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Carpal Tunnel Syndrome is a repetitive stress injury, or cumulative trauma disorder, that affects the hands and wrists. Carpal Tunnel Syndrome is also known are median neuritis, occupational neuritis, partial thenar atrophy, and writer's cramp. It is a nerve disorder, caused by repeated and/or sustained work activities exposing the median nerve in the wrist to pressure from hard, sharp edges of the worksurface and/or pressure from nearby bones, ligaments, and tendons. The carpal tunnel is the section of the wrist between the ulna and radius (two bones in the forearm) and the carpal ligament which runs across the wrist. The tendons for flexing the fingers, the median nerve, and blood vessels pass though the carpal tunnel from the forearm to the hand. Because the carpal tunnel can not expand, if any of the protective tendon sheaths become irritated and swollen (known as tenosynovitis), the median nerve may be pinched, and blood flow though the vessels may be reduced. This can produce pain, numbness, and tingling in the hand.
Pressure on the median nerve affects normal sensation on the back of the hand, palm and fingers. Affected areas are most of the palm, the palm side of the thumb, pointer, middle, and part of the ring finger. Usually, sensation is only affected on the back of the pointer, middle, and part of the ring finger. Pain in the back of the hand is under the skin and may indicate tenosynovitis in that area. Real pain felt in the pinkie finger may indicate damage to the radial nerve or arthritis in the joints, and is not related to the carpal tunnel.
Carpal tunnel syndrome may affect one or both hands, depending on the use of each hand. It is usually worse in the dominant hand. The symptoms; pain, numbness, and tingling, are usually felt most at night while sleeping. In advanced cases of carpal tunnel syndrome, the thenar muscles near the base of the thumb may atrophy, and the strengh and dexterity of the entire hand will decrease.
The only way to effectively combat Carpal Tunnel Syndrome is to use a comprehensive treatment program, including doctors visits, physical therapy, and technology considerations. To confirm carpal tunnel syndrome, medical consultation is needed. Attempts to self medicate or treatments may actually make the symptoms worse. For advanced cases, sometimes surgical intervention is required to cut the carpal ligament and reduce some of the swelling. The average cost for carpal tunnel surgery is around $10,000 per hand. This is why it is so important to seek treatment before the symptoms get to bad. In addition to a doctor's examination, a doctor's referral to a physical therapist who specializes in Hand Therapy is usually called for. The therapist can work with the patient and give them exercises to alleviate the pressure on their median nerve. An example of Carpal Tunnel Exercises can be found at here. These were developed by a study published in 1996 by the American Academy of Orthopedic Surgeons, and is the only study posted on the internet that I am aware of. If you plan on using these exercises as part of a treatment, consult your doctor first. If your doctor is not aware of this study, give him/her the information to look it up. The final component of treatment is technology. You need to change the tools you are using and the way you are using them in order to prevent symptoms from reoccurring. There are ergonomic hand tools available designed especially to prevent cumulative trauma disorders. Computer users should look into computer ergonomic products, and make sure they are appropriately positioned at their workstation. There are many manufacturers and distributors of ergonomic products. Alimed is a good place to start looking for ergonomic products. In the early stages of carpal tunnel syndrome, inexpensive and easy modifications can be made to prevent the condition from worsening. At the condition progresses, often more expensive and complicated solutions are needed. This is another good reason to seek treatment early.
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