Browsing: Hand Wrist Pain

Carpal Tunnel Syndrome Treatment

Carpal Tunnel Syndrome has symptoms of tingling and numbness in the hands, fingers and wrists that is sometimes so painful that it is difficult to sleep. These are the symptoms of Carpal Tunnel Syndrome. CTS is almost always a consequence of some sort of repetitive movement, that is, some sort of movement that you have repeated several hundred to several thousand times in a day.

Relieving CTS in the wrists and other areas is not as difficult as the pain would suggest. Individuals who experience CTS at its most extreme symptoms can not be easily persuaded to avoid the often-recommended surgical procedure. The surgical procedure itself is not necessarily dangerous. The problem with the surgery is that, should it not be successful, or should the condition relapse, and return to its full symptoms, this option is no longer as valid a solution. It is wiser to initially begin in a conservative care program.

Chiropractors, Massage therapists, and acupuncturists often offer successful treatment programs. There are also several herbs available on the market that offers a high level of success. Most importantly, there are a series of stretches and trigger point reductions that you should have made aware of. Reducing these trigger points and incorporating stretches, when used appropriately, will be exactly what you need to reduce your symptoms and to maintain a symptom free condition in spite of your daily activities.

Look for and learn the routines, and if you are unsure of what to do, approach one of the alternative practicers listed in the paragraph above, and ask questions to make sure that they are well trained to treat CTS before you make any appointments. Stretching routines and Trigger Point Reduction may be all you need to provide real, lasting relief.

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Carpal Tunnel “Cure”

Twenty years ago, carpal tunnel was considered a disease, and the search for a “cure” was in great demand. Today, it has become apparent that carpal tunnel is certainly not a disease, but usually just a simple case of muscle imbalance. Of course, receiving a doctor's diagnosis of this is required, as there are other things that will cause carpal tunnel or the same symptoms as carpal tunnel syndrome.

Besides muscle imbalance, water tension, obesity, genetic, diabetes and arthritis can either cause carpal tunnel or exhibit signs of carpal tunnel. Your doctor can run a few tests to rule out most of these and help direct you to the best form of treatment.

The first treatment should be exercises that help promote a healthy balance within your upper extremity. Most people can completely treat or severely reduce their symptoms by focusing on the weak, underused muscles on the backside of the hand and forearm, called the extensor muscles. Studies show that while exercising the weak extensor muscle group, and stretching the tight, over used flexor group (located on the palm side of your hands and forearm) you can easily and rather quickly, end your carpal tunnel dilemma for good.

Due to scientific studies highlighting the potential for great success when carpal tunnel is treated as a muscle imbalance, you can now find a number of healthcare professionals using techniques that will specifically focus on exercising the extensor muscles, while stretching and lengthening the flexor muscles. Before you allow anyone to perform surgery, it is advised you first try more conservative methods. Search out a therapist that understands the theory of muscle balance and carpal tunnel – chances are very good they will be able to alleviate all your symptoms without cutting you open.

Best Wishes and Good Luck !!

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Alternative Remedy for Carpal Tunnel

Finding an alternative remedy for carpal tunnel is a tricky subject. With so many products, from vitamin concoctions to various squeeze balls, all claiming to be successful treatments for carpal tunnel, how do you know where to begin?

We do know that surgery is the last resort for helping carpal tunnel sufferers. It is for those who have tried everything else and failed. After surgery, your grip and hand function will never be the same, no matter what exercises you perform or therapy you undertake, surgery has permanently disabled a part of your hand that will never again be regained. Surgery also has a very low rate of success, considering that after 6 years, 90% of patients are experiencing symptoms again. Therefore, there is a high rate of patients who undergo multiple carpal tunnel surgeries. During the first surgery, doctors cut the ligament, each surgery thereafter is to clear away scar tissue that has build up, creating the same pressure and loss of space as the ligament was doing.

Here are a few of the alternative options that seem to provide the best results and have the most clinical backing.

