Carpal Tunnel Syndrome
What causes carpal tunnel?
Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Sometimes the disorder is due to a“born with it” factor where the carpal tunnel is simply smaller in some people than in others. A good number of people may sleep or work with their wrists in flexed or stressed positions that compress the carpal tunnel. Other contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture; over activity of the pituitary gland; hypothyroidism; rheumatoid arthritis; mechanical problems in the wrist joint; work stress; repeated use of vibrating hand tools; fluid retention during pregnancy or menopause; or the development of a cyst or tumor in the canal. In some cases no cause can be identified.
Who can develop carpal tunnel?
Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women than in men. People 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. Carpal tunnel syndrome usually occurs only in adults. Many believe that heavy computer use is the main cause for carpal tunnel, but in fact, it is three times more common among assembly line workers than among computer data-entry personnel. A 2001 study by the Mayo Clinic found heavy computer use (up to 7 hours a day) did not increase a person’s risk of developing carpal tunnel syndrome.
How is carpal tunnel treated?
Treatments for carpal tunnel syndrome should begin as early as possible. Underlying causes such as diabetes or arthritis should be treated first. Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending. If there is inflammation, applying cool packs can help reduce swelling.
Treatments for Carpal Tunnel Syndrome
Physical/ Occupational Therapy – may be beneficial in people with Carpal Tunnel. Licensed therapists are trained in certain modalities to ease the pain, swelling, and inflammation. Other approaches are stretching the Carpal ligament, mobilizing restricted wrist bones that compress nerves, and educating patients on proper splints to wear. Certain gentle exercises may also be necessary to prevent atrophy or weakening of the hand muscles. Assessing the work environment as well as activity modification is an important part in helping resolve Carpal Tunnel and preventing it from reoccurring or worsening.
Surgery-Carpal tunnel surgery is generally recommended if symptoms last for 6 months, conservative treatment has failed, or a very sudden loss of muscle (atrophy) is observed in the hand muscles. Surgery involves severing the band of tissue around the wrist to reduce pressure on the median nerve.
Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take months. Some patients may have infection, nerve damage, stiffness, and pain at the scar. Occasionally the wrist loses strength because the carpal ligament is cut. Patients should undergo physical/occupational therapy after surgery to restore wrist strength. Some patients may need to adjust job duties or even change jobs after recovery from surgery.
Drugs – In special circumstances, various drugs can ease the pain and swelling associated with carpal tunnel syndrome. It is important to speak with your physician about the right type.