Browsing: Hand Wrist Pain

Joints of the Thumb – Learn the Correct Names of All Three of Them

In this series of articles, I'll go through some of these terms along with some helpful diagrams and shed some light on the common language of hand and arm surgery.

The three joints are as follows:

* Carpometacarpal (CMC)
* Metacarpophalangeal (MP)
* Interphalangeal (IP)

CMC

The CMC joint of the thumb is located at the junction point of the thumb and the wrist. Break down the words in the name, carpometacarpal, and you get carpo- (wrist) and metacarpal (hand bone). This joint is commonly affected by arthritis.

The CMC joint's main function is to allow the thumb to open and grasp wide objects, like a basketball or (for us mortals) a large glass of your favorite beverage.

MP

The MP joint of the thumb is the middle joint of the thumb, located between the CMC joint and the tip of the thumb. Break down the words in the name, metacarpophalangeal, and you get metacarpo- (hand bone) and phalangeal (finger bone). This joint moves a lot in some people and just a little in other people. Compare MP thumb joints around your family and you may find some big differences.

Sometimes this joint is injured when you jam it in a skiing or sports injury. This causes the joint to pop out of place and tear a ligament. This is sometimes called skiier's thumb. The ligament can heal without surgery if it's not moved out of place.

IP

The IP joint of the thumb is at the tip of the thumb. The word interphalangeal means “between the phalanges”. Important tendons attach on the bottom and top of this joint and move the tip of your thumb back and forth.

If you jam your thumb and the tip of the thumb does not move normally, this could be a sign of a ruptured or torn tendon. Tendons move joints – when a tendon is ripped off the bone, the joint no longer moves normally.

Familiarity with the language of the joints of the thumb will help streamline your visit with a hand specialist or other health care provider.

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Who Gets Carpal Tunnel Syndrome?

The US Bureau of Labor Statistics reports about 28,000 CTS cases a year. Because so many sufferers opt for surgery, it has become the leading cause of lost workdays in the United States.

Women are more likely to suffer from CTS than men. Of the 31,457 cases reported during a recent year, 71 percent were women. They spend an average of 30 days off of work.

Industries most commonly affected production workers in food processing and clothing manufacturing, typists who work at keyboards for hours on end, and construction workers who use tools which vibrate, such as jackhammers.

The Journal of the American Medical Association recently estimated that almost 3 percent of adults in the United States may suffer from Carpal Tunnel Syndrome at some point in their lives. The article quoted a workers' compensation specialist and disability management expert who agreed, saying CTS is at epidemic levels in the US He told the Journal that more than half of the cases are not work related. His claim was backed by a number of studies, including a report by a workers 'compensation management and cost containment firm which found that 15 percent of companies' new employees had already suffered from median nerve compression before they came onto the job.

According to the Journal, researchers found that a number of factors give employees a predisposition to CTS, including gender, vitamin deficiencies, obesity and personality.

Gender

The Journal cited a study unveiled at an Australian College of Surgeons conference which found that about 70 percent of CTS sufferers are women. Furthermore, CTS was more common among women who were diabetic, obese, menopausal-age and who smoked.

The Journal went on to say that middle-aged women have a much higher susceptibility for CTS than men mostly because of the hormonal changes that take place during menopause. Expectant mothers are also at risk because of the fluid build-up and vitamin B1 deficiency that occurs during pregnancy.

Weight

The Journal went on to cite findings published in the Journal of Occupational and Environmental Medicine which found that 10 month of following an aerobic exercise program had a very positive effect at improving nerve function and reducing Carpal Tunnel Syndrome symptoms.

Weight reduction directed in better circulation and improved oxygen consumption – reducing the chances of developing Carpal Tunnel Syndrome.

Vitamin deficiency

The Journal also cited another study in the Journal of Occupational and Environmental Medicine which found that a deficiency of the mineral supplement pyridoxal 5 phosphate and vitamin C could be a factor.

What is pyridoxal 5 phosphate? It's a form of vitamin B6, consisting of three natural organic compounds, pyridoxal, pyridoxamine and pyridoxine. Is it important?

Medical science dislikes having to admit that it does not understand a great deal about how the human body works – but the reality is that doctors really do not know what role some compounds play. For example, it is known that aspirin works, but doctors will give you a variety of theories why.

So it is with vitamins. They are important. They work.

