Monday, April 6, 2015

What is carpal tunnel syndrome?

    Phil had been teaching tennis to young people for 20 years. Last year, when he started experiencing discomfort in his hands and wrists, a parent of one of his students suggested it could be carpal tunnel syndrome.
    Phil had his doubts. He led a very active life. The only injuries he treated had to do with his elbow and legs. "Isn't that something people get from typing and working on computers all day?"
    The short answer is "no."
    What is it?
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    The carpal tunnel — literally a tunnel of ligament and bones at the base of the hand — encloses the median nerve and tendons, which provide sensation to the hand and fingers. Carpal tunnel syndrome occurs when that tunnel collapses and the median nerve becomes pressed or squeezed at the wrist (see the National Institute of Health for more information). This can cause a lot of pain for individuals.
    "It's like getting in an elevator," described Dr. M. Shane Frazier, Orthopedic Surgeon for Central Utah Clinic. "Everything is fine unless a couple of things happen. If the tendons start to swell (or everyone on the elevator gains 100 pounds), then the space seems cramped. Tendons and the area around the nerve become inflamed and swollen."
    What is the cause of this inflammation?
    "Carpal tunnel has something to do with use," concluded Dr. Frazier. "The biggest myth is that people get it who are on a computer a lot. That used to be the predominant way of thinking. It's not anymore."
    Dr. Frazier explained that while in many cases the cause of carpal tunnel syndrome remains unknown, a common cause involves repetitive and forceful actions like gripping, grasping and heavy lifting. People who use heavy vibratory machines like jackhammers or heavy machinery and who perform heavy manual labor, assembly line work, sewing or manufacturing are more likely to experience carpal tunnel syndrome.
    Frazier states that while it is difficult to pinpoint the exact cause of carpal tunnel syndrome, it does occur more often in women. According to an article published by the National Institute of Health, carpal tunnel occurs three times more often in women than men; affecting the dominant hand first and produces the most severe pain.
    How does it feel?
    How do you know if you have carpal tunnel syndrome?
    Many patients report experiencing numbness and an uncomfortable tingling feeling in hands and arms. Patients may also experience weakness in their hands and a reduced level of dexterity. Some patients reported dropping items due to an inability to grasp. But the only definitive way to determine whether or not carpal tunnel syndrome is present is to see your doctor.
    Although rare, cases of carpal tunnel syndrome have surfaced in children. The cause is often due to excessive video gaming, typing or playing a musical instrument.
    To verify whether a patient has carpal tunnel, Dr. Frazier uses an electromyogram (EMG), where tiny acupuncture needles are inserted in the patient's skin to stimulate nerves and muscles.
    "Through a machine, they can tell us how fast an impulse is going from point A to point B, and they can tell us a nerve is being compressed, how badly it's being compressed, and where," explained Dr. Frazier.
    Is there a treatment?
    Once carpal tunnel is diagnosed, it can be treated and cured.
    "There is a cure for carpal tunnel syndrome," said Dr. Frazier. "Sometimes nighttime bracing and steroids can cure it. Often activity modification, lifestyle changes, and routines can cure it. As a last resort, surgery will cure it. Treatment largely depends on the severity of the case."
    You don't have to suffer through the pain of carpal tunnel syndrome. Whether you are a mechanic, fish packer, a clerk, or a candy maker, there is a treatment plan available to help you gain relief and comfort.

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