Fatigue, Pain, Tingling, Weakness of Grip, Loss of Dexterity, Stiffness,
Cramping, Numbness, Cold, Burning. They may often occur during or after
periods of rest or sleep. In advanced cases, you may feel pain or cramping
around the base of the thumb or your thumb may become nonfunctional.
These
symptoms often characterize the common disorder. By the time you feel any of
them in your hand, wrist or arm, cell degeneration is in process and should be
taken seriously. It often progresses rapidly if ignored and doesn't take years
to develop as many think. Often, just a few mild instances suddenly never go
away or are brought on by ever decreasing effort.
 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 a minute or after any symptoms
occur.
How Does It Happen?
As shown, the Carpal Tunnel (pink area) is made up of several bones (white)
connected by ligaments. The largest of which is the Transverse Carpal Ligament
(blue). These structures form the perimeter of a passage through its center
called the carpal tunnel (also called the carpal canal). Through this tunnel run
nerves, tendons, blood and other soft tissues. For a variety of reasons some of
these soft tissues swell, especially the tendons (red) and the protective
sheaths that cover them. Overuse (Repetitive Strain Injury or RSI), injuries
such as sprains, friction between the tendons and their protective sheaths,
fractures, fluid retention, forceful movements and infection are a few of the
more common causes. However, unlike most of your body where swelling simply
protrudes, this swelling has no place to expand since it is encircled by bones
and ligaments. Consequently, because the swelling is contained, pressure builds
in the tunnel. This pressure then crushes the main nerve to your hand called the
Median Nerve (yellow), causing it not to function properly. The pressure also
obstructs blood flow which retards healing and causes further cell degeneration
until the cycle spirals out of control. The results are the symptoms listed
above and most victims are amazed by the swiftness mild symptoms can progress
into a major problem. For more information, click
here
for the NIOSH CTS page or
here
for our "What is CTS and RSI?" page.
What Can Be Done?
The most common first aid is to treat the cause of the swelling with drugs.
By trying to reduce the swelling, the pressure is decreased and if the median
nerve is not damaged, it's function can be restored. However, many times the
tissues are so enlarged that drugs can't reduce their size. Another approach is
to use braces. Braces keep the hand in a position that prevents the wearer from
causing even more damage due to bending or twisting at the wrist with the hopes
that the pressure will subside in time. Braces are often used in conjunction
with drug therapies. In addition, changing the way you use your hands can be
beneficial. See our
Ergonomic
Tips page for suggestions. Just minor changes such as lowering your keyboard
height can significantly raise the threshold of effort needed to make the
symptoms arise. For more information regarding proper work area layout,
click
here.
In very advanced cases, a procedure called a Carpal Tunnel Release Operation
is performed. It involves cutting the Transverse Carpal Ligament and letting it
heal back together. This gives more room for the soft tissues and therefore
lowers the pressure.
Surgery
is expensive, usually requires many weeks to recover, and is far from being a
guaranteed cure. However, there is another approach. Even though the transverse
carpal ligament doesn't automatically stretch to accommodate swelling, it can be
stretched externally. This technique can be used a preventative method, as well
as, a way to help relieve symptoms before they spiral out of control. Visit our
Home Page for how this is
done.
Glossary of Terms
- Median Nerve
- a major nerve to the hand that controls the thumb, index
and middle fingers
- Carpal Tunnel
- a passage in the wrist through which the median nerve and
tendons travel to the hand, much of it located at the base of the palm
- Transverse Carpal Ligament
- a tough but elastic structure which holds the bones of the
Carpal Tunnel together, often surgically cut to relieve pressure on the median
nerve
- Repetitive Strain Injuries
(RSI), Cumulative Trauma Disorder (CTD), Repetitive Motion Syndrome (RMS),
Occupational Overuse Syndrome (OOS)
- synonymous terms for disorders caused by prolonged,
repetitious tasks
- Carpal Tunnel Syndrome
(CTS)
- pressure (or compression) on the median nerve that may
cause pain, numbness, weakness, etc.
- Tendonitis
- inflammation of a tendon, the structures that link muscles
to bones
- Tenosynovitis
- inflammation of a tendon's sheath which causes it to swell
and may also retard proper lubrication of the tendon inducing more injury
- Carpal Canal
- sometimes used interchangeably with Carpal Tunnel
- Ulnar Nerve
- another main nerve to the hand which controls the last two
fingers, it passes outside the carpal tunnel but can be affected by tennis elbow
or displacement
Brought to you by the makers of
Click Here for the "Hand Problems Discussion Group"
The
Stretch-assager Home Page
|
What happens?