MASSAGE FOR CARPAL TUNNEL SYNDROME - Stop Arm & Wrist Pain Fast!

CARPAL TUNNEL SYNDROME - 5 Steps to Wrist Pain Relief

VIDEO - Carpal Tunnel Syndrome Exercises

VIDEO - How To STOP Carpal Tunnel PAIN Naturally! There is HOPE!

VIDEO - Carpal Tunnel Syndrome Explained

VIDEO - Carpal Tunnel Syndrome

ERGONOMICS - A Visual Guide to Carpal Tunnel Syndrome

What Is Carpal Tunnel Syndrome?

The carpal tunnel is a narrow passageway on the palm side of your wrist made up of bones and ligaments. The median nerve, which controls sensation and movement in the thumb and first three fingers, runs through this passageway along with tendons to the fingers and thumb. When it's pinched or compressed, the result is numbness, tingling, weakness, or pain in the hand, called carpal tunnel syndrome.

Symptoms: Pain and Tingling

Carpal tunnel develops slowly. At first, you're most likely to notice it at night or when you first wake up in the morning. The feeling is similar to the "pins-and-needles" sensation you get when your hand falls asleep. During the day, you may notice pain or tingling when holding things, like a phone or a book, or when driving. Shaking or moving your fingers usually helps.

Symptoms: Weakness

As carpal tunnel syndrome progresses, you may begin to notice weakness in your thumb and first two fingers, and it may be difficult to make a fist or grasp objects. You may find yourself dropping things, or you may have trouble doing things like holding a utensil or buttoning your shirt.

Symptoms: Sensation Problems

Carpal tunnel syndrome can also cause a feeling of numbness in the hands. Some people feel like their fingers are swollen, even though no swelling is present, or they may have trouble distinguishing between hot and cold.

What Causes Carpal Tunnel Syndrome?

There usually isn't one definitive cause of carpal tunnel syndrome. Because the carpal tunnel is narrow and rigid, anytime there is swelling or inflammation in the area, the median nerve can be compressed and cause pain. Symptoms may be present in one or both hands (usually symptoms develop in the dominant hand first).

Who Gets Carpal Tunnel Syndrome?

Women are three times more likely than men to get carpal tunnel syndrome. Certain conditions can also increase your risk. These include:

• Diabetes, gout, hypothyroidism, and rheumatoid arthritis
• Pregnancy
• Sprain or fracture of the wrist

Could Your Job Be to Blame?

It's a common belief that frequent typing can lead to carpal tunnel syndrome. But it's actually three times more common among assembly line workers than it is among data-entry personnel -- and frequent use of vibrating hand tools increases the risk. In contrast, a 2001 study found that even heavy computer use -- up to seven hours a day -- did not make people more likely to develop carpal tunnel syndrome. 

What Happens Without Treatment?

At first, symptoms of carpal tunnel syndrome come and go, but as the condition worsens, symptoms may become constant. Pain may radiate up the arm all the way to the shoulder. Over time, if untreated, carpal tunnel syndrome can cause the muscles on the thumb side of your hand to waste away (atrophy). Even with treatment, strength and sensation may never be completely restored.

Carpal Tunnel or Something Else?

A few conditions have symptoms that can mimic carpal tunnel syndrome. These include:

• Injury to a muscle, ligament, or tendon
• Arthritis of the thumb or wrist
• Nerve problems such as diabetic neuropathy

Your doctor will do tests to rule out other health conditions.  

Diagnosing Carpal Tunnel Syndrome

There are several tests your doctor will perform to see if you have carpal tunnel syndrome. The Tinel test involves tapping  on the median nerve to see if it causes tingling in the fingers. In the Phalen test, the doctor will have you press the backs of your hands together for a minute to see if this causes numbness or tingling.

Electrodiagnostic Tests

To confirm the diagnosis, your doctor will order a nerve conduction study. In this test, electrodes are placed on the hands and wrists, and small electric shocks are applied to measure how quickly the median nerve transmits impulses. Another test, called electromyography, uses a fine needle inserted into a muscle to measure electrical activity and assess damage to the median nerve.

