Monday Medical: Finding comfort from carpal tunnel pain
For Steamboat Pilot & Today
Dealing with pain, numbness and tingling in your hand and arm? Then, you might have carpal tunnel syndrome.
“It’s the most common problem I see,” said Dr. Patrick Johnston, a Steamboat Springs-based orthopedic surgeon specializing in hands, wrists and elbows, who is also a member of the medical staff at UCHealth Yampa Valley Medical Center.
Below, Johnston outlines things to know about the condition.
What causes carpal tunnel syndrome?
“The carpal tunnel is a tunnel in the wrist, with three sides made of bone and the roof made of a ligament,” Johnston said. “The tunnel is rigid and doesn’t expand, like a train tunnel through a mountain. Inside are tendons that help move the thumb and the fingers, as well as the median nerve, which gives sensation to the thumb, index finger, long finger and half of the ring finger.”
If the surrounding tissue or tendons swell, carpal tunnel syndrome can result.
“The tunnel is rigid, so it doesn’t stretch,” Johnston said. “Any swelling increases pressure and can smoosh the median nerve, causing numbness, tingling and weakness in part of the hand.”
At first, the pain and tingling may only be felt at night, sometimes even waking patients from sleep. As the condition progresses, pain and tingling may crop up when using the hand, and the wrist is held flexed or extended, for instance when typing, using a smartphone or driving.
Who can get carpal tunnel syndrome?
People with a smaller carpal tunnel or issues that cause the tendons to swell, such as rheumatoid arthritis, are more susceptible. Overuse caused by some activities can result in the issue, as can hormonal changes during pregnancy.
But, multiple studies have shown typing is not to blame. In fact, some studies show people who type a lot may be less susceptible than people who don’t type as much.
“People usually think it’s due to overuse from typing, but it’s not,” Johnston said. “It’s just that the position the hand is in when typing or doing other activities can bring out symptoms.”
Why should I treat it?
Even if you feel you can deal with the symptoms of carpal tunnel, the condition shouldn’t be left untreated; otherwise, permanent muscle or nerve damage can result.
“The nerve brings electricity to the muscle, and if that stimulation stops, the muscle can weaken and eventually die,” Johnston said. “It’s kind of like if you stop watering a plant — at first, it wilts, and you can bring it back. But once it dies, it’s gone.”
How is it treated?
The first step is to use a carpal tunnel splint at night to keep the wrist in a neutral position and reduce pressure.
If the splint does not help, Johnston recommends a carpal tunnel release, a five-minute surgical procedure during which the patient can be sedated or awake.
“We release the ligament, or the roof of the tunnel, to decrease pressure and give the nerve room to breathe,” Johnston said.
If the nerve was already permanently damaged, the patient may continue to experience numbness and tingling. In that case, the goal of surgery becomes preventing progression of the symptoms and nerve damage.
When carpal tunnel syndrome is due to a temporary condition such as pregnancy or breastfeeding, an injection of a corticosteroid may help.
Be wary of online resources
When dealing with the issue, your physician is your best resource.
“Don’t trust everything you see online. Carpal tunnel syndrome is such a common problem that there are a lot of people out to try to make money off of it,” Johnston said. “A lot of those treatments, such as magnetic bands, haven’t been shown to offer benefits, so it’s best to see a physician.”
Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at email@example.com.
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