Personality

Can personality play a role? What is “personality” anyway? It has been defined as those character, behavioral, temperamental, emotional and mental attitudes that make each person unique – those distinct qualities of a person, especially those distinguishing personal characteristics that make us unique.

Author and psychiatrist Dr. Martin Rush, who wrote the bestselling Decoding the Secret Language of Your Body, describes treating Carpal Tunnel Syndrome patients who, he observes, invariably have a history of being unable to accomplish what they seek in their lives. It can range from a happy marriage to success on the job – or the ability to buy their own home or drive the kind of car they desire.

Incredibly, he relates, after psychiatric therapy, their CTS symptoms would clear up.

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The Hidden Cause of Your Carpal Tunnel That May Save You From Painful Surgery Or Expensive Drugs

Carpal Tunnel Syndrome is a repetitive strain injury that gained prominence in the 80's and 90s. In fact, it was called the “occupational disease of the 90's” because of how prevalent it was. It continues to cause extreme dysfunction to many.

However, common office work, such as long computer hours, and long periods of writing, are not the only cause. Repetitive motives with the hands: Text messaging, video gaming, homemakers, meat cutters, assembly line workers, carpenters, and even musicians– also suffer from Carpal Tunnel Syndrome.

As a Boca Raton Chiropractor, I have seen many debilitating cases of carpal tunnel syndrome, but treatments can be costly, provide only temporary relief, and lack a long-term prevention plan of care.

For treatment of Carpal Tunnel Syndrome (CTS), many doctors suggest to immobilize the wrist, ice and use drugs (diuretics or anti-inflammatories). If the symptoms persist, corticosteroids may be injected into the hand or wrist. This may provide temporary relief of the symptoms (pain, numbness), but will not prevent a relapse. There may also be side effects.

Carpal Tunnel Surgery may be needed. However, only a comprehensive, therapeutic approach should be used before surgery. Recovery from Carpal Tunnel surgery can take 6 months or longer !.

The limits of standard medical care led the late Robert Mendelsohn MD to state: “Since the medical treatment for this condition is so often unsatisfactory, I have for years been recommending that my patients consult experts in muscle and joint therapy.”

I'm writing this article, because as a Boca Raton Chiropractor , I feel it is my professional duty to get the word out … there are hidden causes of CTS that few people know. This one cause (and treatment) has proved in the past to help people solve their Carpal Tunnel Syndrome issues …

What is the Hidden Cause of Your Carpal Tunnel Syndrome?

In my 22 years in clinical practice as a Boca Raton Chiropractor, I have seen repeatedly different nerve pressure syndromes, directly related to the spine, have been the cause of what appears to be a Carpal Tunnel problem.

That is why I recommend that anyone suffering from CTS should see a Chiropractor to ensure that your spinal column is free from nerve pressure between your arms and wrists and the nerves to your neck.

If you suffer from CTS, you are not only using your wrists in your tasks-the neck is also involved. Altered spinal movements may be creating strain on your neck to cause or aggravate the condition.

In one classic study by Upton and McComas, they found 67% to 75% of patients who had carpal tunnel or ulnar neuropathy also had spinal nerve root irritation. One study revealed that nerve compression in the neck can block the flow of nutrients to the nerves in the wrist, making it more susceptible to injury.

In light of what is known about CTS, anyone suffering from the symptoms of this disorder should be evaluated. As a Boca Raton Chiropractor, I have seen that a spinal adjustment, as well as highly skilled joint mobilization for the wrist and elbow, may make the absolute difference. Do not just jump into injections and pain medications. Seek out a safe, healthy alternative.

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Carpal Tunnel Syndrome and Its Various Stages

Have you been experiencing a sharp pain on your wrist every time you move? If it is also accommodated by numbness, then you may be suffering from carpal tunnel syndrome. Carpal tunnel syndrome or CTS is a medical condition where the median nerve present at the wrist is compressed and finally leads to paresthesias, numbness and muscle weakness in the area. It causes the patient much trauma and even leads them to wake up in the middle of the night. Carpal tunnel treatment is available and if you are experiencing anything of this sort, you must take attention immediately.

First stage of carpal tunnel syndrome

When you first go to your physician, he will diagnose your condition to understand how serious it is. For patients whose condition is at the primary level, doctors suggest using wrist friendly office supplies. These include gelatin mouse-pads, specialized keyboards, amongst other things. You will also be advised to take frequent breaks from your work, to rest your wrist. The other thing to do is gentle flexing exercises to ease out the stress. It has been proved that such regular exercises can prove to be of great help in this syndrome.

