You first notice your fingers have a sensation as if they are “falling asleep” and then at night they become numb. When you wake in the morning, they are tingling and numb, and maybe there’s a burning pain and a numb feeling running up the middle of your forearm -- sometimes as far up as your shoulder. At first you think you might have slept on your arm and you try not to worry too much. But the symptoms start developing during the day and now you’re wondering – could this be arthritis?
The answer is -- NO. All these symptoms indicate you have Carpel tunnel syndrome (CTS). CTS is a chronic irritation that occurs when the median nerve in the arm becomes compressed and pushes against the ligament above it. When it’s constantly constricted it can deteriorate. This results in a marked slowing of nerve impulses, which can cause loss of feeling in the fingers and a loss of strength and coordination at the base of the thumb.
If the condition is not treated, it could result in permanent deterioration of muscle tissue and function.
You can try to figure out what may have caused CTS, but medical experts say the majority of cases have no known cause. However they are sure about this: excessive repetitive movements of the arms, wrists, or hands aggravate the structures of the carpal tunnel, triggering the symptoms of carpal tunnel syndrome. Think of how many hours you spend tapping at the computer keyboard, or working a particular tool, or knitting. Indeed, these kinds of repetitive actions could be triggering the symptoms. Untreated, CTS can become chronic.
But there is good news. When diagnosed early it can be treated easily and recovery is possible in a few months. Severe carpal tunnel syndrome can also be treated, but recovery may take up to a year or longer -- and the recovery many not be complete.
Evidence shows that people with diabetes, rheumatoid arthritis, or metabolic condition like thyroid disease may develop carpel tunnel syndrome more often. The reason? All three conditions directly affect nerves – and make them more sensitive to repetition or compression.
How can you be sure you have carpel tunnel syndrome? There are two very simple diagnostic tests you can do yourself:
Tinel Maneuver: Turn the palm side of the wrist. If you feel tingling sensations than the test is positive.
Phalen Maneuver: Flex your wrist. Again, if you feel tingling than you have CTS.
When the condition has advanced or the diagnostic test is inconclusive, an electromyogram and nerve conduction studies may be done in order to measure the extent your nerves are damaged. Electromyogram is a test that measures the electrical activity in your nerves and muscles. Nerve conduction studies measure the ability of specific nerves to transmit electrical impulses or messages.
However, even if these tests are negative, it doesn’t mean you don’t have carpel tunnel syndrome. Sometimes sufferers need to have significant nerve damage before their condition will be recorded.
If you have Carpal Tunnel Syndrome, how can you be helped?
Change the motion. The first and easiest and most effective treatment is to change the frequency of your repetitive motion. Not only is it suggested you do it less often, but that you take longer rest periods between each motion.
Immobilize. Splints that support the wrist in a comfortable neutral position work well when worn at night. Splints can relieve pain, numbness or tingling. They can also be worn throughout the day to minimize or prevent pressure on the nerves.
Pharmaceuticals. A short course of an anti-inflammatory drug or injections of steroids in the wrist will reduce swelling.
Surgery. Your doctor might suggest surgery if your condition hasn’t responded to any of the other treatments. Surgeons open the carpal tunnel, cut the ligament, and relieve the pain and pressure. It’s proven to be successful, but like any surgery, it should be the last resort. Caveat: If you have other stress injuries from repetitive movement the surgery will not be successful. Also, recovery from the surgery takes time and usually limits a patient’s ability to get back to work – especially if the employment means they will resume the repetitive movement.
HOW TO PREVENT CTS
While working use correct position of your hands and wrists. Ask your doctor to demonstrate it for you.
Avoid repetitively flexing and extending your wrists.
Try to sleep with your wrists straight. If you can’t do that, use a splint.
Do plenty of conditioning and stretching exercises (have your doctor demonstrate) while at work – and don’t forget to rest between movements.
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