|About Carpal Tunnel
Excessive repetitive movements of the arms, wrists or hands can cause injuries that could become chronic conditions. When detected early enough, however, hand and wrist injuries can be treated, and recovery is possible in a few months. Severe hand injuries can also be treated, but recovery may take up to a year or longer.
The carpal tunnel is the passageway in the hand made up of the arching carpal bones (eight bones in the wrist) and the ligament connecting the pillars of the arch. The median nerve and the tendons that connect the fingers to the muscles of the forearm pass through the tightly spaced tunnel. Carpal tunnel syndrome occurs when the median nerve, which relays sensation from the palm of the hand and fingers, becomes pinched, usually by swelling of the tendons. This leads to numbness and sometimes pain of the fingers, hand and sometimes the forearm.
What are the symptoms of carpal tunnel syndrome?
What happens in severe cases of carpal tunnel syndrome?
Do certain medical conditions make people more likely to develop
carpal tunnel syndrome?
What tests can help diagnose carpal tunnel syndrome?
The nerve conduction studies, however, will not become positive until there is significant nerve damage (degeneration). In addition, the severity of a person's symptoms are often not correlated with the findings of a nerve conduction study.
Two other useful tests for diagnosing carpal tunnel syndrome are the Tinel and Phalen maneuvers. Tingling sensations in the fingers caused by tapping on the palm side of the wrist is a positive Tinel test, whereas reproduction of symptoms by flexing the wrist is a positive Phalen test. Dr. Phalen created this maneuver many years ago when he was a hand surgeon at the Cleveland Clinic.
How is carpal tunnel syndrome treated?
Patients may be given short courses of anti-inflammatory drugs or injections of cortisone or steroids in their wrist to reduce swelling. Injections provide temporary relief and are best reserved for people who have carpal tunnel syndrome as a result of an acute (sharp or severe) flare-up of tenosynovitis (an inflammation of the sheath around the tendon). Injections also are used to treat people who have an inflammatory disease, such as rheumatoid arthritis.
If carpal tunnel syndrome does not respond to conservative treatment, then surgery is the next treatment option. During surgery, your surgeon will open the carpal tunnel and cut the ligament at the bottom of the wrist, relieving the pressure.
Carpal tunnel surgery is quite effective when the condition involves only nerve constriction. Relief of painful symptoms is excellent and nerve degeneration is almost always reversible.
When carpal tunnel syndrome is just one manifestation of cumulative trauma disorder (repetitive stress), the results of surgery are not always so good. The difficulty is not in recovering from the operation, but in recovering the ability to return to work, especially to the same job that caused the repetitive disorder to occur. Whether or not true carpal tunnel symptoms recur in these patients, many continue to have pain and are unable to use their hands to any great extent.
What can I do to prevent carpal tunnel?
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