Treatment: Rest and Immobilization

Underlying causes such as diabetes or arthritis will need treatment. Then your doctor may advise resting the hand and wrist and wearing a brace to limit movement. Night use is important to prevent the wrist from curling during sleep, which can make your symptoms flare up. Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen, along with cold compresses, can reduce pain.

Medications for Carpal Tunnel

When carpal tunnel symptoms are more severe, your doctor may recommend corticosteroids by injection or by mouth. Steroids can temporarily reduce inflammation around the median nerve and ease your symptoms. Injection of a local anesthetic such as lidocaine can also relieve symptoms. Other things that may help include diuretics, also known as “water pills,” which reduce swelling, and vitamin B6 supplements.

Surgery for Carpal Tunnel Syndrome

If surgery is needed, it's typically done on an outpatient basis under local anesthesia (meaning you’re awake during surgery). The ligament overlying the top of the carpal tunnel is cut to relieve pressure. The healed ligament will allow more space in the carpal tunnel. Sometimes the procedure is done endoscopically, using a tiny camera inserted through a very small incision to guide the procedure.

What to Expect After Surgery

There may be some swelling and stiffness right after surgery, which can be relieved by elevating your hand over your heart and moving your fingers frequently. You may need to wear a wrist brace for a few weeks while you heal, but will still be able to use your hands. Pain and weakness usually resolve within two months after surgery, but it may take six months to a year to recover completely.

Strengthening Exercises

Once carpal tunnel symptoms subside, a physical therapist can teach you stretching and strengthening exercises to help prevent pain, numbness, and weakness from coming back. A physical or occupational therapist can also teach you the correct ways to perform tasks so that the median nerve doesn’t become inflamed again, causing your symptoms to return.

Complementary Treatments

Some studies suggest that chiropractic manipulation of the wrist, elbow, and upper spine can improve carpal tunnel syndrome. There is also some evidence that acupuncture may help restore nerve function and relieve symptoms. It’s important to speak with your doctor before starting these or any other complementary or alternative treatments.

Can Yoga Ease Carpal Tunnel?

There's strong evidence that yoga can reduce pain and improve grip strength. In one small study, participants who did an eight-week yoga regimen of 11 postures designed to strengthen, stretch, and balance the joints of the upper body had better outcomes than participants who wore wrist splints and participants who were given no treatment at all.

Can Carpal Tunnel Be Prevented?

Though there is no definitive way to prevent carpal tunnel syndrome, these things can help:

• Good posture
• Ergonomic tools and workstations
• Stretching hands and wrists regularly
• Taking frequent rest breaks to shake arms and legs, lean back, and change position throughout the work day

Source: http://www.webmd.com/pain-management/carpal-tunnel/ss/slideshow-carpal-overview

ERGONOMICS - About Carpal Tunnel Syndrome

Image Source: MedicineNet, Inc.

Carpal tunnel syndrome: A type of compression neuropathy (nerve damage) caused by compression and irritation of the median nerve in the wrist. The nerve is compressed within the carpal tunnel, a bony canal in the palm side of the wrist that provides passage for the median nerve to the hand. The irritation of the median nerve is specifically due to pressure from the transverse carpal ligament.

Carpal tunnel syndrome (CTS) can be due to trauma from repetitive work such as that of supermarket checkers, checkers in other types of stores, assembly line workers, meat packers, typists, word processors, accountants, writers, etc. Other factors predisposing to CTS include obesity, pregnancy, hypothyroidism, arthritis, and diabetes.

The symptoms of CTS include numbness and tingling of the hand, wrist pain, a "pins and needles" feeling at night, weakness in the grip and a feeling of incoordination.

The diagnosis is suspected based on symptoms, supported by signs on physical examination, and confirmed by nerve conduction testing.

