The Carpal Tunnel is a passageway inside the wrist, a tunnel surrounded by bones and ligaments. Aiming to protect the median nerve, the nerve that runs down the arm and forearm into the hand, the Carpal Tunnel can sometimes be affected by a syndrome. This syndrome, called Carpal Tunnel Syndrome, occurs when abnormal pressure is placed on the median nerve, causing decreased hand and finger function and leaving those affected sometimes unable to perform even the simplest tasks.
Symptoms of Carpal Tunnel Syndrome
Carpal Tunnel Syndrome can develop for many years with no noticeable symptoms. However, when the first symptoms do appear they include burning or tingling sensations in the fingers, pain and numbness in the hand, an inability to trap onto objects, and a weakness of the hands. Because Carpal Tunnel Syndrome involves the median nerve, it affects the parts of the hand that the median nerve supplies. These include the thumb, the index finger, the middle finger, and half of the ring finger. Since the pinky finger is not controlled by the median nerve, the pinky finger is not usually hindered by Carpal Tunnel Syndrome. Those experiencing symptoms for the first time may notice that their Carpal Tunnel Syndrome flares up at night and that they can sometimes get relief by vigorously shaking their hand.
Known as a “hidden disability,” people with Carpal Tunnel Syndrome may fully function from the view of an outsider, with hands that are capable to engage in most normal activities. But, the person with Carpal Tunnel Syndrome typically has some restriction of hand function or significant pain during hand movement.
What Causes Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is often caused by under conditions that place a strain on the median nerve, compromising the blood supply it delivers to the fingers. These can include existing diseases such as diabetes, which increases the sensitivity of pressure to the median nerve, and hypothyroidism, which can increase the amount of water retained in the arms and wrists.
Many causes of Carpal Tunnel Syndrome are not disease-based, however, causes can be generated from external stimuli, such as wrist injuries, fractures of the arm bone, and dislocation of one of the carpal bones in the wrist. Pregnancy, because it can cause swelling of the wrists, can also place pressure on the median nerve by narrowing the carpal tunnel.
Many instances of Carpal Tunnel Syndrome are thought to be idiopathic, having no obvious cause. However, even with idiopathic events, certain activities can aggravate the symptoms of Carpal Tunnel Syndrome. These can include using power tools or working on an assembly line, constantly performing repetitive – and sometimes awkward – motions. Certain people can even be born with an abnormally narrow carpal tunnel, making them predisposed to the syndrome that may accompany it.
While Carpal Tunnel Syndrome can affect all demographics, it is far more common in women than in men. It is also most common in those who are middle aged and post-menopausal. Obesity and tobacco use increases a person's risk.
Treatment of Carpal Tunnel Syndrome
Many people with a mild case of Carpal Tunnel Syndrome will find relief simply in adjusting their lifestyle and workstyle habits. While foregoing repetitive wrist activity may not be feasible, particularly when a care is based on repetitive motion, allowing the wrist time to rest while at work and at play can greatly alleviate the symptoms of Carpal Tunnel Syndrome. Resting the wrist for great lengths at a time may seem like a reasonable break, but studies have shown that it is more beneficial for those afflicted by Carpal Tunnel Syndrome to take several small breaks, rather than one that is lengthy. Applying cold packs to tie any swilling of the hands and wrists is also a helpful form of treatment.
For those with a case of Carpal Tunnel Syndrome that is not aided by rest or cold compressions, wrist splinting is an alterative form of treatment. A person, wearing a splint that keeps their hand still while they sleep, may notice that the symptoms of burning, tingling, and pain are greatly relieved. Wrist splinting, however, is usually only helpful for those who have had symptoms of Carpal Tunnel Syndrome for less than a year.
While Carpal Tunnel Syndrome certainly does not have a magic pill serving as an antidote in its healing, there are certain medications that can relate its pain and discomfort. These can include Nonsteroidal anti-inflammatory drugs (or NSAIDs) for those whose condition is brought on by inflammation or Corticosteroids to relieve the pressure on the median nerve, reducing the pain in the process.
The literal hands-on approach of spinal manipulation and deep friction massage can help manage the swing that is pressing on the median nerve, causing the symptoms to flare up. Manual stretches of the wrist and tendons, additionally, can help increase the blood flow to the hand.
While the evidence is not definitive, some speculate that dietary changes may lead to diminishing Carpal Tunnel Syndrome symptoms by arming the body with the nutrients it needs to repair nerve damage and decrease inflammation. By taking something as simple as a multi-vitamin, pressure from the median nerve may be diminished, allowing it to repair itself back to its natural state.
While the above mentioned treatment options are usually limited to being beneficial to those who have mild to moderate cases of Carpal Tunnel Syndrome, for those who have severe cases, surgery may be the best option.
Although there are several approved surgeries for Carpal Tunnel Syndrome, they all involve the same theme of the cutting of the ligament that is pressing on the median nerve. They are also all procedures done on an out patient basis, with a small incision cut in the wrist or the palm and a recovery time of just a few weeks. While not all surgeries are successful in relieving the symptoms, roughly 70 percent of patients who choose surgery report satisfaction with the outcome.
Carpal Tunnel Syndrome can happen for reasons that are understood and for reasons that are unknown. However, practicing self-care can prevent some of the symptoms that arise no matter the underlying cause. From keeping hands warm to improving posture, and from relaxing the grip while performing tasks with the hands to taking frequent breaks, the best chance at preventing Carpal Tunnel Syndrome typically lies with some conscientious effort.
About us: The Center for Osteopathic Medicine in Boulder, Colorado believes in The Osteopathic Difference . In a medical industry focused on treating symptoms, the Center is more focused on finding the cause of these symptoms. The Osteopathic Difference is the application of “Hands on Therapeutics” for both the diagnosis and treatment of complaints, disorders, and pain. The Osteopathic Difference will apply the time proven osteopathic fact that function is directly related to structure, and poor structure will lead to poor function.
While The Center tries to focus on health, and above all else, prevention for all those who cross into its threshold, sometimes the best that can be done is to recognize the source of the “DIS-EASE,” and to teach every individual how to manage their symptoms. Believing that it is the most important aspect of any treatment regime, and that it is the primary job of the health care practitioner, The Center works to empower the patient in the maintenance of their own health.
Achieving health is also an elusive place, and The Center will work tirelessly to create a path to health which, when embroidered by the patient over time, will allow the patient to enjoy a positive return on their rehabilitation investment. The Center teaches a Mindfulness Yoga Program that aims to educate the patient in the power of the mind to minimize, if not rid the body of, aches and pain. Although the ultimate goal of health is to live without the use of drugs, natural or otherwise, The Center for Osteopathic Medicine recognizes the importance of physicians and their appropriate use. All styles of “Hands on Manipulation” are practiced at The Center. By combining these Manipulative Techniques with Structural Integration, massage, meditation and Western Medicine, the Center for Osteopathic Medicine helps people to identify disease before it manifests, quiet pains that have been previously diagnosed as Chronic, and embrace a holistic mindset to Live in the Present – and within that presence, live completely well.
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