WHAT
is Carpal Tunnel Syndrome (CTS)? CTS
occurs when pressure is applied to the median nerve which travels from the
neck, through the shoulder, upper arm, elbow, forearm, and through the carpal
tunnel where the “pinch” is located. The median nerve innervates most of the
palm of the hand, the thumb, the index finger, middle finger, and the thumb
side of the ring finger. The carpal tunnel is made up of eight little bones in
the wrist that form the arch and a ligament that forms the floor. There are
nine muscle tendons, the median nerve, as well as blood vessels that travel
through the tunnel.
WHAT
are the symptoms of CTS? The
“classic” symptoms include burning, itching, tingling, and/or numbness of the
second to fourth fingers with the need to shake or “flick” the fingers to “wake
up the hand.” When present long enough, or when the pressure is hard enough on
the nerve, weakness in the grip occurs and accidental dropping of tools, coffee
cups, and so on can occur. Pressure on the nerve increases when the wrist is
bent backwards or forwards, especially for long time frames and/or when the
wrist is moving in a fast, repetitive manner with jobs like carpentry using
vibrating tools, a screw driver, hand drill, a hammer, line production work,
waitressing, and so on. Often, symptoms are first noticed at night, as we tend
to sleep with our wrists bent and tucked under our chin or neck. Symptoms can
also occur during the day, especially when driving or when performing
repetitive work. Difficulties buttoning a shirt, making a fist, grasping small
objects and/or performing manual tasks are common complaints of CTS.
WHAT
are some causes of CTS? CTS is most
commonly caused by a combination of factors that result in swelling of the
tendons that travel through the carpal tunnel. This includes over working the
arm and hand in any of the jobs described above, but it is more likely to
happen when conditions that create generalized swelling occur. Some of these
conditions include trauma (like a sprained wrist), hypothyroidism, an
over-active pituitary gland, during menstruation or pregnancy, menopause,
rheumatoid arthritis, diabetes, mechanical wrist problems, repetitious work
(work stress), or the repeated use of vibratory hand tools. It is also possible
to develop a cyst (like a ganglion) or a fatty tumor within the tunnel. CTS is
also more common with obesity, but sometimes, no logical cause can be
identified!
WHO
is at risk of developing CTS? Women
are three to four times more likely to develop CTS. This may be because of the
hormonal aspects described above and/or the relative smaller wrist, which
results in a smaller carpal tunnel. There's also an increased risk of CTS in
people over the age of 50. Other at risk individuals include diabetics, people
with hormonal imbalances (taking birth control pills, pregnancy, hypothyroid,
etc.), and people who work on assembly lines.
How
is CTS diagnosed? EARLY diagnosis and
treatment is KEY to a successful outcome! The physical exam includes assessing
the structures of the neck and entire upper extremity, as the pinch is often in
more than one place. A blood test for thyroid disease, diabetes, and rheumatoid
arthritis is also practical. Other tests that may help us diagnose CTS can
include and EMG (nerve test) and/or x-ray/MRI. Next month, we’ll discuss
treatment and prevention!
We realize you have a choice in whom
you consider for your health care provision and we sincerely appreciate your
trust in choosing our service for those needs.
If you, a friend, or family member requires care for Carpal Tunnel
Syndrome, we would be honored to render our services.
No comments:
Post a Comment