Carpal Tunnel Syndrome

What Is Carpal Tunnel Syndrome?

At the base of the palm is a tight canal or “tunnel” through which tendons and nerves must pass on their way from the forearm to the hand and fingers. The nerve that passes through this narrow tunnel to reach the hand is called the Median Nerve. This narrow passage between the forearm and hand is what we call “The Carpal Tunnel”.

The Carpal Tunnel is normally quite snug and there is just barely enough room in it for the tendons and nerves that have to pass through it. If anything takes up extra room in the canal, things become too tight and the nerve in the canal becomes constricted or “pinched”. This pinching of the nerve causes numbness and tingling in the area of the hand that the nerve travels to. The condition that results when the Median Nerve is being pinched in The Carpal Tunnel is commonly referred to as Carpal Tunnel Syndrome or “CTS”.

Symptoms
- Painful tingling or numbness in hand during the night, that is sometimes painful enough to disturb sleep.
- The feeling of swollen fingers when they are not.
- Tingling may develop during the day in the thumb, index, and ring fingers.
- Decreased ability to squeeze things.
- Some people with Carpal Tunnel Syndrome are unable to differentiate hot from cold by touch with their fingers.
- Have trouble tying their shoes or picking up small objects.
- Sometimes you feel a pain that goes up the arm to as high as the shoulder.
- Your doctor may also ask you to wear a splint on your wrist.


A common test for CTS is Phalen's Maneuver.
Put the backs of your hands together while keeping your arms parallel to the floor and your fingers pointing down. Hold your hands together firmly. If within a minute, you experience one, or a combination, of the symptoms, you probably have the disorder. Don't hold this position for more than the required minute.



Treatment
- Prop up your arm with pillows when you lie down.
- Avoid using your hand too much.
- Find a new way to use your hand by using a different tool.
- Try to use the other hand more often.
- Avoid bending your wrists down for long periods.
- Surgery is a last resort.

Prevention

- Maintain an average weight.
- Try not to bend, extend or twist your hands continually for long periods.
- Don't work with your arms too close or too far from your body.
- Don't rest your wrists on hard surfaces for long periods.
- Switch hands during work tasks.
- Make sure your tools aren't too big for your hands.
- Take regular breaks from repeated hand movements to give your hands and wrists time to rest.
- Don't sit or stand in the same position all day.
- If you use a keyboard a lot, adjust the height of your chair so that your forearms are level with your keyboard and you don't have to flex your wrists to type.