Second stage of carpal tunnel syndrome

If your condition is more serious than that, then you might have to consider using wrist braces. Your doctor will help you to choose the right size of braces. You may want to shop for the braces online, but it is advised that your doctor helps you in choosing the right size and the right fit. Most commonly these braces are used by people when they are either sleeping or are at work. They help in providing relief to the patient and is filed for those patients who are suffering from a temporary condition.

Carpal tunnel release surgery

This is the final and the extreme stage of the carpal tunnel syndrome. If your condition has become very serious, then you will have to meet Las Vegas plastic surgeons to take care of your problems. However you must remember that meeting a doctor for a surgery is the last option that you must consider. This is an extreme step which is considered when all other options have failed. The surgery process can be quite painful for the patient, and is generally followed by a dose of powerful painkillers.

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The Symptoms of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome's symptoms can range from mild tingling in your palm and fingers to complete numbness and grow to excruciating wrist, arm and hand pain.

Watch for burning, tingling, itching and numbness at night, particularly of your thumb and your index finger. Some sufferers report a sensation in the fingers that make their hand feel swollen and useless – even though no swaining is visible.

Other sufferers report a need to wake during the night with an urgency to “shake out” their hands or wrist.

As the condition worsens, sufferers say the tingling continues not only a night, but also during the day. Their fingers lose the ability to discern between hot and cold. They lose the strength to grip their fist or pick up small objects.

If left untreated, the condition can worsen so that wrist muscles begin to atrophy – wasting away.

The sufferer has the sensation of pins and needles in the ring and little fingers, often in the early morning. As the problem worsens, it may develop into a burning pain in the hand and wrist, followed by numbness in the affected fingers.

The patient may become weak and clumsy when trying to pinch the thumb and forefinger or spread all five fingers.

Then there are rheumatoid arthritis, lupus and fiber myalgia. None of them should be ignored. Untreated lupus can lead to kidney failure. Untreated rheumatoid arthritis will worsen with serious damage to joints and bones.

Rheumatoid arthritis' symptoms include tendness and swelling around the joints – as well as increasing pain, fever, redness, fatigue and weight loss.

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Treatments and Reasons For Tendonitis of the Wrist

Wrist Tendonitis, also known as Tenosynovitis, is a difficult problem experienced in the wrist. Tendons are fibrous tissues that join the muscles to the bone, and they carry out a critical role of keeping the wrists supple and strong.

Many tendons surround your wrists and pass through a tendon sheath known as tenosynovium. Wrist Tendonitis usually takes place when the tenosynovium is not able to facilitate the clear passage of the tendons. The Tendons are then unable to move in a seamless way, and this can cause immunity pain around the wrist joints.

Causes of Wrist Tendonitis

Wrist Tendonitis can be generally associated with injury, strain, and the aging process. There may be other medical issues that cause Wrist Tendonitis, but statistics indicate that injury, strain, and age account for the largest occurrences of Wrist Tendonitis.

Overuse of the Wrists: The Wrist Tendons usually get strained when they are overused. Certain groups of people specifically tend to overuse their wrists. For example, people who work on the computer for long hours tend to relentlessly use their wrists and fingers. Tennis players tend to overload their wrists while playing shots. Wrist Tendonitis may also be common in people who play musical instruments such as the piano.

Sprains on Tendons: The Wrist Tendons tend to get injured when athletes and body builders go about their exercise routine using wrong techniques. For example, a body builder may lift weights the wrong way or without properly warming up his / her body and wrists. This places the tendons under immense strain and is likely to cause injury.

Injuries: One can also pick up Tendonitis as a result of injuries to adjacant parts of the tendons. For example, Wrist Tendonitis may also develop because of injuries to elbow tendons. Associated injuries like these usually arrise because the injury in the adjacent body part has not been healed entirely.

Age: Older people are believed to be more vulnerable to Wrist Tendonitis. This is because their tendons tend to lose the natural flexibility and elasticity with age and become more tough. The tendons are no longer able to move smoothly through the tenosynovium and consequentially, the wrist experiences inflammation.

Treatments for Wrist Tendonitis

There are two main treatment solutions for Wrist Tendonitis: medical involvement and natural cure. Medical intervention may require all or any combination of anti-inflammatory drugs, Cortisone injections, and surgery. Each of these options has the potential to cure or at least alleviate Wrist Tendonitis to various degrees.

