Carpal Tunnel Syndrome:

A few years back I started to feel some weakness in my right arm after working for extended periods of time. I had heard of carpal tunnel syndrome (CTS) but at 30 I didn't think I would get it. I worked out regularly, played tennis, and didn't have the numbness I had heard was associated with the problem. For years I had been a data entry specialist but that was years ago and now I was doing mostly website design with lots of "cutting, pasting, and dragging" with the computer mouse. The pain I felt was not even in my hand or wrist initially, it was in my upper arm. It just felt sore all the time. I ignored it for a while and because I am naturally left handed it didn't effect most of the things that I do on a daily basis besides the work related things. Once I started feeling the numbness in my hand while working I got more serious and looked into how to treat the onset of carpal tunnel syndrome. There are stretches and exercises you can do to alleviate some of the pain and help with the potential numbness.

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At some point, about 10% of the population will have CTS and the average age is about 40 when people start noticing the symptoms. Carpal tunnel syndrome became prevalent in the United States back in the 1990's when more people moved from production line jobs to office jobs. Although experts say that the condition is not necessarily due to repetitive movements like using a computer mouse or keyboard, I beg to differ. Most office jobs require typing and now almost all require using a computer mouse. My condition is directly related to using the computer mouse for extended periods of time. All the other activities that I do on a daily basis never effect my CTS. Only after using the mouse for hours at a time do I feel the weakness in my wrist and hand. The real problem with the condition is that if your job requires you to do repetitive motions, especially those on a computer or a production line using vibrating equipment, it's not like you can tell your boss that you need to stop working for 2 hours to alleviate your symptoms. More and more employees are losing time at the office or factory due to this injury and workmans compensation insurance is only picking up part of the bill. Perhaps there will be a test that we can all take someday to let us know if we are predisposed to a condition like CTS so we can get jobs that won't effect us so much.

Causes and Symptoms:

The median nerve, which goes from the forearm into the hand, gets compressed at the wrist due to the carpal tunnel (ligaments and bones) swelling up and thickening to the point that is squeezes the median nerve. There are 9 tendons that pass through the canal as well. The nerve, over time, can get more and more damaged leaving the person with nighttime numbness or a loss of feeling in the fingers and hand. I knew I was in trouble when I would wake up at night with both my hands completely numb. It took a few seconds to stretch them out and get feeling back. Most people assume that carpal tunnel is brought on by repetitive movements and motions by the hands or wrists. You often hear of clerks at grocery stores that work at cash registers getting this type of injury. Experts say that is not always the case as carpal tunnel syndrome is probably a congenital predisposition. The carpal tunnel is smaller in some people than others making them more likely to get the injury over time as their is less room for the inflamed ligaments and tendons to compress around the median nerve (women are 3 times more likely to get this condition). My doctor noted that I have very small wrists for a man and that could have been a precursor for me getting CTS. Not everyone who types all day or uses a cash register gets this condition. Other things like wrists sprains or fractures can cause the swelling involved in carpal tunnel syndrome. It's important to get treated for CTS as soon as possible. The numbness and tingling in your hands and fingers will most likely get worse over time and you don't want to do irrepairable damage. You may even notice that when you go to shake someones hand you lack the strength to do basic things like that. I noticed I had very little strength in my right arm to raise a weight from my waist up to eye level.

Diagnosis and Treatments:

Your doctor can get your medical history and give you a better idea of causes related to your condition. A Tinel test or Phalen test are just 2 examples of ways for doctors to initially diagnose the condition. The Phalen maneuver involves flexing your wrist as fas as you can and holding the position. This type of stretch will induce CTS symptoms in those that have it already, usually within 60 seconds. The Tinel's test is less accurate, but still performed on patients by tapping the area directly over the nerve in your wrist to see if the doctor can get a tingling sensation to show that the nerve is damaged. Other diagnosis tests involve ultrasound imaging and electrodiagnostic tests. Treatment starts by resting your hands and wrists for 2 weeks, often wearing immobilizing wrist splints and in some cases casts. For those with severe inflammation around the wrist, experts recommend using cold packs to reduce swelling. Drugs, such as anti-inflammatory ones are often prescribed as well. You can take aspirin, ibuprofen or other pain relievers to help the symptoms. Once the 2 week period is up hopefully some of your symptoms have gone away (at least temporarily) and you can begin doing some exercises with a physical therapist. Gentle stretching or even strengthening exercises are what the therapist will help you with. We have heard that certain yoga exercises are beneficial as well. If your symptoms persist beyond th 6 month range, then surgery is an option. There are generally 2 types of Carpal tunnel surgery - open release and endoscopic. Open release surgey calls for the cutting of the carpal ligament so there is more room in the carpal tunnel and supposedly less potential for swelling and squeezing on the median nerve. It's done under local anesthesia and it's an outpatient procedure with no overnight stay required. The endoscopic surgery is certainly less invasive than open release and the recovery is often faster. The same carpal ligament is cut but this time the incisions are smaller and the scarring is minimal in the wrist area. The good news is that if you decide on the surgery, the chance of getting CTS again is highly unlikely. There are some post-operation physical therapy exercises to do, but the symptoms should be gone.

Products:

A whole list of products have been developed to help those with carpal tunnel syndrome. The wrist splints that immobilize the hands and wrists are perhaps the most popular I've seen. When I go to my local Safeway grocery store I see some of the check-out clerks wearing them as they run their registers. I started wearing wrist wraps while working at my computer and they do seem to make things feel better at the time of working, but I still have issues at night while sleeping and periodic weakness in my arm. I have chosen to not get the surgery as of now. My physical therapy at the gym strengthens my right arm and the stretching exercises I do throughout the day seem to be working to at least keep the condition in check. Painreliever.com carries some of the wrist splints and the Pro-Tec Wrist Wrap ($12) that I wear while working on the computer. With carpal tunnel surgery ranging from $5000 to $10000, these products seem cheap.

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