Creating Muscle Balance: Studies have shown that most people, even those with moderate to severe carpal tunnel, can greatly reduce or completely treat their symptoms by performing exercises that create balance within their hand, wrist and forearm. Clinical research has demonstrated that the overuse of the flexor muscles that close the hand, and under use of the extensor muscles, which open the hand, cause the hand to collapse in on itself, squeezing the carpal tunnel, restricting space and initiating the cycle of pain, numbing and weakness. By simply strengthening the extensor muscles that cross the finger, wrist and elbow joints, it has been found, you can control or completely alleviate your symptoms! NOTE: Squeezing and gripping devices have long been proven, time and again, to worsen carpal tunnel! Only exercise of the extensor muscles that open the hand are recommended.

Wrist Braces and Splints: For those in the earliest stages of carpal tunnel, when worn at night, a wrist brace may be enough to regain control of your carpal tunnel symptoms. Wrist braces and splints are not effective in treating carpal tunnel syndrome for those with moderate or severe symptoms, but can assist when used at night. These devices are meant to keep the wrist from curling into a fist so that the wrist stops in a straight position in order to reduce impingement of the carpal tunnel. Be aware, studies have proven that wearing a wrist brace too often will further damage the extensor muscles and worsen your carpal tunnel.

Massage: For many with mild symptoms, massage can provide the necessary relief of carpal tunnel. For those with moderate to severe carpal tunnel symptoms, massage is often very helpful, but temporary. Massaging and stretching the stronger, shorter and tighter flexor muscles helps relax and loosen the restriction around the carpal tunnel, allowing for temporary relief. Once you have had the flexor muscles massed and stretched out, it is recommended you follow immediately with strengthening exercises for the opposing muscles, which will very well hold the stretching and lengthening of the flexor muscles in place.

Ultrasound: Ultrasound tend to have its highest rate of success when used in conjunction with a treatment program that includes soft-tissue work, stretching of the flexor muscle group, and the strengthening of the extensor muscle group. Ultrasound can help reduce inflammation in an acute case of tendonitis, carpal tunnel syndrome, or other forms of injury.

Always consult a physician or healthcare professional before starting any type of exercise or treatment program. Good Luck!

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Carpal Tunnel is Being Built While You Work

Carpal Tunnel Syndrome (CTS) affects anyone who treats on his or her hands for work. Over time, repetitive motives in the workplace or at home cause strain on the eight carpal bones within the wrists that lead to the fingers – making up the carpal tunnel. This strain leads to swelling and severe pain, often inhibiting people from being able to do every day things like cooking, cleaning, sewing and despite most significant of them all, working.

In fact, according to the Bureau of Labor Statistics, Carpal Tunnel is the number one work-related injury. Furthermore, Carpal Tunnel Syndrome is cited as the top injury that leaves people out of work for the longest amount of time – 31 days or more for 50 percent of CTS sufferers!

The most frequent remedy for fixing Carpal Tunnel Syndrome is through surgery, but surgery is costly, decreases work productivity and, often does not fully heal. In fact, according to the Bureau of Labor Statistics, a mere 23 percent of those who undergo the surgical procedure are unable to return to their former job for a variety of reasons, including CTS symptoms reoccurring.

According to some estimates, $ 30,000 is lost per worker over the course of a CTS sufferer's life from, among other things, medical expenses and an accessibility to find work.

If you feel as though you may have Carpal Tunnel Syndrome but are not sure, there are certain sure-fire questions you can ask yourself that will give you a good idea:

Does it hurt to shake hands with someone? Is it painful to pick things up? Do you get a repeating tingling sensation in your hands? Does it hurt to grip things?

If you answered in the affirmative to these questions, there's a good chance you have Carpal Tunnel Syndrome.

But there's good news. You can cure symptoms of CTS naturally, with a series of exercise designed under the “How to Cure your Carpal Tunnel Syndrome Naturally” electronic guide.

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Carpal Tunnel Syndrome

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.

The information discussed in this article is for informational and educational purposes only. If you are experiencing symptoms of a health problem, please visit your doctor. The material discussed on this website is not meant to replace the opinion or diagnosis of a medical professional.

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When Do You Need Carpal Tunnel Release Physical Therapy?

Carpal tunnel is the term for a vessel found in the hand, which contains many other important nerves. Carpal tunnel syndrome occurs when there is pressure or inflammation in the nerves within the carpal tunnel.

