Early Diagnosis Key to Easing Carpal Tunnel Pain

By Guest Contributor March 15, 2009 15:47

By Lili Cadeaux Hapgood

One of the most common conditions that hand therapists treat is carpal tunnel syndrome. Many people believe this condition is found only in younger office workers, largely computer users, but it is quite prevalent in the retired and senior populations as well. It can accompany other disease processes, such as arthritis, diabetes and vitamin deficiencies, or can be an after-effect of trauma, such as wrist fractures.

Carpal tunnel syndrome involves the median nerve, which is one of the major nerves that supply the hand. This nerve passes, along with many of the finger and wrist tendons, through a bony structure called the carpal tunnel. This tunnel is very prone to pressure from changes in swelling, wrist and hand positions, and anatomical deformities linked to trauma or genetics.

The syndrome is defined as a set of neurological symptoms in the hand: tingling, burning, numbness and/or pain in the palm, thumb, and/or tips of the index, middle finger and part of the ring fingers. If the discomfort is in the pinkie or the pinkie side of the ring finger, it is likely a result of a different nerve. Sometimes, people experience joint pain or pain along the thumb near the wrist – this is usually arthritis, or a tendon and joint problem, rather than carpal tunnel.

A good diagnosis and early treatment is important to relieve symptoms and prevent further nerve damage. In some cases, neck, shoulder, and other neuromuscular disorders also can be the culprit and need to be ruled out.

In the early stages, a wrist brace that keeps the wrist in a neutral position can be helpful, particularly at night when many people place their hands/wrists in awkward positions. Daytime use can also help alleviate tingling and numbness.

If inflammatory swelling is the cause of symptoms, non-steroidal anti-inflammatory medications can help relieve pain: aspirin, ibuprofen, and naproxen, among others. There can be side effects, and use should be cleared by a physician. Cortisone injections can be a next step. These need to be administered by a physician, either an orthopedic or physical medicine specialist.

A therapist can help by properly fitting a splint or brace, or by non-invasive anti-inflammatory treatment, such as transdermal electronic administration of a steroid or other preparation. And, a therapist can offer tips on avoiding activities or postures that may be causing or aggravating symptoms. Gentle range of motion and tendon-gliding exercises can be therapeutic as well. Icing techniques have also been helpful.

If all else fails, surgery to relieve the pressure on the median nerve by sectioning the transverse carpal ligament is frequently very successful.

Lili Cadeaux Hapgood has been a registered occupational therapist for 26 years, and owns Mountain Hand Therapy (533-0412) in East Sonora.

© 2009, Friends and Neighbors Magazine

By Guest Contributor March 15, 2009 15:47
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