|
|
Carpal Tunnel Syndrome (CTS)
Carpal tunnel syndrome (CTS) occurs when
the median nerve, which runs from the forearm
into the hand, becomes squeezed at the wrist.
The median nerve controls the muscles in
the hand and also controls the sensation
on the palm side of the thumb, index, middle,
and part of the ring finger. The carpal tunnel
is a small 'tunnel' created by a circular
configuration of the wrist bones and a ligament.
Tendons, nerves, veins, and arteries pass
through this small tunnel but the median
nerve is the most superficial structure in
this tunnel. When the hand is overworked
(such as from long periods of typing, mouse
use, or knitting), the tendons are irritated
and swell. This increases the pressure in
the carpal tunnel and compresses the median
nerve against walls of the tunnel.
The early symptoms of a lightly compressed
median nerve are only sensory - tingling,
pins and needles, numbness, and/or mild decrease
in sensation in the fingers. Late stage median
nerve compression results in exaggerated
sensory symptoms along with decreased strength
and atrophy of median nerve innervated muscles
in the hand.
For many people, the pressure in the carpal
tunnel may be adjusted and symptoms relieved
by the following methods; as with any medical
issue, consult your doctor to determine which
approach is best for you:
- Work Positioning - If the wrist is strained
from poor wrist positioning while typing
or using the mouse, consider using an ergonomic
keyboard and wrist pads to maintain the wrist
in a position; you may also want to try wrist
splints, which position the wrist in proper
alignment.
- Sleeping Position - Many people sleep with
their both wrists curled forward under their
chin. Often people wake up in the middle
of the night from pain or in both hands.
Try simply 'shaking it out.' If more severe,
use a splint to position the wrist so the
carpal tunnel will not be compressed during
sleep.
- Exercise - Some people develop CTS because
of overuse of the wrist and hands. When the
carpal tunnel symptoms have abated, exercise
and stretching can condition your forearm
muscles allowing you to work harder without
as much strain and swelling. A Certified
Hand Therapist (CHT) or Occupational or Physical
Therapist can develop a customized exercise
regiment.
- Drugs - In some cases, your doctor may be
able to prescribe medicines to decrease swelling
from irritated tendons or water retention
in the extremities.
- Surgery - If you experience CTS symptoms
for over six months with severe
sensory symptoms
that will not 'shake off' and/or
demonstrating
decrease hand strength, dexterity
and visible
atrophy of median nerve innervated
muscles
in the hand, consult a Board
Certified Hand
Surgeon or Orthopedic Surgeon
to determine
whether surgery is appropriate.
|
|
|