The initial treatment for carpal tunnel syndrome is non-surgical. However, if symptoms do not improve or the condition persists for more than six months, your doctor will most likely recommend surgery, also known as carpal tunnel release, to ease the pressure on the carpal tunnel.

What happens in a carpal tunnel release?

Carpal tunnel release is a surgical procedure, which involves cutting the surrounding tissues on the wrist to lessen the pressure on the affected nerve. The traditional method of surgery is open release surgery, wherein the doctor widens the carpal tunnel by cutting the ligament through an incision made on the wrist about two inches in size.

Another type of carpal tunnel release surgery is endoscopic surgery, which often requires two incisions, each half an inch in size, one on the wrist and another on the palm. Some doctors may make only one incision on the wrist. Next, the doctor inserts a tube with a camera through one of the incisions and by observing the onscreen view of the affected area, the doctor efficiently proceeds with cutting the carpal ligament. Endoscopic surgery provides quicker recovery, minimal post-surgery discomfort and less scarring than open release surgery.

Patients may have carpal tunnel release done on one or both hands. Patients are usually under local anesthesia during the surgery but some cases may require general anesthesia. Carpal tunnel release is an outpatient procedure so patients do not have to stay in the hospital overnight.

After surgery, your focus will naturally be a speedy recovery. It is important to note that complete recovery may take several months. Patients should go through carpal tunnel release physical therapy to strengthen the wrist. If it is not necessary for you to change your job, your therapist may ask you to change some work habits or adjust some activities that may affect your recovery.

Doctors usually recommend carpal tunnel release physical therapy when patients are undergoing surgery on both hands. In this case, the patient undergoes carpal tunnel release physical therapy in between surgeries to advance the recovery process. When recommending carpal tunnel release physical therapy, doctors look at the extent of the surgery and the condition of the operated area. While carpal tunnel release physical therapy is not compulsory, it will certainly contribute to a faster recovery.

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Pain Management: Treat Carpal Tunnel – Wrist Pain Without Drugs

In alleviating sore wrists, sore hands and other recurrent tendonitis and irritated neurology, symptoms often attributed to Repetitive Stress Injury (RSI) and Carpal Tunnel Syndrome (CTS), we look at the cause not the symptoms.

We find that the basic cause of many forms of CTS, wrist Pain are what we call, Repetitive Muscle Stress, reactive muscle imbalances. That is muscles not working together and communicating with the brain. The tendon, joint, and nerve injury is secondary.

Remember, Muscles pull bones; bones do not pull on muscles.

The bottom line cause of CTS, Wrist Pain is the muscles in the forearm get very stressed, tight and pulls on the Carpal Tunnel, which unexpectedly collapses.

The stress on the wrist will begin to irritate and injure the tendons and nerves passing through the wrist area, greatly increasing the pain intensity. In time the injury may become so intense that you will be unable to use your fingers.

What is a Reactive Muscle?

Reactive muscles are muscles that weakened when another muscle, the reactor, is activated. The weakened muscles can lead to muscle pain, and the overly strong reactor muscles can cause tendon and joint pain.

Reactive muscle combinations may be created by sudden injury or repetitive muscle movements (as found in playing musical instruments, using computer keyboards, etc.).

Muscles play a tug of war with each other. They have to learn to work together and communicate with the brain.

A Grocery Store Check-out Clerk suffered constant pain in her shoulders and could not raise her arms to put pullover sweaters on or off. She also had severe wrist pain. Going through the movements involved in a checkout procedure, sliding packages along the counter with one hand while punching cash register keys with the other triggered multiple reactive muscle imbalances. Correcting these muscle imbalances relieved the pain and enabled her to raise her hands over her head. This also deleted the stress in her wrist.

A Creative Musician, who was recording her own compositions using a synthesizer keyboard, was so troubled with pains in her arms and wrists that she was unable to continue her recording sessions. Resting for several days at a time was no help; since when she went back to playing the keyboard, the problems would return.

We had her sit down and mimic playing the keyboard and corrected the resulting reactive muscle imbalances. Her pain level was much reduced.

