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Carpal Tunnel Syndrome

February 26, 2010


What is carpal tunnel syndrome?
How does it occur?
What are the symptoms?
How is it diagnosed?
How is it treated?
How long will the effects last?
How can I take care of myself?
When can I return to my sport or activity?

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What is carpal tunnel syndrome?
Carpal tunnel syndrome is a common, painful disorder of the wrist and hand.

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How does it occur?
Carpal tunnel syndrome is caused by pressure on the median nerve in your wrist. People who use their hands and wrists repeatedly in the same way (for example, illustrators, carpenters, and assembly-line workers) tend to develop carpal tunnel syndrome. Pressure on the nerve may also be caused by a fracture or other injury, which may cause inflammation and swelling. In addition, pressure may be caused by inflammation and swelling associated with arthritis, diabetes, and hypothyroidism. Carpal tunnel syndrome can also occur during pregnancy.

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What are the symptoms?
The symptoms include:
– Pain, numbness, or tingling in your hand and wrist, especially in the thumb
and index and middle fingers: pain my radiate up into the forearm
– Increased pain with increased use of your hand, such as when you are driving
or reading the newspaper
– Increased pain at night
– Weak grip and tendency to drop objects held in the hand
– Sensitivity to cold
– Muscle deterioration especially in the thumb (in later stages).

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How is it diagnosed?
Your doctor will review your symptoms, examine you, and discuss the ways you use your hands. He or she may also do the following test:
– The doctor may tap the inside middle of your wrist over the median nerve.
You may feel pain or a sensation like an electric shock.
– You may be asked to bend your wrist down for one minute to see if this cause
symptoms
– The doctor may arrange to test the response of your nerves and muscles to
electrical stimulation

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How is it treated?
If you have a disease that is causing carpal tunnel syndrome (such as rheumatoid arthritis), treatment of the disease may relieve your symptoms. Other treatment focuses on relieving irritation and pressure on the nerve in your doctor may suggest:
– Restricting use of your hand or changing the way you use it
– Wearing a wrist splint during sleep and physical activity involving the wrist
– Exercises
Your doctor may prescribe a cortisonelike medicine or a nonsteroidal anti- inflammatory medicine, such as ibuprofen. Your doctor may recommend an injection of a coritsonelike medicine into the carpal tunnel area. In some cases surgery may be necessary.

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How long will the effects last?
How long the symptoms of carpal tunnel syndrome last depends on the cause and your response to treatment. Sometimes the symptoms disappear without any treatment. Sometimes the symptoms disappear without any treatment, or they may be relieved by nonsurgical treatment. Surgery may be necessary to relieve the symptoms if they do not respond to treatment or they get worse. Surgery usually relieves the symptoms, especially if there is no permanent damage to the nerve. Symptoms of carpal tunnel syndrome that occur during pregnancy usually disappear following delivery.

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How can I take care of myself?
Follow your doctors recommendations. Also try the following:
– Elevate your are with pillows when your lie down
– Avoid activities that overuse your hand
– Find a different way to use your hand by using another tool or try to use
the other hand
– Avoid bending your wrists down for long periods.

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When can I return to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport will be determined by how soon your wrist recovers, not by how many days or week it has been since your injury occurred. In general, the longer it will take to get better. You may return to your sport or activity when you are able to painlessly grip objects like a tennis racquet, bat, golf club, or bicycle handlebars. In sports such as gymnastics, it is important that you can bear weight on your wrist without pain. You must have full range of motion and strength of your wrist.
What can I do help prevent carpal tunnel syndrome?
If you do very repetitive work with your hands, make sure that your hands and wrists are comfortable when you are using them. Take regular breaks from the repetitive motion. Avoid resting your wrists on hard or ridged surfaces for prolonged periods. If you have a disease that is associated with carpal tunnel syndrome, effective treatment of the disease might help prevent this condition. In some cases is known and carpal tunnel syndrome cannot be prevented.

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