Treatment depends on the severity of symptoms and the underlying cause. Early CTS is usually treated by modification of activities, a removable wrist brace and anti-inflammatory medicines. Caught early, CTS is reversible. If numbness and pain continue in the wrist and hand, acortisone injection into the carpal tunnel can help. Surgery is only indicated if other treatments have failed. In advanced CTS, particularly with profound weakness and muscle atrophy (wasting), surgery is done to avoid permanent nerve damage.

The surgical procedure is called a carpal tunnel release. It relieves the pressure exerted on the median nerve within the carpal tunnel. This surgical procedure is performed via a small incision using conventional surgery or a fiberoptic scope (endoscopic carpal tunnel repair).

Additional Information

Image Source: MedicineNet, Inc.

Intricate in design and function, the hand is an amazing work of anatomy. Form follows function in the hand; therefore, any injury to the underlying structures of the hand carries the potential for serious handicap. To reduce this risk, even the smallest hand injuries require a good medical evaluation. The hand consists of 38 bones; 10 metacarpal bones and 28 phalanges (finger bones).

Image Source: MedicineNet, Inc.Finger Anatomy: Fingers are easily injured, and broken fingers are some of the most common traumatic injuries seen in an emergency room. Finger fractures may account for up to 10% of all bone fractures. Because fingers are used for many everyday activities, they are at higher risk than other parts of the body for traumatic injury, including sports injuries, workplace injuries, and other accidents.

Understanding the basic anatomy of the hand and fingers is useful in understanding different types of finger injuries, broken fingers, and how some treatments differ from others. Fingers are constructed of ligaments (strong supportive tissue connecting bone to bone), tendons (attachment tissue from muscle to bone), and three  phalanges (bones). There are no muscles in the fingers; and fingers move by the pull of forearm muscles on the tendons. The three bones in each finger are named according to their relationship to the palm of the hand. The first bone, closest to the palm, is the proximal phalange; the second bone is the middle phalange; and the smallest and farthest from the hand is the distal phalange. The thumb does not have a middle phalange.

The knuckles are joints formed by the bones of the fingers and are commonly injured or dislocated with trauma to the hand.

• The first and largest knuckle is the junction between the hand and the fingers - the metacarpophalangeal joint (MCP). This joint commonly is injured in closed-fist activities and is commonly known as a boxer's fracture.
• The next knuckle out toward the fingernail is the proximal inter-phalangeal joint (PIP). This joint may be dislocated in sporting events when a ball or object directly strikes the finger.
• The farthest joint of the finger is the distal inter-phalangeal joint (DIP). Injuries to this joint usually involve a fracture or torn tendon (avulsion) injury.

Image Source: MedicineNet, Inc.

Fingernail: A fingernail is produced by living skin cells in the finger. A fingernail consists of several parts including the nail plate (the visible part of the nail), the nail bed (the skin beneath the nail plate), the cuticle (the tissue that overlaps the plate and rims the base of the nail), the nail folds (the skin folds that frame and support the nail on three sides), the lunula (the whitish half-moon at the base of the nail) and the matrix (the hidden part of the nail unit under the cuticle).

Fingernails grow from the matrix. The nails are composed largely of keratin, a hardened protein (that is also in skin and hair). As new cells grow in the matrix, the older cells are pushed out, compacted and take on the familiar flattened, hardened form of the fingernail.

The average growth rate for nails is 0.1 mm each day (or 1 centimeter in 100 days). The exact rate of nail growth depends on numerous factors including the age and sex of the individual and the time of year. Fingernails generally grow faster in young people, in males, and in the summer.

Fingernails grow faster than toenails. The fingernails on the right hand of a right handed person grow faster than those on their left hand, and vice versa.

ERGONOMICS - Carpal Tunnel Syndrome

By Mayo Clinic Staff

Definition

Carpal tunnel syndrome is a progressively painful hand and arm condition caused by a pinched nerve in your wrist. A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems and possibly patterns of hand use.

