Carpal Tunnel Syndrome Treatment and Prevention

Carpal tunnel is a passageway, through which major nerve system of the forearm passes into the hand. Carpal tunnel syndrome is a painful disorder of the wrist that occurs from the compression of the median nerve at the wrist. It is caused by the continuous hard work using hand for long hours such as playing piano or guitar, computer keyboard typing, working in an assembly line or working in garment industry etc.

The carpal tunnel is composed of bone and ligament; the repeated movement thickens the lubricating membrane of the tendons and presses the nerves against the hard bone. Women are more susceptible to this disease because their carpal tunnel space is smaller than that of men. Statistics show that highest sufferers are women above 30 years of age, engaged in typing work, sewing work etc. and they are three times more likely than men to get this disorder.

The people who are working in manufacturing industry, engaged in works such as sewing, cleaning etc. are the common patients of carpal tunnel syndrome. Professionals like accountants, musicians, painters, writers, assembly line workers, drivers, carpenters and computer operators have high risk of the attack of this disease.

Risk factors also include certain medical conditions that you are already suffering. The risk factor is more in patients who have arthritis, diabetes, hypothyroidism, metabolic disorder, wrist fracture, tendon inflammation etc. Pregnant women have a chance to cause swelling in the area which may lead into carpal tunnel syndrome.

The repeated work for a long duration using the hand can be said as the general cause of this disease. Carpenters, typists, people working with electric drills or vibrating instruments, tennis or squash players and users of some musical instruments are using their hands continuously for completing their job and they are likely to develop this disease. Some diseases such as arthritis, hypothyroidism, diabetes and pregnancy can also be the cause of carpal tunnel syndrome

Symptoms usually take place near the palm of the hand. The thumb and the first three fingers of the hand, that is most used, will feel a burning sensation in addition to the tingling and numbness. This hand will show weakness while trying to pick up some objects. These symptoms will become more severe in early in the morning or at night. Sometime the patient may feel a sensation of swelling in the finger without any visible swelling.

This disease can be diagnosed after evaluating the physical symptoms and their history. For advanced diagnosis, neurological examinations and diagnostic tests are used. Following tests are used for the diagnosis of carpal tunnel syndrome:

• Neurological Examination – For testing the ability of the thumb to bend toward the palm and toward the other fingers.
• Nerve Condition Velocity (NCV) and Electromyography (EMG) – For testing the functionality of the nerve and the muscle.
• Differential Diagnosis – For getting details about the inflammation of the nerve roots and the compression of the median nerve outside carpal tunnel.

In some cases, the carpal tunnel syndrome will disappear without any treatment. But in most of the cases some kind of treatment is necessary; otherwise the initial discomforts such as the numbness and tingling can be developed into severe pain in the forearm or shoulder. By adopting nonsurgical and surgical treatments, about 90% of the carpal tunnel syndrome symptoms can be relieved.

• Giving rest to the wrist and avoiding further activity for some period is the first step to reduce the pain. Wearing splint as a part of the treatment is also helpful to relieve the symptoms. With the help of an occupational therapist, you can adopt improved modifications in your work site. By improving the body position and changing the position frequently, you can reduce the serious effect of the symptoms.
• Administration of nonsteroidal anti-inflammatory drugs (NSASIDs) such as aspirin and ibuprofen can reduce the pain and inflammation. Injection of cortisone, combined with lidocaine, will give long lasting relief from the pain.
• Surgery (carpal tunnel release) is the next option where other options are not successful. For getting complete recovery, three to twelve months are needed after the surgery. The complications associated with the surgery are infection, stiffness, swelling, incomplete release of the ligament, pain caused by the nerve damage etc.

In the beginning stage of the disease, many home remedial options are available for the cure of the disease. Following are some of the home remedial measures for carpal tunnel syndrome symptoms:

• Place ice on the affected wrist for 20 minutes to get temporarily relief.
• Keep your arms in a raised position by using pillows, while sleeping.
• Do stretching and strengthening exercises.
• Use a wrist splint.
• Using other helpful devices such as braces, wrist trolley, fingerless gloves, wristrests etc. may be helpful to get relief from the symptoms.
• Keep your hands and wrists in line with the forearms.
• Hold your elbows close to your sides.
• Do stretching exercises every 30 to 60 minutes.

• Physical Therapy: Motion exercises, stretching and ultrasound are included in physical therapy treatment.
• Using wrist splints continuously for a long time will have good effect.
• Acupuncture therapy is found to be effective in some cases.
• Yoga exercise which includes stretching exercises is effectual and it will give positive results.

If you have a job demanding continuous work using hands, you should be careful to take some preventive measures against the carpal tunnel syndrome attack that may happen in future. The people involved in jobs like working with vibrating instruments, driving, knitting, typing etc. are at risk of this disease. Following simple precautions can minimize the risk of affecting carpal tunnel syndrome:

• When you lift some object, do it with both hands.
• Take frequent breaks from the continuous activities and alternate with some other works.
• Do the typing job with soft touch and avoid pounding keys.
• When you are using a computer keyboard, make sure that the fingers are lower than your keyboard.
• While driving, do not use much pressure to hold the steering.
• If you feel pain in your wrist while working or playing, stop the work and give some rest to the wrist.
• Maintain a proper body posture, while doing a work which requires repetitive wrist movements.
• Do normal exercises for physical fitness, maintain healthy body weight, control or reduce other adverse health conditions such as diabetes, arthritis etc.
• Avoid smoking because this habit can cause constriction of the small blood vessels of the hand which can lead to more aggressive condition.

The National Institute of Neurological Disorder and Stroke (NINDS), a part of the National Institute of Health is a leading supporter of the research activities related to carpal tunnel syndrome. Researchers are studying the possibilities to find the ways to limit or prevent this disease in the work place. Scientists are also investigating the effects of acupuncture on pain and the changes in the brain that is associated with the carpal tunnel syndrome.