Preventing Carpal Tunnel Syndrome

What is carpal tunnel syndrome?

Carpal tunnel syndrome is pain, tingling, and other problems in your hand because of pressure on the median nerve in your wrist.

The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel. The median nerve controls movement and feeling  in your thumb and first three fingers (not your little finger).

What causes carpal tunnel syndrome?

Pressure on the median nerve causes carpal tunnel syndrome. This pressure can come from swelling or anything that makes the carpal tunnel smaller. Things that can lead to carpal tunnel syndrome include:

• Illnesses such as hypothyroidism, rheumatoid arthritis, and diabetes.
• Pregnancy.
• Obesity.
• Making the same hand movements over and over, especially if the wrist is bent down (your hands lower than your wrists), or making the same wrist movements over and over.
• Wrist injuries and bone spurs.
• Smoking, because it can reduce blood flow to the median nerve.

What are the symptoms?

Carpal tunnel syndrome can cause tingling, numbness, weakness, or pain in the fingers or hand. Some people may have pain in their arm between their hand and their elbow.

Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little finger.

You may first notice symptoms at night. You may be able to get relief by shaking your hand.

How is carpal tunnel syndrome diagnosed?

Your doctor will do a physical exam and ask about your health and activities. You also may have some tests.

Your doctor will ask if you have any health problems-such as arthritis,hypothyroidism, or diabetes-or if you are pregnant. He or she will ask if you recently hurt your wrist, arm, or neck. Your doctor will want to know about your daily routine and any recent activities that could have hurt your wrist.

During the exam, your doctor will check the feeling, strength, and appearance of your neck, shoulders, arms, wrists, and hands.

Your doctor may suggest tests, such as:

• Blood tests to see if any health problems might be causing your symptoms.
• Nerve testing to find out if the median nerve is working as it should.

How is it treated?

Mild symptoms usually can be treated with home care. The sooner you start treatment, the better your chances of stopping symptoms and preventing long-term damage to the nerve.

You can do a few things at home to help your hand and wrist feel better:

• Stop activities that cause numbness and pain. Rest your wrist longer between activities.
• Ice your wrist for 10 to 15 minutes 1 or 2 times an hour. Try taking nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce swelling.
• Wear a wrist splint at night to keep your wrist in a neutral position. This takes pressure off your median nerve. Your wrist is in a neutral position when it is straight or only slightly bent. Holding a glass of water is an example of your wrist in a neutral position.
• See your doctor if your symptoms do not get better after 1 to 2 weeks of home care, or if you have had bad symptoms from the start. You may need medicine for carpal tunnel syndrome or for a health problem that made you likely to get carpal tunnel syndrome.
  Surgery is an option. But it's usually used only when symptoms are so bad that you can't work or do other things even after several weeks to months of other treatment.
  During surgery, the doctor cuts the ligament at the top of the carpal tunnel. This makes more room in the tunnel and relieves pressure on the nerve. Surgery usually works to ease symptoms. But in some cases it does not completely get rid of numbness or pain.

  How can you keep carpal tunnel syndrome from coming back?

  To keep carpal tunnel syndrome from coming back, take care of your basic health. Stay at a healthy weight. Don't smoke. Exercise to stay strong and flexible. If you have a long-term health problem, such as arthritis or diabetes, follow your doctor’s advice for keeping your condition under control.
  You can also try to take good care of your wrists and hands:
• Try to keep your wrist in a neutral position.
• Use your whole hand-not just your fingers-to hold objects.
• When you type, keep your wrists straight, with your hands a little higher than your wrists. Relax your shoulders when your arms are at your sides.
• If you can, switch hands often when you repeat movements.

• Treatment 

  The goal of treatment for carpal tunnel syndrome is to allow you to return to your normal function and activities and to:

  • Address other health conditions if they are making your symptoms of carpal tunnel syndrome worse.
  • Reduce any inflammation of tissues in the wrist that puts pressure on the median nerve.
  • Determine the causes of your carpal tunnel symptoms. You can then identify whether there are activities for you to avoid or do differently and ways you can help prevent the condition.
  • Prevent nerve damage and loss of muscle strength in your fingers and hand.

  Treatment for carpal tunnel syndrome is based on the seriousness of the condition, whether there is any nerve damage, and whether other treatment has helped. Treatment options include treatment without surgery (non-surgical treatment) or with surgery.

  • If treated early, carpal tunnel symptoms usually go away with non-surgical treatment.
  • If your symptoms are mild, with occasional tingling, numbness, weakness, or pain, 1 to 2 weeks of home treatment are likely to relieve your symptoms.
  • If home treatment does not help, or if your symptoms are more severe (including the loss of feeling in your fingers or hand, or the inability to perform simple hand movements such as holding objects or pinching), have your doctor examine you and recommend treatment.

  Non-surgical treatment

  If your symptoms are not severe, expect your doctor to recommend non-surgical treatment to see whether symptoms improve. Nonsurgical treatment includes:

  • Evaluating any other medical problems that might contribute to carpal tunnel syndrome, and changing your treatment for those problems if needed.
  • Changing or avoiding activities that may be causing symptoms, and taking frequent breaks from repetitive tasks.
  • Wearing a wrist splint to keep your wrist straight, usually just at night. See a picture of a wrist splint .
  • Using non-steroidal anti-inflammatory drugs  to relieve pain and reduce inflammation. Although studies have not shown NSAIDs to be effective for carpal tunnel syndrome, they may help relieve your symptoms.
  • Learning ways to protect your joints as you go through your daily activities.

  In some cases, oral corticosteroids or corticosteroid injections into the carpal tunnel may be considered if other methods to reduce inflammation do not work.

  Surgical treatment

  Surgery is sometimes recommended when other treatment has not helped, if a carpal tunnel condition has continued for a long time, or if there is nerve damage or the risk of nerve damage. Surgery involves cutting the ligament that forms the roof of the carpal tunnel. This relieves the pressure on the median nerve, which eases or ends the symptoms of carpal tunnel syndrome.

  See a picture of the ligament involved in carpal tunnel release surgery .

  Surgery is usually successful. In some cases it does not completely relieve the numbness and pain in the fingers or hand. This may be the case if there has been permanent nerve damage caused by long-standing carpal tunnel syndrome or by other health problems such as diabetes.

Preventing Carpal Tunnel Syndrome

If you spend a lot of time doing activities that involve forceful or repetitive hand or wrist movement or use of vibrating equipment, you have an increased risk of developing carpal tunnel syndrome. These activities can include driving, working with small instruments, knitting, or using a sander. You can reduce your risk-and any hand pain or weakness you may already have-by taking a few simple steps.

ps- this is only for information, always consult you physician before having any particular food/ medication/exercise/other remedies.

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