However, allopathic medicines are usually accompanied by side effects and may cause other problems. Here, one needs to take medicines under strict medical supervision and according to one's medical situation.

Natural methods, however, are devoid of side effects and can be equally effective in improving Wrist Tendonitis. The other unique selling properties of natural cures are that they are cheap, appropriate to all age groups, and can tackle the problem from it's roots.

Let 'take a look atseveral natural remedies for Wrist Tendonitis:

Follow sound ergonomic principles: Talk to acknowledgable physiotherapist orhealth specialist, and determine the exact actions or wrist postures that are responsible for the irritation. Once this is resolved, stop repeating the postures immediately.
If you work on the computer throughout the day, observe your work space to see whether it follows standard ergonomic principles. If it does not ,ructure the office to comply with sound ergonomic principles. Always make sure that your desk area allows you to keep a natural wrist posture while working.

Immobilization: If the infection is due to overuse of the wrist, make sure that it gets enough rest. Place your wrist in a splint or cast to rest your tendons. The inflammation will decrease with sufficient rest.

Keep your wrist healthy: You can keep your wrists healthy and supple by buildingyour muscles to respond, and work, therefore reducing the solo workload of tendons. If you combine the use of muscles and the tendons, the latter will not wear out as quickly.

Also, take routine breaks from work, as this will decrease the stress applied on your tendons. Try alternating between both arms while doing work. For example, if an individual isright handed and use a computer mouse, try using the mouse withyour left hand instead. The strategy is to lessen the burden on one set of muscle and tendon groups.

Apply ice: Applying an ice pack on the swollen area will help cool the inflammation and stimulate the bloo flow.

Natural remedies can thus prevent, as well as alleviate Wrist Tendonitis. As is evident, natural remedies highlight notifications in lifestyle and the way we go about our daily functions.

Consequently, the tendons are more equipped to undertake the strains and stresses of everyday life, provided you give them adequate rest. However, depending on the severity and seriousness of a person's infection, medical intervention may be appropriate in some cases.

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Why Are So Many Carpal Tunnel Syndrome Cases Diagnosed?

Experts say that the majority of Carpal Tunnel Syndrome diagnoses are incorrect.

How can this be?

Some doctors defer to patients' insistence and self-diagnosis – particularly at high-volume clinics where doctors have severe workloads and will see so many cases a day that it is difficult to devote the personal attention that a patient in a low-volume situation might enjoy.

Indeed, what about the wealthy patient, such as Prince Philip, who has his or her own personal physician, versus the migrant worker who is treated at a free clinic run by a charity – and who volunteer doctors deal with 100 cases a day?

In countries where everyone receives free health care, the assumption is that everyone is treated equally. However, equality can not be legislated. Some patients even at the busiest clinics will enjoy the attention of a dedicated doctor who will spend great amounts of time trying to sleuth the causes and solutions of a patient's problem.

Other patients – even those paying for extra attention at a fashionable clinic – will find themselves treated by a callous caregiver who can not wait to get out of the office and onto the golf course … and will do the absolute minimum required to get by.

Friendships – patient-doctor personal relationships – can be a factor as well. A doctor treating a patient who has become a dear friend over 30 years may spend a little more time searching out medical journals, researching latest findings and experimenting with such homeopathic remedies as aroma-therapy, aqua-aerobics or cleansing diets to see if they have any effect on this particular patient.

On the other hand, doctors who are wary of dealing with a litigant patient who is eager for an excuse to file a new malpractice suit are honest to treat that person by-the-book with no deviations from recognized procedures. No doctor in his or her right mind mind will experiment with yoga, for example, or herbs with such a patient.

Some doctors find them losing patience with clients who are enamored with having a fashionable ailment that they heard about on talk radio or that they read about on an Internet blog. During the 1960s, doctors reported a high incidence of whatever new and interesting disease was being eliminated with that week by TV's primetime Dr. Kildare, played by the handsome actor Richard Chamberlain.

But what about those patients who wrists indeed do hurt and which living beings are being jeopardized because they are in such an intense pain that they can not work?

They want an answer. They want treatment. They rightly resent being suspected of faking their condition in hopes of a legal settlement.

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What Are The Real Causes Of Carpal Tunnel Syndrome?

Other than repetitive motion, a few other causes of CTS that doctors have reported include diabetes, arthritis, pregnancy, thyroid gland imbalance and the hormonal changes associated with menopause and pregnancy.