She telephoned a couple of days later to tell us she was feeling better and better, and had started up her recording sessions again.

Muscles are the missing link to our aches and pains.

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Simple Steps To Prevent Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a serious and painful form of Repetitive Strain Injury (RSI). It can disrupt your work and leisure activities by affecting your hand and wrist. It is easier to prevent than to treat.

Regular exercise can prevent carpal tunnel syndrome. Perform conditioning and stretching exercises on your wrist at the start of work and during frequent breaks. Strengthen the fingers, forearms, hands, shoulders and the neck also. Integrating these simple exercises into your daily life can decrease median nerve pressure and keep carpal tunnel syndrome from developing.

You can take preventive measures when you work in an office. Set up an ergonomic desktop station. Position the keyboard tray below the work surface. Arrange your activity and work space using ergonomic guidelines. Either use a cushioned wrist rest for mouse or a track ball instead of a mouse.

Avoid any activities that contribute to carpal tunnel syndrome. For example, either stop or reduce repetitive movements that put your wrist in a bent position. If you have to perform repetitive wrist motions, then keep your wrists in a neutral position, maintain a proper posture, and take regular breaks from repetitive activities. You can also switch your task to reduce pressure on your wrist and prevent infection in the hand and wrist from advancing into carpal tunnel syndrome.

If your job requires repetitive wrist motions, ask your orthopedic surgeon about wrist splints to restrict wrist movement. Orthopedically designed wrist braces such as SmartGlove and Wrsteasy can prevent carpal tunnel syndrome and treat wrist pain.

To prevent carpal tunnel syndrome, keep your hands and wrists at a comfortable temperature while working. If your hands are cold, you are more likely to develop carpal tunnel syndrome. Position and align your wrists and hands properly while working. Place your wrists parallel and your elbows at a right angle to your table.

Carpal tunnel syndrome, a common wrist pain, places heavy toll on productivity and compensation claims. These simple steps can help you prevent carpal tunnel syndrome. Why allow it to develop and interfere with your life when you can stop it? Prevention is better than cure.

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Signs And Symptoms Of The Carpal Tunnel Syndrome

The Carpal tunnel syndrome (CTS) is a medical condition in which the median nerve is compressed at the wrist. The median nerve passes through the carpal tunnel. The Carpal Tunnel is a canal in the wrist. The Carpal tunnel syndrome typically starts gradually, with a light pain in your wrist that can from there extend into the hand or forearm of a patient who is experiencing this problem. The Carpal Tunnel Syndrome also comes with a few other common signs and symptoms. These signs and symptoms include (but are not limited to):

Burning, tingling or numbness in your fingers or hand, especially the thumb, index, middle or ring fingers. Be aware that the little finger of your hand will NOT show these symptoms. This feeling or sensation actually often occurs while operating a vehicle or when being on the phone or when reading a newspaper. It also sometimes bears a patient upon awakening. A fruitless attempt to “fix the problem” is trying to “shake out” the hands to get a relationship from the symptoms.

Other signs or symptoms of the Carpal Tunnel Syndrome are:

– A constant pain extending from your wrist up into your arm all the way up to your shoulder or down into the palm or fingers of your hand.

– A sense of weakness in your affected hands. It is not uncommon to develop a tendency to drop objects that you are holding in your hands.

– A constant and persistent loss of feeling in some or all affected fingers. This usually can occur if the condition is already at an advanced state.

The Carpal tunnel syndrome is specifically associated with specific manual tasks including:

– Repetitive hand movements

– Awkward hand positions

– Strong gripping

– Mechanical stress on the palm

– Strong, repeating vibrations

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Carpal Tunnel Syndrome

At the base of the palm bounded by bones and ligaments, the carpal tunnel is a narrow passageway about as big around as your thumb. The median nerve passes through this tunnel along with 9 tendons. Carpal Tunnel Syndrome (CTS) occurs when the median nerve becomes compressed or squeezed at the wrist causing pain, weakness or numbness and tingling in the hand and wrist which can radiate up the arm. Symptoms typically develop gradually and may become worse at night. Symptoms often follow a pattern of improving with rest then worsening with activity that require gratifying items or bending the wrist.

What causes Carpal Tunnel Syndrome?

