Carpal Tunnel Syndrome
Introduction:
Carpal tunnel syndrome (CTS) is an injury caused by a pinched nerve in the wrist. The injury causes pain and numbness in the index and middle fingers and weakness of the thumb. Carpal tunnel receives its name from the eight bones in the wrist, called carpals, which form a "tunnel" through which the nerve leading to the hand extends.
Signs and Symptoms:Signs and symptoms of CTS include:
The carpal tunnel is filled with tendons (bundles of collagen fibers that attach muscle to bone) that control finger movement. Tasks requiring highly repetitive and forceful movements of the wrist can cause swelling around the tendons, resulting in a pinched nerve and producing CTS.
Who's Most At Risk?:
People working with small hand tools in manufacturing and those using a computer keyboard on a regular basis are especially at risk.
Women are 2 - 5 times more likely than men to develop CTS. It most commonly occurs in people ages 30 -60. CTS is associated with health conditions, such as Lyme disease, hypothyroidism, rubella, pregnancy, obesity, and menopause. High caffeine, tobacco, or alcohol intake are contributing risk factors.
What to Expect at Your Provider's Office:
If you have symptoms of CTS, you should see your health care provider. Your health care provider can help you determine which treatment or combination of therapies will work best for you.
Your health care provider will perform a physical examination and some simple tests to determine if there is a loss of sensation or some weakness in your thumb or fingers. Your health care provider may also perform more sophisticated diagnostic procedures ranging from a nerve conduction study to electromyography (EMG). X-rays or magnetic resonance imaging (MRI) may be used to reveal the cause and the nature of the injury.
Prevention:
You can help prevent CTS or alleviate symptoms by making some simple changes in your work and leisure habits, such as:
Physical Medicine:
Contrast hydrotherapy -- alternating hot and cold water applications -- may offer relief from CTS symptoms. This approach decreases inflammation, offers pain relief, and enhances healing. Immerse your wrists fully in hot water for 3 minutes, followed by 1 minute in cold water, and repeat three times. Do this 2 - 3 times daily.
Castor Oil Packs -- Apply castor oil to a cloth, loosely wrap around wrist, and then cover with Saran Wrap. Apply a heating pad for 1 hour, or without using a heating pad, sleep with the application on the wrist. Do this for 4 - 5 nights per week until improvement occurs.
Acupuncture:
According to the National Institutes of Health, acupuncture may help treat CTS. Studies suggest that acupuncture restores normal nerve function and can provide long term relief of pain associated with CTS. Acupuncturists treat people with CTS based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of CTS, acupuncturists will often target the liver, gallbladder, and kidney meridians.
Chiropractic:
CTS is commonly treated by chiropractors. The methods most chiropractors use to treat CTS include manipulation of the wrist, elbow, and upper spine, ultrasound therapy, and wrist supports. Two studies support the use of chiropractic treatment for CTS.
In the first study, 25 individuals diagnosed with CTS reported significant improvements in several measures of strength, range of motion, and pain after receiving chiropractic treatment. Most of these improvements were maintained for at least 6 months.
A second study compared the effects of chiropractic care with conservative medical care (wrist supports and ibuprofen) among 91 people with CTS. Both groups experienced significant improvement in nerve function, finger sensation, and comfort. The researchers concluded that chiropractic treatment and conservative medical care are equally effective for people with CTS.
Massage:
Massage may help prevent or relieve symptoms, especially in combination with rosemary or St. John's wort oil.
Carpal tunnel syndrome (CTS) is an injury caused by a pinched nerve in the wrist. The injury causes pain and numbness in the index and middle fingers and weakness of the thumb. Carpal tunnel receives its name from the eight bones in the wrist, called carpals, which form a "tunnel" through which the nerve leading to the hand extends.
Signs and Symptoms:Signs and symptoms of CTS include:
- Nighttime painful tingling in one or both hands, frequently causing sleep disturbance
- Feeling of uselessness in the fingers
- A sense that fingers are swollen even though little or no swelling is apparent
- Daytime tingling in the hands, followed by a decreased ability to squeeze things
- Loss of strength in the muscle at the base of the thumb, near the palm
- Pain shooting from the hand up the arm as far as the shoulder
The carpal tunnel is filled with tendons (bundles of collagen fibers that attach muscle to bone) that control finger movement. Tasks requiring highly repetitive and forceful movements of the wrist can cause swelling around the tendons, resulting in a pinched nerve and producing CTS.
Who's Most At Risk?:
People working with small hand tools in manufacturing and those using a computer keyboard on a regular basis are especially at risk.
Women are 2 - 5 times more likely than men to develop CTS. It most commonly occurs in people ages 30 -60. CTS is associated with health conditions, such as Lyme disease, hypothyroidism, rubella, pregnancy, obesity, and menopause. High caffeine, tobacco, or alcohol intake are contributing risk factors.
What to Expect at Your Provider's Office:
If you have symptoms of CTS, you should see your health care provider. Your health care provider can help you determine which treatment or combination of therapies will work best for you.
Your health care provider will perform a physical examination and some simple tests to determine if there is a loss of sensation or some weakness in your thumb or fingers. Your health care provider may also perform more sophisticated diagnostic procedures ranging from a nerve conduction study to electromyography (EMG). X-rays or magnetic resonance imaging (MRI) may be used to reveal the cause and the nature of the injury.
Prevention:
You can help prevent CTS or alleviate symptoms by making some simple changes in your work and leisure habits, such as:
- Stretch or flex your arms and fingers before beginning work and at frequent intervals.
- Alternate tasks to reduce the amount of repetitive movements.
- Modify or change daily activities that put pressure on your wrists.
- Modify your work environment. If you use a computer, have an adjustable keyboard table and chair, and a wrist rest.
Physical Medicine:
Contrast hydrotherapy -- alternating hot and cold water applications -- may offer relief from CTS symptoms. This approach decreases inflammation, offers pain relief, and enhances healing. Immerse your wrists fully in hot water for 3 minutes, followed by 1 minute in cold water, and repeat three times. Do this 2 - 3 times daily.
Castor Oil Packs -- Apply castor oil to a cloth, loosely wrap around wrist, and then cover with Saran Wrap. Apply a heating pad for 1 hour, or without using a heating pad, sleep with the application on the wrist. Do this for 4 - 5 nights per week until improvement occurs.
Acupuncture:
According to the National Institutes of Health, acupuncture may help treat CTS. Studies suggest that acupuncture restores normal nerve function and can provide long term relief of pain associated with CTS. Acupuncturists treat people with CTS based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of CTS, acupuncturists will often target the liver, gallbladder, and kidney meridians.
Chiropractic:
CTS is commonly treated by chiropractors. The methods most chiropractors use to treat CTS include manipulation of the wrist, elbow, and upper spine, ultrasound therapy, and wrist supports. Two studies support the use of chiropractic treatment for CTS.
In the first study, 25 individuals diagnosed with CTS reported significant improvements in several measures of strength, range of motion, and pain after receiving chiropractic treatment. Most of these improvements were maintained for at least 6 months.
A second study compared the effects of chiropractic care with conservative medical care (wrist supports and ibuprofen) among 91 people with CTS. Both groups experienced significant improvement in nerve function, finger sensation, and comfort. The researchers concluded that chiropractic treatment and conservative medical care are equally effective for people with CTS.
Massage:
Massage may help prevent or relieve symptoms, especially in combination with rosemary or St. John's wort oil.
