Neurology Diagnostics

Archive for the ‘Carpal Tunnel Syndrome’ Category

You are working at your desk, trying to ignore the cramps or numbness has been felt for months in the hand and wrist. Suddenly, he begins to feel a sharp stabbing pain in the wrist that runs through the arm. Is it a passing cramp? Chances are that you suffer from carpal tunnel syndrome, a painful progressive condition caused by compression of a major nerve in the wrist.

What is carpal tunnel syndrome?
Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, pressed or trapped at the wrist. The median nerve controls sensations to the back of the fingers (except the little finger) and the impulses of some small muscles in the hand that allow them to move the fingers and thumb. The carpal tunnel-a narrow, rigid passageway of ligament and bones at the base of the hand contains the nerve and tendons medium.

Sometimes, thickening from irritated tendons or other swelling narrows the tunnel and cause them to compress the median nerve. The result can be pain, weakness or numbness of the hand and wrist, radiating across the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common compression neuropathies and widely known of which are compressed or traumatized body’s peripheral nerves.

What are the symptoms of carpal tunnel syndrome?
Symptoms usually begin gradually and are manifested by feelings of warmth, cramping, or numbness in the palm and fingers, especially the thumb and index and middle fingers. Some patients with carpal tunnel syndrome say their fingers feel swollen and useless, although no apparent swelling. Symptoms often first appear in one or both hands during the night, since many people sleep with bent wrists.

A person with carpal tunnel syndrome may wake up feeling the need to “shake” the hand or wrist. As symptoms worsen, patients begin to feel the cramp during the day. The decrease in the pulse of the hand can hamper a fist, grasp small objects or perform other manual tasks. In chronic cases and / or untreated, the muscles at the base of the thumb can weaken or atrophy. Some people can not distinguish between heat and cold by touch.

Carpal tunnel decompression is one of the most common surgical procedures in the United States. This surgery is generally recommended if symptoms last for at least 6 months and involves separating a portion of tissue around the wrist to reduce pressure on the median nerve. The surgery is performed under local anesthesia and requires hospitalization. Many patients require surgery on both hands. Here are the different types of surgery carpal tunnel decompression.

Open decompression surgery is the traditional procedure used to correct carpal tunnel syndrome consists of making an incision up to 2 inches in the wrist and then cutting the carpal ligament to enlarge the carpal tunnel (a set of bones wrist). The procedure is usually done with local anesthesia and is ambulatory, unless there are unusual medical considerations.

Endoscopic surgery can result in a faster functional recovery and causes less postoperative discomfort than traditional open decompression surgery. The surgeon makes two incisions (about ½ inch each) in the wrist and palm, inserts a camera attached to a catheter, observes the tissue on a screen and cuts the carpal ligament (the tissue that holds joints). This two-portal endoscopic surgery (incisions) usually performed using local anesthesia, is effective and minimizes the marks and scars softening, if any. Also available is a portal endoscopic surgery for carpal tunnel syndrome.

Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take months. Some patients may have infection, nerve damage, stiffness and pain in the incision. Occasionally the wrist could lose strength as a result of having cut the carpal ligament. Patients should perform physical therapy after surgery to restore wrist strength. Some patients may need to change your work activities or to change jobs after recovery from surgery.

Recurrence of carpal tunnel syndrome after treatment is unusual. Most patients recover completely.

Some patients may need to change your work activities or to change jobs after recovery from surgery.

While deciding whether to get surgery or not, it should be mentioned that being free of Carpal Tunnel can give you more affordable health insurance and recurrence of carpal tunnel syndrome after treatment is unusual. Most patients recover completely.

Drugs – In special circumstances, various medications can relieve pain and swelling associated with carpal tunnel syndrome. Nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen and other nonprescription pain relievers can help relieve the symptoms have been present for a short time or following a forced activity. The orally administered diuretics (“water pills”) can decrease swelling. Corticosteroids such as prednisone or lidocaine, injected directly into the wrist or taken by mouth, can relieve pressure on the median nerve and provide immediate temporary relief to people with mild or intermittent symptoms.

