What's happenning to my hand? - Carpal Tunnel Syndrome-

Hi!

Today’s topic is Carpal Tunnel Syndrome, which I frequently confront both in my career and my personal life. If you have numbness on your hand so bad that it wakes you up at night, and if its is getting more and frustrating, this is the right post for you.

Let’s get started…

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What is Carpal Tunnel Syndrome?

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There is an area called carpal tunnel in the wrist. In the tunnel goes; Median nerve and 9 tendons reaching from the forearm to the hand. The transverse Carpal ligament forms the roof of the tunnel..

So, what does median nerve do?

It supplies the sense of the thumb, index finger, middle finger and the ring finger and also some movements of the thumb.

What’s going on, in tunnel?!

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Increasing of the standard pressure of the Carpal Tunnel for some reason, (32-110mmHg, depending on wrist position )*[A]) causes compression on the nerve and prevents the functioning of the nerve. Then, turns into the Carpal Tunnel Syndrome with the symptoms of pain, numbness and tingling sensation in the hands and fingers.

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What causes Carpal Tunnel Syndrome?

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Usually the cause is unknown. But some factors are known to cause the inside pressure of the tunnel increases;

• The tendons passing through the tunnel, corroding through years with repetitive hand movements. And with the effect of this, getting thicker and having the possibility of causing compression on the nevre.
• The fructures and dislocations narrowing the tunnel
• Water retention (Edema), especially seen in pregnancy is known to increase the pressure

Which activities ?

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• prolonged grasping
• forceful grasping
• using of hand tools, especially those that vibrate
• using the wrist in awkward positions
• activities that compress the palm
• repetitive impact to the base of the palm.

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At whom is it more common?

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More common in females than in males, its occurrence is commonly bilaterally with a peak age range of 40 to 60 years [1]; although it occurs in all age groups.
such as manufacturing, sewing, finishing, cleaning and packing (e.g. meat, poultry, or fish). In fact, CTS is three times more common among assemblers than among data-entry personel.

In all western countries, an increase is reported in the number of work-related musculoskeletal disorders (WMSDs) caused by strain and repeated movements (biomechanical overload).

Carpal Tunnel Syndrome symptoms consists of 3 phases . Because most people get help at the 2nd phase; the treatment period extends and the chance of success decreases. I recommend you not to neglect this, if you have the below symptoms ;

1st phase: Aching, numbness and tinglings strong enough to wake you up from sleep start in the areas which median nerve is in charge of supplying the sense.
2nd phase: In time, it will show itself during some activities such as driving and reading a newspaper. You will start droping some objects from your hand.
3rd phase: At further stages loss of sensation on fingers and muscle weaknesses on the thumb starts.

Well, can we be sure of this condition?

Though it does not mean anything in the matter of precise diagnosis,there is a test that you can take at home and help you judge the situation yourself called PHALEN test:

The Phalen test is (%50) sensitive It is done by holding your wrist at maximum flexing point for about a minute. The pozitive test results are tingling and numbness in the median nerve’s spreading region.

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What is the treatment?

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First of all, you should know that Early diagnosis and treatment will make you feel relived and prevents the nerve damage to continue.
In treatment, early stage indications might be prevented by some methods.
These are ;

• Its possible with learning to use your hand at proper pozitions at home or office

• A proper tool to regulate pressure on the nerve

• Medicine treatment

• Exercise

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• If the Symptoms are strong and the other treatment methods fail to cure it, loosening transverse carpal ligament by a surgical operation relaxes the nerve.

Don't forget that the most common of entrapment neuropathy types; the carpal tunnel syndrome , has too many negative effects on your lives that you can't even imagine. As I always say ;

Everything starts with awareness...

sources:

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• Carpal Tunnel Syndrome: A Review of the Recent Literature. I. Ibrahim ,W.S. Khan, N. Goddard and P. Smitham.
  The Open Orthopaedics Journal, 2012, 6, (Suppl 1: M8) 69-76

• [1]Phalen GS. The carpal-tunnel syndrome. J Bone and Joint Surg Am
  1966; 48(A): 380-3.

• [2] European Agency for Safety and Health at Work. Work related
  neck and upper limb musculoskeletal disorders. Office for Official
  Publication of the European Communities, Luxembourg 1999.

• [1A] Paget J. Lectures on surgical pathology. Philadelphia: Lindsay and
  Blakiston 1854

• [A] Amirlak B, Upadhyaya K, Ahmed O, Wolff T, Tsai T, Scheker L.
  Median Nerve Entrapment. 1-11-2010. Internet Communication.
  [Accessed: 24/10/2011].