublesome symptoms in less than half of CTS patients. For this reason, MyHealth routinely recommends that surgery should only be pursued if there's clinical evidence of damage to the radial or ulnar nerve with unremitting pain, numbness, and possible actual wasting of the muscles of the affected hand.
And we also feel it's always a wise strategy to try a three- to six-month trial of noninvasive therapies before you think seriously about undergoing surgery. Actually, you might consider one of the manipulative therapies, such as osteopathy or chiropractic, well before considering surgery. You've basically got a mechanical problem, i.e., a compressed nerve due to some local swelling.
Gentle manipulation of the bones and soft tissue of the wrist by a health-care provider trained in the appropriate techniques may actually shift the fluids responsible for the swelling and release the entrapped nerve. Although such treatment may take several visits, you can really tell if you're heading in the right direction because your pain should lessen and your grip strength improve.
There are also a number of specific lifestyle changes you can make, as well as several supplements that can help improve your circulation, reduce the inflammation and generally promote healthy nerve tissue.
Remember, help is near to home. If you are concerned about your health or considering care for carpal tunnel syndrome. At MyHealth here in Mississauga you can count on us. We look forward to evaluate your health and offer you the best treatment or alternatives. We are conveniently located in Streetsville Village in Mississauga. Get started...
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