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Carpal
Tunnel Syndrome falls in to the category of neurological
conditions called nerve entrapment disorders and by far
is the most common of these disorders. As the name suggests,
these conditions occur when a nerve is trapped or constricted
between other tissues of the body causing irritation and
dysfunction of the nerve. Dr. Cady has been treating carpal
tunnel syndrome for the past 16 years.
Anatomy:
The
Carpal Tunnel is located in the underside of the wrist and
is a passageway in which the Median nerve travels through
on its way to innervate the hand and fingers. Along with
the Median nerve, the Carpal Tunnel contains the nine tendons
of the forearm muscles that are responsible for bending
and flexing of the fingers and thumb. There are also arteries
and lymphatic vessels that supply circulation to the hand
located within the tunnel. The bottom and sides of this
tunnel are formed by wrist bones and the top of the tunnel
is covered by a strong band of connective tissue called
the transverse carpal ligament. The diameter of the carpal
tunnel is about the same as the index finger making the
carpal tunnel a densely packed space. The flexor tendons,
arteries and Median nerve are expected to glide smoothly
past each other during wrist and finger movement.
If
the tendon size increases from inflammation or hypertrophy
(growth), or if the carpal tunnel size decreases because
of a mechanical dysfunction of the carpal bones, the Median
nerve can become constricted or entrapped with the carpal
tunnel. The initial symptoms of carpal tunnel syndrome usually
include pain, numbness, paresthesia (pins and needles) and
tingling in the fingers and hands especially the thumb and
adjacent two fingers. These symptoms are especially noticeable
in the night and often wake people from their sleep as the
individual has to sit up in bed and shake-out and/or rub
the hands in order decrease the these unpleasant feelings.
The hands can also feel clumsy, weak and fatigue easily
with activity. Over time, the ability to grasp small objects
using the thumb and fingers can be affected dramatically
and if left untreated, can lead to total dysfunction of
the hand.
Some
common causes and associated conditions are:
- Repetitive
and forceful grasping with the hands
- Prolonged
computer usage especially with poor wrist position
- Activities
that require repetitive bending of the wrist
- Broken
or dislocated bones in the wrist which produce swelling
- Arthritis,
especially the rheumatoid type
- Thyroid
gland imbalance
- Sugar
diabetes
- Hormonal
changes associated with menopause or pregnancy
Although
any of the above can predispose one to carpal tunnel syndrome,
in many cases the cause is unknown. However people who perform
jobs that use vibration tools and machinery, and/or work
in extreme temperatures are often subjected to this condition.
Even household activities as simple as repetitive wringing
clothes by hand can help cause this syndrome. By far the
most significant reason for the increase of people suffering
with CTS is the continuous rise in the use of computers.
This is becoming a major concern in the developed world
where people of all ages are spending much of their time
typing on a keyboard & clicking on a mouse.
Treatment:
Proper
diagnosis and management of this condition is essential
in order to curtail the disabling symptoms associated with
the advancement of CTS. Dr. Cady is qualified to deal with
this problem and can offer many sufferers with relief. Treatment
can include ultrasound to help reduce inflammation, electro
therapy to strengthen weak muscles of the forearm, soft
tissue massage to stretch contracted tissues and of course
adjustments of the dysfunctional joints of the wrist. You
might be advised to wear a splint or support, especially
at night, to help hold the wrist in a neutral position to
decompress the carpal tunnel. Your treatment should also
include specific exercises to stretch and/or strengthen
muscles of the forearm and hand. For severe cases that do
not respond to conservative care, surgery is a possible
alternative.
Call
us today at 408-739-2273 to start feeling
better.
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