Letting Go of Carpal
It starts with mild tingling in your hand. Then numbness
from time to time. It progresses and begins to interfere with your work. You
have to pause and literally "shake it off. It gets worse, and you wake up in night
after night with pain shooting up your wrist.
These are the classic symptoms of
carpal tunnel syndrome, one of the most common causes of wrist and hand pain. Although most people think of the hands when
they think of carpal tunnel pain, Dr. Andrew Foret, hand and wrist specialist
with Center for Orthopaedics, says the condition can affect the wrist too, and
actually starts there, when the median nerve, which is on the palm side of the
hand, becomes compressed by other structures in the wrist.
He says the risk of developing carpal tunnel syndrome is not
confined to people in a single industry or job, but it is a classic overuse
injury, occurring most often in those performing repetitive-type tasks in the
manufacturing, construction, clerical, sewing, finishing and cleaning
industries. "Basically, anyone who often has their wrist situated
at an awkward and repetitive angle for extended periods of time is vulnerable
to the condition.
Carpal tunnel syndrome usually occurs only in adults, and women
are three times more likely than men to develop carpal tunnel syndrome. Dr. Foret says this may be because the carpal
tunnel itself is typically smaller in women than in men. The dominant hand is
usually affected first and produces the most severe pain. Persons with diabetes
or other metabolic disorders that directly affect the body's nerves and make
them more susceptible to compression are also at high risk. Carpal
tunnel syndrome may also be genetic, according to recent research.
untreated, Dr. Foret says pain from the condition becomes more severe,
spreading up the arm and making it difficult to complete manual tasks, like
typing or holding a hammer.
Dr. Foret says this
is why it is very important to pay attention to early warning signs the
tingling, numbness and mild pain or cramping and seek an evaluation. "If we can diagnose early, there are more
options for non-surgical treatment, and we can hopefully avoid permanent damage
of the median nerve, which can lead to loss of grip strength.
A diagnosis of
carpal tunnel syndrome involves a physical examination of the hands, wrists,
arms and shoulders, along with electrodiagnostic tests to measure the
electrical activity of nerves and muscles.
Once a diagnosis is confirmed, Dr.
Foret says non-surgical treatment options are always considered first. These
include medication, injections, bracing and exercises to strengthen the muscles
in the hand and wrist, just to name a few.
For some people, these measures
can prevent, or at least delay, the need for surgery. If surgery is needed, Dr.
Foret says an endoscopic carpal tunnel release procedure is performed in most
cases. "Endoscopic procedures have become commonplace thanks to todays
technological advances. Using this technique for a procedure like carpal tunnel
release means a shorter recovery time and an almost immediate reduction in the