Pressure on the Median nerve can be caused by trauma or injury to the wrist, frequent use of vibrating hand tools or any repetitive, forceful motion with the wrist in a bent position especially when done for prolonged periods without rest. CTS can also be caused by underlying medical conditions including rheumatoid arthritis, osteoarthritis, diabetes, pregnancy and thyroid problems. Symptoms of CTS typically resolve or improve when these underlying medical conditions are treated.

Non-surgical Treatment for Carpal Tunnel Syndrome

Treatment for CTS focuses on decreasing demands on the wrist and hand and reducing pressure on the median nerve. This is usually accomplished by activity modification, splinting, exercise and anti-inflammatory measures which may include ultrasound, iontophoresis, cold packs and oral medication. Non-surgical treatment is most effective with mild to moderate symptoms of CTS.

Activity Modification

Wrist position is key to controlling carpal tunnel symptoms. The carpal tunnel is most narrow when the wrist is bent down or extended all the way back and largest when the wrist is straight. The more the wrist is bent, the more pressure is placed on the median nerve. Changing how you do repetitive hand activities or avoiding these activities all together can help. Principles of activity modification to follow:

o Avoid flexed finger / flexed wrist postures.

o Take frequent breaks (every 30-60 minutes) from repetitive hand activity.

o Avoid repetitive, forceful grasp and prehension activities.

o Relax your grip. Avoid grasping too hard when driving, writing or using hand tools.

o Alternate activity frequently.

o Wear padded gloves when working with vibrating equipment.

o Use correct posture.

Wrist Splints (braces)

Splints are used to immobilize the wrist in a neutral (unbent) position to maximize the size of the carpal tunnel and reduce pressure on the median nerve. Splints are worn during the night. Usually it is not necessary to wear splints during the day. Doing so may actually worsen the problem because it makes work more awkward.

Physical Therapy and Exercise

Anti-inflammatory modalities of iontophoresis, ultrasound and cold packs and special hand exercises can help to relieve mild to moderate symptoms of CTS.

Arm & Shoulder Stretch

Lace fingers together & turn palms facing out as you press your hands away from your body until a stretch is felt. Hold 10 seconds, Repeat 3-5 times

Cervical Forward Bending

Bend head forward until a stretch is felt. Hold 10
seconds, Repeat 3-5 times.

Wrist Flexor Stretch

Keeping elbow straight, grasps involved hand and slowly bringing wrist back until a stretch is felt. Hold 10 seconds, Repeat 3-5 times.

Executive Stretch

Lace fingers together behind your head, bringing your elbows back as far as possible. Squeeze your shoulder blades together. Hold 10 seconds, Repeat 3-5 times.

Cervical Side Bending

Tilt head toward shoulder until stretch is felt. Hold 10 seconds, Repeat to opposite shoulder, Repeat 3-5 times.

Wrist Extensor Stretch

Keeping elbow straight, grasped concealed hand and slowly bend wrist down until a stretch is felt. Hold 10 seconds, Repeat 3-5 times.

Posterior Shoulder Stretch

Grasp your elbow with other hand as shown. Pull the elbow and arm across your chest so that you feel a stretch. Hold 10 seconds. Repeat 3-5 times.

Cervical Rotation

Turn head to look over shoulder until a stretch is felt. Hold 10 seconds. Repeat to opposite shoulder. Repeat 3-5 times.

Strengthening exercises for affected muscles and reconditioning of the arms are begin as symptoms resolve. See your physician or an Excel physical therapist if you are experiencing symptoms of CTS. http://www.ExcelPT.com

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Carpal Tunnel Syndrome In Musicians

Carpal Tunnel Syndrome is caused by compression of the median nerve that passes through the carpal tunnel in the wrist. Along with the diagnosis of Carpal Tunnel Syndrome comes considering pain and injury along with numbness, paresthesia (pins and needles) and loss of hand strength, coordination, and pincer grass. This disadvantage is problematic for almost any profession; however, it can be absolutely disabling for musicians.

