Whether it's tingling in your fingers, pain in your hand or brief moments of agony when bending your wrists away from the computer keyboard -- it could be related to the medical traffic jam of wrist nerves and tendons more commonly known as carpal tunnel syndrome. In many patients, the condition develops when the median nerve and surrounding tendons are impacted by pressure applied to the narrow space where they pass through bones and ligaments in the wrist -- known as the carpal tunnel. Wrist and hand positions that constrict the carpal tunnel passage against the nerve and tendons are a common cause, but physicians often put on their medical detective hats to help patients uncover other reasons why they're being affected.
"Many may think carpal tunnel syndrome is only caused by long hours of typing, but the symptoms can be tied to other conditions such as hypothyroidism, diabetes, rheumatoid arthritis, obesity and even pregnancy," said Dr. Marcus Talerico, MD an orthopedic hand surgeon with the MidAmerica Hand to Shoulder Clinic in Libertyville. "To pinpoint the exact cause of the tingling and pain, we'll run through a series of patient questions and tests to identify root causes of pressure on the carpal tunnel and identify the correct course of treatment."
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Questions about a patient's daily routine, specific fingers affected by tingling, whether the pain is worse at night than during the day and if shaking one's wrists alleviates discomfort can help doctors determine if the problem is directly related to carpal tunnel syndrome or possibly something else. A thorough patient history also helps determine whether a specific activity may be to blame, such as smoking, which can restrict blood flow to the median nerve. Swelling caused by another injury or activity can also constrict the nerve, but in some patients carpal tunnel syndrome could be hereditary -- meaning something more than a common treatment may be needed.
Options for Relief
Treatments can range from simple things like adding a wrist-rest pad in front of a computer keyboard, wearing wrist splints to take pressure off the median nerve and taking nonsteroidal anti-inflammatory drugs or NSAIDs. But more complex treatments may include steroid medications such as injections of corticosteroids to alleviate inflammation. The shots can provide temporary relief for weeks and even months, but they are not a permanent solution.
Surgery may be considered for sufferers who endure severe carpal tunnel syndrome pain and don't respond to previous treatments. Orthopedic surgeons can create more space in the carpal tunnel by cutting the traverse carpal ligament in the wrist to relieve pressure on the median nerve. An endoscopic procedure may also be used where surgeons insert a thin, narrow tube through a small wrist or palm incision. A tiny camera at the end of the tube allows the physician to see what is applying pressure on the nerve and cut ligaments if necessary, without making a larger incision.
"Carpal tunnel syndrome is treatable and those who think they may be affected should see a physician if the tingling and pain is interfering with their job and overall quality of life," added Dr. Talerico. "There are different ways it may affect sufferers and knowing a patient's medical history and routine activities are important first steps for doctors to help patients achieve relief."
To learn more about carpal tunnel syndrome and the MidAmerica Hand to Shoulder Clinic of Libertyville, please visit www.handtoshoulderclinic.com or call 1-855-4MY-ORTHO (1-855-469-6784).