Common symptoms and what you can do about it.
Carpal tunnel syndrome is compression of the median nerve at the level of the wrist. It affects women more often than men. Risk factors for CTS are repetitive use, poor postures, obesity, pregnancy, vibratory tool technicians, diabetics, people with osteoarthritis and autoimmune disorders. Usually there are a few common symptoms to look for to asses if you may have CTS. Nothing beats a visit to your doctor, however.
The first is nocturnal(night time) numbness in the thumb, index and middle fingers. You could have numbness, tingling, burning (known as paresthesias) in the first three fingers all at once or sometimes the whole hand and at times only one finger. Does the numbness wake you up from sleep? This can be frustrating and sometimes scary. Are you able to shake the numbness off and go back to sleep? Do you have numbness in the day during work or certain tasks? Yes to any of those questions and you may have CTS.
Second, do you notice you tend to be a bit more clumsy lately? Dropping a lot of things around the house. Maybe you are having trouble writing or typing. Its very common for people with CTS to have difficulty using a pen, or stylus. They tend to drop a lot of things like, cups, dishes, small items like earrings, change, and keys.
Third, You may also experience pain in the palm side of the hand or fingers which radiates to the elbow or shoulder. Most of the time the pain is a “burning” sensation. Like you are holding your hand over a flame. Sometimes the burning turns in to “acheyness”. All you want to do is “massage” your arm because the pressure relieves the stress.
Next, you might notice a loss in hand strength. Mabe you used to be able to open all those jars and cans. Now you can barely open a door.
In severe cases you will notice muscle atrophy. Visible atophy can be seen in the “meaty” section of your thumb on the palm side. This muscle is called the thenar muscle and loss of bulk in this muscle is called thenar wasting. This is a case to warrant surgical intervention.
Often people who have muscle atrophy have let CTS go on far too long and may not have a good result after surgery. Hopefully this article will preempt any atrophic cases.
Now it is possible to either reverse or recover 100% from CTS with out surgery and with out muscle wasting. For some people they may have a very benign case- the precursor “cousin” to CTS called Repetitive Strain Injury (RSI). Often RSI is the “wake up call” to CTS.
If you think you have CTS, get a definitive diagnosis by a doctor. A neurologist can conduct a few tests to determine if you have CTS. Electromyography (EMG)and nerve conduction studies (NCS) can help determine the nerve damage if any.
Become More Aware and Change Poor Habits
Decide if there are any changes you can make to the repetive tasks you are doing at home or at work. I find that most of my patients are extremely unaware of the movements, time frames and the poor postures they employ on a daily basis. There is ALWAYS something they can be aware of that can make all the difference in their symptoms. That includes sleeping positions at night too.
I tell them to play the “freezegame”. As soon as you become aware of your hand or symptoms , you STOP!, don’t move! take inventory of where you are, what you are doing, how you are doing it, and for how long have you been doing it?
Now that you realize you been typing on that computer for 3 or 4 hours straight with no breaks, one leg up, left arm resting on a hard edge of the desk, your right hand STILL resting on top of that mouse, shoulders rounded, neck protruding forward! Only now you will see how you have gotten to this point.
For example if you are on the computer at work for 8 to 10 hours /day I would suggest taking multiple mini breaks through out the day. All you need is 60 seconds to 3 minutes of changing your position. Stand up! Take a short walk to help with the stagnant position you have been in for the last few hours. Do any movement wich is the opposite of what you were doing. Do this every 30 to 60 minutes while at work. Purchase a sit to stand workstation. I like VariDesk or Kangaroo desk top. These desks can move up and down, you can have the best of both worlds.
If you were going to use the excuse of how your boss wont let you take any breaks then do a little math…8 hours at 30 seconds per hourly break is only 4 minutes! Really? Not so much to ask for is it? Not for the health of your body.
At night wear a “carpal tunnel brace”. You can buy them over the counter at any local drug store or on amazon. I like these (futuro) By wearing a splint at night you are able to keep the wrist in a neutral position allowing for more blood flow. This is key with any injury but especially with nerve entrapments.
Analgesics or Pain Relief
Try using a heating pad (jacuzzi)in the mornings and ice packs in the mid day and evenings. These thermal treatments may help with pain control and stiffness. There are no hard and fast rules but heat is usually good for mornings first thing, cold weather, or chronic injuries. Ice is usually good for long bouts of exercise, swelling, and acute injuries(first 24 to 48 hours).
Exercise and Healthy Hands
Try the exercises below along with the above strategies. One to 3 times per day, 10 to 20 reps of each for the tendon gliding (TGE). One time a day try the nerve flossing exercise, gentle rhythmical movements to the arm can help to improve nerve flow and the nutrients surrounding the nerve.