Carpel Tunnel Syndrome

Carpel Tunnel Syndrome is a nerve disorder, where the median nerve in the wrist is compressed, which causes pain,muscle weakness and numbness in the wrists and hands. It is more common in women than in men and the usual onset is early 40's but it can happen at any age. The definitive cause of CTS is still unknown, but it is believed to be caused by repetitive activity. It can have multiple symptoms making it difficult to treat, but there are many treatments available. We will discuss the symptoms and treatments in this article.

You may not realize you have CTS until you discover more frequent parenthesis in the hands. (Feeling of falling asleep). This usually occurs during sleep, where the nerve is more compressed due to sleeping with bent wrists. Another common sign or symptom is pain when using your hands. It often feels like a sharp pain shooting through the center of the palm of the hand. It may feels like it is coming from the wrist. Muscle weakness is the third most commonly reported symptom. It may feel like you cannot bend your fingers or wrist, or that you cannot grip onto anything securely. It will be hard to make a fist. This is generally a sign of CTS progression.

The treatment options are many and usually center around therapy. In the worst case scenario surgery may be required.The course of treatment will also depend on whether or not the CTS is caused by an underlying medical condition such as hypothyroidism; in which case once that is treated CTS usually disappears.

Immobilizing Braces

The benefits of using of braces and splints is well known, but unfortunately not many people are willing to wear them. They are considered the best initial treatment option, sometimes combined with NSAIDs (non-steroidal anti-inflammatory drugs, such as Advil). It is usually advised that the person wear them at night, and during the activities that cause the pain. They benefit by keeping the wrist straight and therefore removing pressure on the compressed nerve.

Physiotherapy

This offers many ways to treat and control CTS symptoms. It should be directed at the particular activities and location of pain which can be diagnosed by a therapist. It may consist of soft tissue massage, conservative stretches and sometimes the above mentioned braces.

Localized Steroid Injections

Steroid injections can provide very effective temporary relief of CTS pain and symptoms, but is not appropriate for long term therapy. Doctors and medical professions will only prescribe this until a more permanent treatment plan can be found.

Medications

NSAIDs are the common medication used to relieve symptoms. Examples of these are Advil, Naxopren and Aspirin. The side effects though of long term use can be gastro-intestinal irritation and bleeding.

Surgery

Surgery is usually required when all other methods have not reduced the pain and symptoms of CTS. The hand surgeon will do a test on the nerves to determine how compressed they are. The surgery goal is to divide the transverse carpal ligament into two. This ligament runs across the hand from the base of the thumb to the base of the fifth finger. When the surgeon cuts it in half, it no longer puts pressure on the nerve in the hand and creates relief. The success rate is very high for surgery as long as this is the definitive source of the problem. This surgery only corrects carpal tunnel syndrome, and if pain is caused by other unknown source, relief will not be achieved this way.

Unfortunately, permanent relief usually requires surgery.

Avoiding CTS in the first place, or catching the symptoms early is key to relieving the pain and preventing progression. This is achieved by creating an ergonomic workplace. Start using a DVORAK or COLEMAK keyboard instead of the QWERTY system. This has shown in studies to prevent early symptoms from progressing. Take frequent breaks while working and schedule them according to how much pain you suffer. You can get computer programs that force you to take a break every few minutes for 30 seconds. This has been shown to be more beneficial than taking longer, less frequent breaks. Make sure your body is properly aligned with your keyboard and computer. Your keyboard should be the same height as your elbows.

The best thing to do is discuss any symptoms you are having with your doctor. They will best determine the course of action (if any) you need to take.