However, many cases have no obvious cause. Doctors say that Carpal Tunnel (CTS) can result from a combination of factors, such as a pre-disposition from birth; some people just are born with smaller Carpal Tunnels than others.

Other contributing factors may include a sprained or fractured wrist that never heals correctly, a small cyst or tumor – benign or otherwise – inside the canal, fluid retention during pregnancy or menopause, hypothyroidism, an overactive pituitary gland, rheumatoid arthritis, and stressful activity at work – such as making L-cuts on the chicken deboning assembly line.

But in many cases, no cause can be identified. Doctors just find themselves scratching their heads. In fact, there is a scarcity of clinical data providing yet repetitive and forceful movements of the hand actually cause Carpal Tunnel Syndrome.

Repeated motions performed in the course of a normal day can result in quite a few other repetitive motion disorders such as tendonitis and bursitis, which are mistaken for Carpal Tunnel (CTS). Some people mistake writer's cramp – in which they experience aches, pressure in the fingers, loss of fine motor skill coordination and other pain or discomfort in wrist or forearm – for Carpal Tunnel (CTS).

Some doctors say CTS is associated with obesity. However other doctors dispute that conclusion, instead saying that CTS is caused by pre-existing conditions as well as by the work environment. There are recreational activities that can cause Carpal Tunnel Syndrome as well. In fact, it is a problem in some competitive sports, including bowlers, kayakers and canoeists. Among the worst affected are bicyclists.

However, many of them do not have Carpal Tunnel (CTS), but something different altogether. Those sufferers can develop CTS. However, traditional Carpal Tunnel Syndrome-focused medical treatment does not always solve the problem since CTS may be only one part of a complex problem.

After all, suppose that various nerves are being affected at different points extending along the neck to the fingers. How can it be effective only to treat the wrist? Indeed, relieving stress there can well exacerbate the problems elsewhere in other parts of the body.

Without a doubt, it hurts.

It's also difficult to diagnose. Carpal Tunnel (CTS) causes more missed days at work than any other condition. It's dreaded by employers – an incredibly expensive, hard-to-disprove condition that is a persistent problem in the workplace.

But what causes it? How should the sufferer treat it? How do you know if you have it? What can be done to prevent it.

Not all doctors are in agreement.

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Does Repetitive Motion Actually Cause Carpal Tunnel Syndrome?

Swelling and irritation of the membranes inside the Carpal Tunnel cause the Syndrome. But what keeps such swelling and inflammation? The most commonly held belief is that CTS is caused by repetitive and forceful gratifying of the hand.

Consider the poultry industry worker on a production line who job consists of making an “L” -shaped cut in chickens as they whiz past on a mechanized chain. The worker's job is to make the same cut over and over, at least five times a minute as part of the de-boning process.

The result is delicious chicken nuggets and filets. Human workers are far more efficient than machines – and do a better job of taking all the meat off of the bone. However, many such workers complain of soreness in the wrist after only a few hours on the job.

Usually they adapt – as their muscles strengthen, much like an athlete's. However, sometimes the body just can not. Symptoms of CTS begin to develop.

Another cause of CTS is tiny broken bones. Occasional a sufferer has tiny bone chips and unnoticed fragments of the small bones in the wrist.

It is not uncommon for such a break or chip to be ignored, particularly by budget-conscious sufferers who prefer not to rush to the doctor every time they have an ache or a pain. However, ignoring such a condition can produce the swing that brings on Carpal Tunnel Syndrome.

Is CTS even caused by repetitive motion?

Experts can not agree.

The debate continues if Carpal Tunnel Syndrome and repetitive tasks are actually related.

The Occupational Safety and Health Administration (OSHA) has issued a set of rules and regulations relating to repetitive motion disorders. However, the American Society for Surgery of the Hand (ASSH) says those rules are based on political pressure, not science. The ASSH says medical science does not currently show a direct relationship between such work activities and the development of CTS.

A review by the National Institute for Occupational Safety and Health (NIOSH) found that jobs requiring specific wrist postures or repetitive manual acts can be scientifically associated with CTS, but that it is yet to be established that such work actually causes the condition.

Increasingly, however, that's not happening. Employers are being pro-active, changing the workplace so that employees rotate between jobs – never staying in a position that requires the same repetitive motion day after day for months at a time. By paying attention to the work conditions, employers eliminate any complaints of negligence.

