Carpal Tunnel Syndrome
- Numbness or tingling in your hands (especially at night)?
- Shooting pains in the forearm and wrist?
- Clumsiness in handling objects?
These may be symptoms of carpal tunnel syndrome. Carpal tunnel syndrome is the result of compression of the forearm’s median nerve. This nerve travels through a “tunnel” in your wrist. If part of this tunnel becomes swollen for some reason, the nerve can become cramped and pressured.
Some common causes of carpal tunnel syndrome are repetitive and forceful grasping with the hands. This can occur with tennis, golf and/or occupations such as mechanics, electricians, packers and frequent computer users. Repetitive bending and grasping of the wrist can also cause carpal tunnel (which often occurs in occupations involving a lot of computer use). A broken wrist bone can also cause the condition, as can arthritis, pregnancy, diabetes, thyroid disease and hormonal changes. Frequently, however, the exact cause is unknown.
Diagnosis & Treatment
After a thorough evaluation, which may include nerve studies (EMG/electromyogram), mild cases of carpal tunnel syndrome are treated nonsurgically. This is often with a brace or splint on your wrist and forearm to keep your wrist from bending, a nonsteroidal anti-inflammatory medication to reduce the swelling, physical therapy, and periods of activity restriction. Occasionally, severe cases may warrant a cortisone injection. These nonsurgical treatments work best when the condition is treated early by an orthopedic surgeon.
Surgery is sometimes necessary to relieve carpal tunnel syndrome. This so-called “release” procedure involves cutting the transverse ligament that forms the roof of the carpal tunnel to relieve the pressure on the nerve. After surgery, your symptoms may be relieved immediately or in a short period of time, though it may take weeks of rehabilitation to establish normal use of the arm, wrist and hand. Researchers are also evaluating the use of multiple ultrasound wave treatments as an alternative to surgery in severe cases, but results are not encouraging.
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