(Caution: People with diabetes or a predisposition to diabetes should be aware that prolonged use of corticosteroids can make it difficult to regulate insulin levels. The corticosterioides not be taken without being prescribed by a doctor.) In addition, some studies show that supplements of vitamin B6 (pyridoxine) may relieve symptoms of carpal tunnel syndrome.

Exercise – The stretching and strengthening exercises can be beneficial for people whose symptoms have subsided. These exercises may be supervised by a properly trained physiotherapist to treat physical impairments through exercise, or by a properly trained occupational therapist to evaluate patients with physical impairments and helping them acquire skills to improve their health and wellbeing.

Alternative therapies – acupuncture treatments and / or chiropractors have benefited some patients but their true efficacy has not been proven. Yoga is the exception, since it has been shown to reduce pain and improve the pulse in the hand in patients with carpal tunnel syndrome.

How is carpal tunnel syndrome?

Treatments for carpal tunnel syndrome should begin as soon as possible, following medical instructions. The less obvious causes, such as diabetes or arthritis should be treated first.

Initial treatment generally involves resting maintain hand and wrist affected at least 2 weeks, avoiding activities that worsen symptoms, and immobilizing the wrist in a cast or splint to prevent further damage from twisting or bending it. If there is inflammation, applying cool compresses may help reduce swelling.

How can you prevent carpal tunnel syndrome?

In the workplace, workers can perform work conditioning, stretching exercises, take frequent breaks, wear splints to keep wrists straight and maintain correct posture and wrist position. Use fingerless gloves to help keep hands warm and flexible. You can redesign workstations, tools, handles of tools and tasks to enable the worker’s wrist to maintain a natural position during work.

Also, the work can be rotated among workers. Employers can design specialized programs in ergonomics, ie the process of adapting workplace conditions and job demands to the capabilities of workers. However, research has not conclusively proven that these changes in the working environment prevents the occurrence of carpal tunnel syndrome.

Women are three times more likely than men to suffer from carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and suffer the pain more intense. People with diabetes or other metabolic disorders that directly affect the body’s nerves and make them more susceptible or prone to compression are also at high risk. Generally, carpal tunnel syndrome occurs only in adults.

The risk of carpal tunnel syndrome is not limited to people working in one industry or trade, but is particularly common in people who perform work in assembly plants, manufacturing, sewing, industrial finishing, cleaning and meat packing , poultry or fish. In fact, carpal tunnel syndrome is three times more common in people assemblers who perform computer data entry. A study by the Mayo Clinic in 2001 revealed that continuous use of a computer (up to 7 hours a day) does not increase the risk that a person will develop carpal tunnel syndrome.

In 1998 it was estimated that three out of 10 thousand workers had to be absent from work due to carpal tunnel syndrome. Half of these workers lost more than 10 working days. The average cost of carpal tunnel syndrome, including medical bills and lost time from work, is estimated at around $ 30,000 per worker.

What are the causes of carpal tunnel syndrome?

Often, carpal tunnel syndrome is the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a nerve problem itself. The disorder is most probably due to a congenital predisposition – the carpal tunnel is simply smaller in some people than others.

Other factors contributing to the diagnosis include trauma or injury to the wrist that cause swelling, such as a sprain or a fracture, an overactive pituitary gland, hypothyroidism (low thyroid function), rheumatoid arthritis, mechanical problems in the joint of the wrist, work stress, repeated use of vibrating hand tools, fluid retention during pregnancy or menopause, or the development of a cyst or a tumor in the carpal tunnel. In some cases it is impossible to determine the causes.

There are few clinical data to prove whether repetitive and forced to perform movements with the hand and wrist in work or leisure activities can cause carpal tunnel syndrome. Repetitive movements are performed in the normal course of work or other daily activities can lead to repetitive motion disorders such as bursitis (inflammation of a bursa, a small bag that facilitates the movement of muscles and tendons on the bone) and tendonitis (inflammation of the tendons). The writer’s cramp – a condition caused by a lack motor coordination, pain and pressure in the fingers, wrist or forearm due to repetitive activity – is not a symptom of carpal tunnel syndrome.