They also are seeing more productivity – as tasks become less boring, less repetitive and less likely to provoke a worker to try to find creative ways to go on the disabled list.

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Is There Relief For Carpal Tunnel Syndrome?

EASY SYSTEM TO ELIMINATE CARPAL TUNNEL SYNDROME
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Imagine waking up one day experiencing numbness and a tingling sensation in your hands. How would you like to start living a pain-free life? How does a peaceful night sleep sound like to you? Would you like to be able to do anything without worrying that your hands hurting? Do you wish that the wrist pains would go away so you can play your favorite games again? These are the symptoms of the Carpal Tunnel Syndrome. You often drop things shattering those fragile items at home. You need to finish a written project your boss has given you.

WHAT IS CARPAL TUNNEL?
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Any condition that causes inflation or an alteration in the position of the tissue within the carpal tunnel can squeeze and irritate the median nerve. This is an inflammatory disease which makes the median nerve from the hand to the forearm ensnared. Your fingers are stiff, there is difficulty in grasping some objects and performing manual activity as buttoning a blouse or knotting a tie. The symptoms start gradually.

SYMPTOMS
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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. In this cyber era, many keyboard workers are likely candidates for this disease.

TREATMENTS
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Medication must be taken with a full stomach to avoid abdominal symptom. Everyone's first impulse is, sometimes, to see a doctor. Remember it is always best for you to spend lots of time playing out doors and having fun with friends and your family. Soon you will be able to feel your hands and wrist as you pass the day away. The wrists pain can get more and more painful of carpal tunnel each attack that it wakes you up in the middle of the night. This is a condition where the carpal canal is squeezed together within the tunnel and cause too painful feeling and usually with numbness of the wrists through the hands. You should immediately take the time to find ways to be free carpal tunnel. Those boring times of massages, applying ointments and applying non-stop rubbing of your nerves can be very tedious and time consuming. Be aware of the reasons why you acquired the carpal tunnel syndrome and then you can avoid those strenuous activities in the future. No more staying home at all times because you can not enjoy the outdoor life with your family and friends. Initial carpal tunnel treatment generally involves resting the affected hand and wrist for at least few weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending.

COMMON QUESTIONS:
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> You have hand and wrist pain and want to learn simple stretches and exercises to immediately relieve the tension, burning and tingling.
> You want to learn the best treatment using easy-to-follow, simple and step-by-step techniques from the comfort of home.

SYSTEM BENEFITS:
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For instance, try no to wet or wash those tired hands after typing for a long time. Less pains, means more play. Other tips include hand and wrist exercises that are also advisable when you are feeling such early pains. By wearing wrist splint, you are able to keep wrist in a neutral position and decrease stress on your fingers, hands and wrist. While performing repeated motors, switch hands and vary positions. Professional therapy is optional at the early carpal tunnel symptom stage. By wetting your hands while tired, it will cause severe pains in the future. Follow the step by step procedures as instructed and you will have a brand new feeling of freedom in movement in your hands in just one week. Your hands may feel numb and painful at the same time if you are suffering from carpal tunnel.
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Understanding Your Trigger Finger

A trigger finger or thumb is a common painful condition which causes the fingers or thumb to lock in a bent position.

Tendons that help bend the fingers slide through a protective covering known as the tendon sheath. The main problem in a trigger finger, stems from either the opening of the sheath becoming smaller, or the tendon itself becoming thickened, so that it can no longer slip smoothly through the tendon sheath.

When trying to straighten the affected finger, the inflammed portion of the tendon momentarily gets stuck at the mouth of the tendon sheath, then pops as the tendon eventually makes its way through this tight area. This is what causes the “triggering”.

In several cases, the “stuck” finger can only be straightened with the help from the other hand.

Who Gets Trigger Finger?

Trigger fingers tend to be more common in women than men, typically affecting those between 40 to 60 years of age. They are also more commonly associated with certain medical conditions:

Rheumatoid arthritis
• Diabetes mellitus
• Gout

How is it Treated?

Mild cases may improve with just rest and anti-inflammatory medication. Sometimes, splints may be used to enforce rest of the affected finger.

Hydrocortisone and lignocaine (H & L) injections are frequently given to treat trigger fingers, however, they tend not to be very useful if the trigger finger has been present for a long time, or when it is associated with other medical conditions, such as diabetes. H & L injections should also not be given more than 3 times a year, as too frequent repeated injections in the same area, would increase the risk of tendon rupture.