The most widely diagnosed nerve entrapment disorder, carpal tunnel syndrome, is characterized by pain, swelling, numbness, and tingling in the hand and wrist. The disorder stems from excessive stress and strain placed on the arm, wrist, and hand that result from repetitive and / or static (non-moving) flexion of the fingers and wrist. This unidirectional strain causes a muscle imbalance in the hand and forearm, resulting in the stronger, shorter flexor muscles that close the hand to compress the undering medium nerve within the carpal tunnel, which is central to hand, and wrist movement.

The median nerve actually begins in the neck and travels through the shoulder joint through the brachial Plexus down to the elbow and eventually to the carpal tunnel joint in the wrist. With repetitive unidirectional motions / activities being performed on a regular basis, the imbalanced muscles in the hand and forearm can cause the carpal bones that form the carpal tunnel to become misaligned, creating pressure and pain in the wrist as the bones compress the median nerve within . Critically, it is not only carpal tunnel syndrome that can result from an existing muscle imbalance in the hand and arm, but also other repetitive strain injuries that involve the ulnar and radial nerves at the wrist or elbow junctions. Thus, effective treatment must address muscle length and strength imbalances that may be present in the entire upper extremity region.

For musicians, carpal tunnel syndrome can be akin to a death sentence. Incapacitated through the hand and forearm, musicians may have to modify practice and performance routines. It is impossible to play the piano, strum the guitar, or manipulate the bow of a cello without superb dexterity and responsiveness in the fingers and wrist. Rest is often the first-line recommendation for treating carpal tunnel syndrome, but it is an option that few professionals can afford to take.

Thankfully, there are effective treatments that can protect against the development of carpal tunnel syndrome in musicians and that can curb the impact of symptoms as soon as they emerge. Strategically designed exercises that target specific muscles and groups of muscles in the hand and forearm have been shown to reduce symptoms of carpal tunnel syndrome with 90 percent effectiveness.

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RSI & Carpal Tunnel Syndrome – Natural Ways for Relieving the Pain

As more and more people become reliant on computers during their day to day routine, so has there been an increase in RSI (repetitive strain defects) such as Carpel Tunnel Syndrome. Many people who suffer from this chronically painful and sometimes debilitating injuries are now turning to alternative methods of treatment including looking for a safe and natural pain relief.

The problems that many company's face because of carpal tunnel syndrome is that it lowers the productivity of its staff and goes along way to company's losing large amounts of work time and the expenses incurred in claims being made by employees each year.

The first signs that some one may possibly be suffering from RSI is that they usually have a burning, tingling or itching numbness in the palm of their hand and the fingers. This especially seems to affect the thumb, index and middle fingers of a person's hand. The usual treatment for such an injury is by the taking of anti-inflammatory drugs such as aspirin, ibuprofen and any other over the counter non-prescription pain relievers that are available. However, because of the side affects that now seems to be associated with the long term ingestion of such medication, people are now looking for a more natural alternative.

One such alternative is a spray, which will help to alleviate the pain that you feel. It works by centering on the bodies electrical pathways which send messages to the brain informing of the pain. Really it works in much the same way as acupuncture, but without the needles, and because it is made only with natural ingredients you will find that it has no side effects. It also means that you do not have to visit the doctor as it is always close at hand for use when required.

So if you are looking for an alternative to the usual over the counter drugs that are available, then you could look no further than by visiting a Chinese medicine shop or one of the many alternative therapy / health foods shops that are open. You can even purchase such products over the internet.

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Carpal Tunnel Syndrome

Introduction

Carpal tunnel syndrome (CTS) as some other similar diseases belong to the group of so-called overuse injuries. This is a manifestation of nerve and tissue damage from fast, forceful and seemingly harmless repetitive wrist and hand movements (prolong repetitive trauma), which result in swelling, tenderness and pain.

Carpal tunnel syndrome occurs mostly in middle-aged women, who does repetitive labor work (eg typing) and mostly in dominant hand. It is also often seen in production and manufacturing workplaces (with repetitive activities such as cutting meat, dressing poultry and assembling automobiles). The condition is very common among musicians, who play string instruments and piano. During last 10-15 years people can get this problem as a result of extensive computer work (computer manufacturers now use warning labels to alert consumers that keyboard use may increase the risk of CTS). This is second most common (after lower back pain) for both males and female reason for seeking for medical attention. According to recent studies, around 1% of population sufferers from CTS. Statistics from the National Center for Health indicate that 2.4 million visits were made to physicians in 1999 because of CTS, of which 1 million were made to orthopedic surgeons. American Academy of Orthopedic Surgeons (AAOS) published data, that approximately 366,000 CTS surgeries were performed in 1999, a 300% increase from 1991.

