Carpal Tunnel Syndrome

By Spencer Schreckengaust
Categories: , , ,

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CARPAL TUNNEL SYNDROME (CTS)

Carpal tunnel syndrome (CTS) is the most common of all , nerve compression conditions as it will affect 1 out of every 10 persons. Repetitive activity of various kinds can result in CTS as the median nerve becomes squeezed in a small anatomical space at the wrist called the carpal tunnel. This median nerve compression can cause numbness, tingling, or a burning sensation at the thumb, index, third and ring fingers. With further irritation, the median nerve becomes more swollen and can actually cause more symptoms stemming from that entrapped nerve. These symptoms are usually worse in the morning. If these symptoms go unchecked, the muscles associated with the median nerve of the effected hand can become weak and decrease the ability to grip, grasp and perform hand functions with a high degree of dexterity.

While studies show computer use does not automatically increase the risk for CTS, there is a trend for increased CTS with frequent computer use, frequent mouse use and longer duration of computer use.  More importantly, activities with exposure to high levels of hand forces and a higher frequency of gripping more likely can increase the risk of CTS. This condition is more common in women, assembly-line workers, individuals with diabetes, and those who have experienced injury to the wrist.

Conservative treatment options include:

  1. Decrease the amount of repetitive activity and allow for more frequent rest breaks.
  2. Decrease the frequency and intensity of forceful hand activities
  3. Alternate methods with computer use such as arrow keys, touch screens, alternating the mouse hands, different keyboards with lower strike force
  4. Use of a neutral-positioned wrist splint worn at night and possibly during the day if symptomatic.
  5. Use of superficial or moist heat for symptom relief.
  6. Participation in formal physical therapy or occupational therapy.
  7. Stretching exercises.

Further medical intervention:

If symptoms persist, please consult your physician as your health care professional might consider further diagnostic testing, medications and possible injections.

https://www.medbridgeeducation.com/patient-education-library/condition/97-Carpal-Tunnel-Syndrome

Aroori S, Spence RA. Carpal tunnel syndrome. Ulster Med J 2008;77:6–17.

Keith MW, Masear V, Chung K, et al. Diagnosis of carpal tunnel syndrome. J Am Acad Orthop Surg 2009;17:389.

Padua L, Coraci D, Erra C, et al. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol 2016;15:1273–84.

Atroshi I, Gummesson C, Johnsson R, et al. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999;282:153–8.

Benstead TJ, Sangalang VE, Dyck PJ. Acute endothelial swelling is induced in endoneurial microvessels by ischemia. J Neurol Sci 1990;99:37–49.

Rydevik B, Lundborg G. Permeability of intraneural microvessels and perineurium following acute, graded experimental nerve compression. Scand J Plast Reconstr Surg 1977;11:179–87.

Karadağ YS, Karadağ Ö, Çiçekli E, et al. Severity of Carpal tunnel syndrome assessed with high frequency ultrasonography. Rheumatol Int 2010;30:761–5. 

Erickson M et al. Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome. Clinical Practice Guidelines Linked to the international Classification of Functioning, Disability and Health From the Academy of Hand and Upper Extremity Physical Therapy and the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys. Ther. 2019 ; 49(5): CPG1-CPG85.

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