Thursday, April 28, 2011

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) affects 3-6% of adults and is the most common entrapment neuropathy. Symptoms are due to compression of the median nerve in the wrist, which results in pain, numbness and tingling.  More than half the patients with CPS have symptoms in both hands.

CTS is often associated with over-use type injuries caused by repetitive motion. Other causes include obesity, pregnancy, arthritis, diabetes and thyroid disorders.

The pain, numbness and tingling typically occur in the thumb, index and middle fingers and may radiate to the forearm. Patients will often notice loss of grip strength and may be awakened by pain at night. The patient may try to shake the hand or flick the write to alleviate the discomfort.

In patients with mild disease, six to twelve weeks of splinting and anti-inflammatory medication may lead to relief. Patients who are not better with conservative treatment or who have severe symptoms may need surgical management.  

Even better than treating CTS is preventing it. I recommend avoiding repetitive motions.  Use ergonomic equipment to keep your wrist in the neutral position, such as wrist rests and ‘fat’ pens, and avoid vibrating tools. Take frequent breaks. Smoking lessens the blood supply to the median nerve; this may exacerbate symptoms. A uniquely suburban recommendation: don’t clutch the steering wheel – we all have power steering.

There is little evidence that dietary supplements will either prevent or cure CTS.

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