The carpal tunnel is a narrow tunnel on the inner surface of the wrist where tendons for flexing muscles of the digits travel. It bordered anterioly by transverse carpal ligament, medially by pisiform bone and hook of hamate bone, laterally by the tuberculle of trapezium bone and posterioly by the carpals. Along with these muscles lie medium nerve, which innervate the skin on palmar surface of the palm as well as palmar surfaces of 1,2,3 and half of 4th finger. When a person does repetitive and long (for hours) work with his wrist or fingers, the tendons become inflamed, which causes their swapping and compression of the median nerve. The same symptoms may occur after wrist trauma (eg Colles fracture – fall on extended wrist) or when one of the wrist bones (lunate) displaced (subluxation) and compress medium nerve. This may also occur with osteoarthritis of the wrist, at the last trimester of pregnancy, with hypothyroidism or acromegaly. This is so-called carpal tunnel syndrome.

Symptoms

People usually complain about numbness, tingling or pain in their hands along the median nerve distribution. The symptoms mostly occur at night and aggravate with repetitive hand motion. Thenar atrophy may also be seen. Careful questioning may determine, that little finger is spared (distribution of median nerve). Without treatment hand muscles deteriorate and lose their ability to grip. CTS sufferers may become permanently disabled if they ignore the symptoms.

Diagnosis

Diagnosis is made based on clinical symptoms. Tapping over carpal tunnel reproducing pain within median nerve distribution (positive Tinel symptom). Passive maximal flexion of the wrist for 1 minute cause tingling along median nerve distribution (positive Phalen symptom). Boston questionnaire may be useful to evaluate symptoms of CTS.
American Association of Orthopedic surgeons also recommend wrist X-ray to rule out other things.

Differential diagnosis

There are several similar to CTS conditions. One of them is De Quervian's disease. This problem is usually seen in people who does repetitive forceful sentences together with ulnar deviation. Eg wrist in playing tennis (squash) or repetitive use thumb in work-related situations. Pain localized to the radial aspect of the wrist (inflammation of the tendons of the thumb muscles).

Treatment

The earlier time of diagnosis and treatment will benefit in shorter duration of treatment and in treatment cost.

Initial treatment includes include immobilization, ice packs and non-steroidal anti-inflammatory drugs.

Wrist splints and braces used for immobilization. Wrist splints stabilize the wrist in neutral position, protecting the nerve from being compressed, take the inflammation down. It usually take from 6 to 8 weeks.

Surgery performed in the most severe cases, in order to enlarge the Carpal Tunnel and repair ligaments

Physical therapy is the corner stone in managing CTS. The goal is to avoid the surgery, and in most cases we can do this. Physical therapy includes combine manual therapy along with special modalities, which provide reduction of swelling and inflammation as well as relief pain and other symptoms of carpal tunnel syndrome.
Our experience extends more then 30 years working with string musicians and pianists. Perform the manual therapy only is not enough to successfully cure the disease. Because of repetitive chronic microtrauma, physical therapists have to use various modalities to reduce swelling, pain and other symptoms of CTS and speed up process of healing. According to our data, we found so-called cold laser is most useful among different modalities.
Laser (Light amplification by stimulated emission of radiation) was produced in the previous century and first experimental applications of low-level laser therapy (LLLT) were reported in 1968, when researchers used ruby ​​and argon lasers on non-healing or slow-to- heal ulcers. Later research substantiated the efficiency of laser treatment to accelerate the healing of wounds, attenuate pain, and reduce tissue inflammation in both humans and animals. One of the human body's reactions to the soft tissue trauma is to “splint” the injury with edema, which is accumulation of the fluid in tissue spaces or cell interstices, causing a swelling. This swelling advances excessive movement of the damaged tissue and results in secondary pain (primary pain is from actual trauma itself). Laser with special wavelengths (820-840 nanometers) have an extremely low absorption rate in human tissue, so allowing deep penetration of laser light. Low-level laser (LLLT) therapy first targets the lymphatic system, because it contains the fluid balance in the body and also improves reabsorbtion of the edema. With LLLT, waving is reduced, allowing movement to return to the treated area.