For intractable cases, which do not improve with medical treatment or H & L injections, surgery may have to be considered. Basically, surgical treatment of trigger fingers, involves widening the opening of the tendon sheath, so that the tendon can once again slide through more easily. This is done via a small incision in the palm of the hand. Post-surgical physiotherapy may be required to help reduce joint stiffness.

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Dupuytren’s Contracture – What Is It And How Is It Treated?

Dupuytren's contracture is a fixed flexion contracture of the hand, caused by an abnormal thickening of the palmar aponeurosis (the tough tissue underneath the skin of the palms and fingers). The actual cause for this abnormal thickening, however, is not known.

The sunset is preliminary, often beginning as a tender lump felt under the skin of the palm. Over time, the lump disappears, and a tough band of tissue develops, causing the fingers to curl up towards the palm. The ring and little fingers tend to be most commonly affected. As the contractures increase, use of the affected hand may be significantly impaired.

Risk Factors for Dupuytren's Contracture:

The actual cause is unknown. However, there are certain risk factors which have been associated with the condition, and it has been found to primarily affect:

• Men (men are about 10 times more likely to develop this condition)
• People over the age of 40
• Those with a family history of Dupuytren's contractures
• People of Scandinavian or Northern European ancestry
• People with liver cirrhosis

Dupuytren's contractures are also associated with smoking, drinking and certain medical conditions, such as diabetes mellitus, thyroid problems and epilepsy.

Treatment of Dupuytren's Contracture:

The goal of treatment is to try to keep the affected hand working as best as it can.

• Injections are sometimes given for pain-relief.

• Surgery is recommended with the contractures significantly limit hand function. Surgery generally involves opening the skin over the affected cords and excising the fibrous tissue. As surgery is not curative, the condition does sometimes recur and repeat surgery may be required.

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Understanding Carpal Tunnel Syndrome

Carpal tunnel syndrome is a condition in which the median nerve gets compressed as it passes from the forearm into the hand via the carpal tunnel in the wrist. The carpal tunnel is a rigid narrow passageway of ligaments and bones in the wrist.

If the median nerve gets thickened (due to inflammation), or if the carpal tunnel becomes narrowed due to swilling of the surrounding soft tissue, the median nerve can get compressed. This is what causes Carpal Tunnel Syndrome.

The median nerve supplies sensation to the palm side of the thumb and fingers, as well as stimulator for movement of the small muscles of the hand, since its compression results in painful and troubling symptoms of the affected hand.

What are the Symptoms?

Symptoms of CTS usually start gradually and get progressively over time. One or both hands may be affected and women are about three times more likely than men to develop this disorder. As overuse predisposes one to developing the condition, it is the dominant hand which is more at risk of developing CTS.

• Burning, tingling or numbness in the hand, especially the thumb, index and middle fingers
• Feeling of swelling in the fingers (without any actually swelling)
• Clumsy in the hands, gradually having difficulty gripping things or performing other simple tasks
• Pain in the hand during sleep, causing one to wake up and feel the need to “shake out” the hand
• Severe loss of sensation may make it difficult to differentiate hot from cold

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome is usually the result of a combination of various factors that cause narrowing of the carpal tunnel. It is likely that some people are born with narrows in carpal tunnels, making them more likely to develop the syndrome.

Other factors which may increase the risk of developing CTS include:

• Previous injury to the wrist eg. previous fraction
Rheumatoid arthritis
• Hypothyroidism
• Diabetes mellitus
• Overactivity of the pituitary gland
Fluid retention during pregnancy
• Frequent use of vibrating hand tools
• Repetitive movement causing bursitis and tendinitis in the wrist region
• Certain occupations eg those who work in an assembly line (manufacturing, cleaning, packing, sewing etc)

How is it Diagnosed?

Early diagnosis and treatment are important as chronic compression of the nerve can result in permanent damage to the nerve.

Your doctor will assess your hand for movement, muscle atrophy and sensation. He / she will also look for the likely site of compression of the nerve, whether in the wrist, or higher up (such as nerve compression in the neck region due to cervical spondylosis). Possible underlining causes are also looked for.

2 simple tests are commonly performed:

The Tinel test:
This involves tapping or or pressing on the median nerve in the wrist. Tingling or a shock-like sensation in the fingers indicates a positive test.

The Phalen or wrist-flexion test:
The forearms are held upright and the fingers are pointed downwards, pressing the back of the hands together. The presence of carpal tunnel syndrome is suggested if there is increasing numbness or tingling in the fingers within one minute of adopting this position.

