Health Library ~ Family Medicine in Mullica Hill, NJ

Carpal Tunnel Syndrome

By Craig M. Wax, DO

Before you grasp the handle of another tool or begin typing your next report, you may want to consider a way of spreading the pending pressure or motion evenly throughout your hand and wrist. By doing so you may avoid the most common work-related injury-- Carpal Tunnel Syndrome (CTS).

Individuals who work with their hands are greatly at risk for the tingling, numbness, weakness, or pain that may be triggered by CTS, says Craig M. Wax, D.O. an osteopathic Family physician. This syndrome remains the most common cause of absence from work places where strong or repetitive hand movements or hand-arm vibration is required.  In fact, the Center for Carpal Tunnel Studies (CCTS) reports that the incidence of CTS in the general population is 1-3 percent and anywhere between 10-17 percent in the industrial workforce.

While many may suffer from CTS, few may be aware that it is caused by the swelling or thickening of tissues close to or within the carpal tunnel in the wrist. The swelling or thickening increases pressure on both the median nerve and the blood vessels that support the nerve.

Individuals suffering from CTS may experience varying degrees of symptoms associated with the disorder, from mild to severe. Mild to moderate cases of CTS can include intermittent pain and numbness in the fingers that often occur at night or diminish with gentle hand activity but rapidly return with any grasping or pinching movement. Severe CTS symptoms may consist of constant numbness, severe pain, inability to effectively pinch, or thumb muscle atrophy.

A common indication of CTS is when the symptoms specifically occur in the thumb, index, middle, or ring finger, but not the little finger. The little finger is not controlled by the median nerve therefore is not usually affected by CTS, advises Dr. Wax.

Although repeated hand and wrist movements frequently lead to CTS, any condition that makes the tissues in the wrist swell will increase pressure on the median nerve and may cause CTS.  Diseases or conditions like obesity, rheumatoid arthritis, gout, diabetes, lupus, hypothyroidism, and multiple sclerosis may weaken or irritate tissues in the body, which will predispose an individual to CTS.  In other instances, some broken wrist bones, dislocated bones, or new bone growth from healing bones could directly press on the nerve and cause the syndrome.  CTS could even be caused by pregnancy, tumors, and other growths.

There are some easy home treatments that can ease pain or tingling in mild cases of CTS that might prevent further damage in the wrist and possibly relieve symptoms altogether:  

The best way to relieve symptoms is to stop the activities that are causing the numbness or pain, advises Dr. Wax.  In addition to stopping the activity, you may also relieve pain and reduce swelling by icing the wrist for 10 to 15 minutes at a time once or twice an hour and taking nonsteroidal anti-inflammatory drugs, such as ibuprofen.

Dr. Wax also recommends wearing a wrist splint at night and doing simple range-of-motion exercises with the fingers and wrist to help prevent stiffening of the joints or tendons, provided the exercises are not painful.

If you are experiencing any severe symptoms or if mild symptoms persist longer than two weeks, consult your family physician immediately, explains Dr. Wax.

Dr. Wax says that CTS is one of many bone and joint, or musculoskeletal, disorders increasingly affecting individuals today, which happen to have a neurologic component.  Due to the growing impact of bone and joint disorders on patient and healthcare systems and an understanding that resources need to be more efficiently used, the international effort known as Joint Motion 2000-2010, was created. The group is comprised of more than 46 national action networks and 750 professional medical societies, patient advocacy groups, governments, industry, research institutions and publications.

Joint Motion 2000-2010 is a part of the Bone and Joint Decade, which among its many efforts, works to raise awareness about musculoskeletal diseases through the promotion of cost-effective prevention and treatment of these disorders. The group also empowers patients to participate in their own health care. For more information about this non-profit organization, or other musculoskeletal disorders, readers should visit the Bone and Joint Decade Web site at www.boneandjointdecade.org.

As complete physicians, D.O.s are able to prescribe medication, perform surgery and can be found practicing in all areas of medicine.  D.O.s also use their hands to diagnose injury and illness and to encourage the bodys natural tendency toward good health through the use of Osteopathic Manipulative Treatment (OMT).