Carpal Tunnel Syndrome (CTS), according to medical reviews, affects four to ten million Americans. The average person with CTS is forty to fifty years old and according to research, fifty percent of CTS individuals have it in their family background. A large portion of patients are women who are three times more inclined to be have it than men.
A person with CTS may experience numbness and tingling (dysesthesia) in the first three fingers and half of the ring finger. A person may have a swollen feeling in the fingers. The symptoms are usually worse at night in the beginning caused by constant flexion (bending) of the wrist. It’s possible for symptoms to occur during the day as the condition worsens or if a person is doing something during the day that aggravates the condition. As it gets worse a person can also get muscle involvement and the hand can experience weakness. It is unusual for the symptom to spread up the arm or into the shoulder. If a person experiences a symptom above the level of the wrist, it could indicate some other cause requiring further investigation.
What causes the problem? One of the common sources is frequent, repetitive, movements with the hands or excessive flexion of the wrist. Another contributing factor may be joint or bone disease. When CTS occurs the median nerve that runs from your forearm through a passageway in the underside of the wrist may experience a number of troubling symptoms. Any disease that causes swelling in ligaments or tendons can predispose you to have the disorder. The carpal tunnel is a path in your wrist formed by the carpal bones on the bottom of the wrist and the carpal ligament across the top of the wrist. The median nerve and several tendons run through the tunnel.
The primary diagnostic tool, after taking history and an exam, is an EMG, which is an electrical exam of nerves and muscle. The first part of the exam utilizes electrical impulses along different nerves to measure the speed and amplitude (strength) of the nerves. The second part of the exam uses a tiny needle inserted into muscles to check for nerve damage. Imaging studies may not be recommended.
Treatment may include carpal tunnel splinting, carpal tunnel injections, therapy, and or, surgery. Splinting the hand supports and keeps the wrist in a position that tends to keep the tunnel as open as possible. That will reduce compression of the nerve inside the tunnel. A person can also take anti-inflammatory medication to reduce swelling. For people spending hours on the computer, changing position of the computer keyboard or making other ergonomic changes can help ease symptoms. Additionally, exercise such as stretching, and strengthening drills may be helpful for people to improve symptoms. These exercises may be supervised by a physical or occupational therapist. As a final option, surgery releasing the carpal ligament, may be recommended.
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