Evaluation

Subjectively patient will have decreed pain, paresthesia, objectively it'll be increase strength of thenar muscles (electromyography studies), negative Tinel and Phalen signs.

Prevention

Prevention is the corner stone in CTS. Educational programs for patients as well as for employees and employers can help to avoid development of this particular problem. It may be postural education, work site modification, wrist supports for keyboard along with exercises for upper extremity (hand, forearm, shoulder) and neck. Exercises like flexion-extension, rotation and stretchening will provide adequate blood supply and get relief for tensile muscle and tendons. This should help to avoid the development of CTS or speed up the treatment of the condition.

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Doctor – What Can I Do About Carpal Tunnel Syndrome?

Carpal tunnel syndrome occurs when the median nerve, one of the major nerves that provides innervation to the hand, is pinched in the carpal tunnel. The carpal tunnel is a narrow space on the palm side of the wrist. The “floor” of the tunnel is formed by the wrist bones; the roof is created by a tough piece of tissue called the flexor retinaculum. If the carpal tunnel opening becomes constricted for whatever reason, then pressure is exerted on the median nerve. The patient will develop symptoms such as burning, numbness, and tingling in the hand involving mostly the thumb, index, third, and part of the fourth fingers. If the pressure continues without adequate treatment, then the ability to use those fingers to grip will also worsen.

The carpal tunnel can be narrowed as a result of trauma, edema (fluid build-up as occurs during pregnancy), repetitive motion, thyroid disease, acromegaly (growth hormone excess), gout, and various forms of arthritis (rheumatoid arthritis is the most common).

The diagnosis is suspected by taking a careful history. Further corroboration is established through a careful physical examination by a skilled clinician. Nerve conductions tests are also helpful for confirmation.

The initial treatment may consist of splinting as well as anti-inflammatory medications. Rest- staying away from keyboard work if this is what welcomed it on in the first place – is mandatory.

If symptoms persist, then a corticosteroid injection into the carpal tunnel using ultrasound needle guidance is a good option. Data indicates that this procedure may be very helpful in alleviating the symptoms. In the past, patients who did not respond to injection and splinting were probably considered candidates for surgery.

A new technique may make this approach obsolete.

Percutaneous needle release using ultrasound guidance is a minimally invasive approach. Using local anesthetic with ultrasound guidance, a small needle is inserted and fluid is injected at the same time to shred the fibers of the flexor retinaculum, the tough band of tissue that forms the roof of the carpal tunnel. With repeated movements of the needle and further hydrodissection with fluid, the retinaculum weakens and the physician is able to gently break the retinaculum. A splint is applied and the patient is back to normal activities the next day.

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Hand Pain and Computer Keyboards

When you touch a keyboard do you have pain in your fingers / hands or arms? Do you feel, if you have to spend one more minute keying on a computer you will scream? Do you feel alone in your pain? If you answered yes to any of these questions, read on.

Typing on a keyboard is a repetitive action which dries up the fluid inside your hands. After years of typing the inside of your hands look like and start feeling like a rotten apple. The more you type on a keyboard or use your hands in any capacity the worse this gets.

Many people go to occupational therapy or hand therapy and this can relieve their hand pain. There are many people who do not have their hand pain treated by therapy. Their hands have rotted on the inside and only surgery or complete hand rest will resolve the problem.

I discovered years ago, after my numerous hand surgeries / hand therapies something by accident. I placed a pad underneath my keyboard. Itave my hands instant relief from pain when typing on a keyboard.

It cushioned my hands and now I can type on a keyboard comfortably. Without it I am in extreme pain. This remarkable pad can help you too. Why suffer in pain everyday?

Thank you for reading my article. Please feel free to read my other numerous articles.

Copyright 2006 Linda E. Meckler

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