Further investigations are sometimes done:

• Electroltrasound imaging
• Magnetic resonance imaging

How is Carpal Tunnel Syndrome Treated?

Treatment for CTS should begin as early as possible to reduce further damage to the median nerve.

Initial conservative (non-surgical) treatment include:

• Resting the affected hand
• Immobilization in a splint
• Cold therapy to help reduce swelling
• Anti-inflammatory drugs
• Physiotherapy
• Acupuncture and chiropractic care

Surgery:

Surgery to release the transverse carpal ligament, known as “carpal tunnel release surgery”, is recommended when there is constant numbness, muscle weakness or wasting, and when splinting of the affected wrist at night no longer controls intermittent symptoms.

There are two main types of carpal tunnel release surgery: the Open Carpal Tunnel Release, and the Endoscopic Carpal Tunnel Release.

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Sprained Wrist – 5 Day Recovery Method

I found that the “RICE” Method was not practical for me. I did not have the time to take off work to rest my hand for 40 hours, as I work with computers all day and need my hand and fingers all the time. So I start my own experiment.

Just about every article I read seem to copy the one plain old method verbadum:

R Rest the joint for at least 48 hours.
I Ice the injury to reduce swelling.
Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice or a package of frozen vegetables. Apply ice for about 20 minutes at a time.
C Compress the swelling with an elastic bandage.
E Elevate the injury above the level of the heart.

The first thing I realized was that the Ace Bandage I had around my hand was way too tight (too pressurized). So I loosed it a bit and still firm, and the pain was even less, and I could work without any interference. Coming to the end of the day, I took off the bandage and lightly wrapped it back around my wrist and palm and pinned it together.

When I got home, I had to take off the bandage to take a shower. It hurt like hell. After showering, I put the Ace Bandage back on, very light with very little pressure, and I realize that my hand did not have any pain in my wrist, and it was actually “setting” in place for recovery. So I used that hand as little as possible, but did not keep it elevated.

The 2nd day of work, I could use my hand again almost half way, I was amazed and went back online and wondered if I was doing something that was causing me to recover quickly, but did not see any clues. When I got free time, I unwrapped my hand and iced it for about 10 minutes (put ice in a ziplock bag). Then I lightly put the Ace Bandage back around my wrist and palm.

On the 4th day, I could take off the Ace Bandage with no pain felt, however, I still kept it on until Sunday to make sure it was fully healed. At this point, my hand was back and I thought it was a miracle, but it was not, it only made more sense to me why it worked so fast. The wrist needed just the right amount of pressure to keep it in place so the body could perform the necessary repairs.

Hope this helps to give you more of an explanation from an actual sprained wrist victim.

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What Causes Carpal Wrist Tunnel Syndrome?

Everybody has a ” Carpal Tunnel .” Doctors call it the “fibro-osseous canal.” It is a narrow, rigid passage made of bones and ligaments at the base of your hand. It houses various tendons and that all-important median nerve.

In Latin, it's called the canalis carpi or the sulcus carpi. It is the fibro-osseous passageway on the wrist's palmar side, connecting the distal forearm to the middle compartment of the palm's deep plane.

Whatever you want to call it, this canal is quite narrow. Whenever any of the ten long flexor tendons passing through it swells or become inflamed, the result is that they fill the canal. That results in the median nerve being squeezed.

That gives the nerve insufficient room – compressing it.

Pain, weakness and / or numbness in the wrist and hand result, sometimes spreading up the arm. Occidentally, the pain radiates all the way up the shoulder.

The “median nerve” runs from your forearm into the palm. When it is continuously pressed or compressed, Carpal Tunnel Syndrome can occur.

The median nerve controls your feelings in the inside of your thumb and your three largest fingers. The median nerve also affects some of the smaller muscles used to move your fingers and thumb.

Often Carpel / Carpal Tunnel Syndrome (CTS) is worse at night, robbing the sufferer of sleep, which makes recovery even more difficult.

There is no standard sunset. Carpal Tunnel Syndrome can come on slowly or suddenly. However, the best advice for those who suspect they are showing symptoms: do not ignore it. It is always a mistake with CTS to “tough it out,” ignoring the pain.

If the problem is done early enough, chances for a complete recovery are far, far better. However, if you ignore the symptoms and the pain is allowed to persist, permanent nerve and muscle damage can follow.

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