Bound by bones and ligaments, the carpal tunnel is a narrow passageway — about as big around as your thumb — located on the palm side of your wrist. This tunnel protects a main nerve to your hand and nine tendons that bend your fingers. Compression of the nerve produces the numbness, pain and, eventually, hand weakness that characterize carpal tunnel syndrome.

Fortunately, for most people who develop carpal tunnel syndrome, proper treatment usually can relieve the pain and numbness and restore normal use of their wrists and hands.

Symptoms

Carpal tunnel syndrome typically starts gradually with a vague aching in your wrist that can extend to your hand or forearm. Common carpal tunnel syndrome symptoms include:

• Tingling or numbness in your fingers or hand, especially your thumb and index, middle or ring fingers, but not your little finger. This sensation often occurs while holding a steering wheel, phone or newspaper or upon awakening. Many people "shake out" their hands to try to relieve their symptoms. As the disorder progresses, the numb feeling may become constant.
• Pain radiating or extending from your wrist up your arm to your shoulder or down into your palm or fingers, especially after forceful or repetitive use. This usually occurs on the palm side of your forearm.
• A sense of weakness in your hands and a tendency to drop objects.

When to see a doctorIf you have persistent signs and symptoms suggestive of carpal tunnel syndrome, especially if they interfere with your normal activities and sleep patterns, see your doctor. If you leave the condition untreated, nerve and muscle damage can occur.

Causes

Carpal tunnel syndrome occurs as a result of compression of the median nerve. The median nerve runs from your forearm through a passageway in your wrist (carpal tunnel) to your hand. It provides sensation to the palm side of your thumb and fingers, with the exception of your little finger. It also provides nerve signals to move the muscles around the base of your thumb (motor function).

In general, anything that crowds, irritates or compresses the median nerve in the carpal tunnel space can lead to carpal tunnel syndrome. For example, a wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation resulting from rheumatoid arthritis.

In many cases, no single cause can be identified. It may be that a combination of risk factors contributes to the development of the condition.

Risk factors

A number of factors have been associated with carpal tunnel syndrome. Although by themselves they don't cause carpal tunnel syndrome, they may increase your chances of developing or aggravating median nerve damage. These include:

• Anatomic factors. A wrist fracture or dislocation that alters the space within the carpal tunnel can create extraneous pressure on the median nerve. Also, carpal tunnel syndrome is generally more common in women. This may be because the carpal tunnel area is relatively smaller than in men and there's less room for error. Women who have carpal tunnel syndrome may also have smaller carpal tunnels than women who don't have the condition.
• Nerve-damaging conditions. Some chronic illnesses, such as diabetes and alcoholism, increase your risk of nerve damage, including damage to your median nerve.
• Inflammatory conditions. Illnesses that are characterized by inflammation, such as rheumatoid arthritis or an infection, can affect the tendons in your wrist, exerting pressure on your median nerve.
• Alterations in the balance of body fluids. Certain conditions — such as pregnancy, menopause, obesity, thyroid disorders and kidney failure, among others — can affect the level of fluids in your body. Fluid retention — common during pregnancy, for example — may increase the pressure within your carpal tunnel, irritating the median nerve. Carpal tunnel syndrome associated with pregnancy generally resolves on its own after the pregnancy is over.
• Workplace factors. It's possible that working with vibrating tools or on an assembly line that requires prolonged or repetitive flexing of the wrist may create harmful pressure on the median nerve, or worsen existing nerve damage. But the scientific evidence is conflicting and these factors haven't been established as direct causes of carpal tunnel syndrome. There is little evidence to support extensive computer use as a risk factor for carpal tunnel syndrome, although it may cause a different form of hand pain.

Tests and diagnosis

History of symptoms. The pattern of your signs and symptoms may offer clues to their cause. For example, since the median nerve doesn't provide sensation to your little finger, symptoms in that finger may indicate a problem other than carpal tunnel syndrome. Another clue is the timing of the symptoms. Typical times when you might experience symptoms due to carpal tunnel syndrome include while holding a phone or a newspaper, gripping a steering wheel, or waking up during the night.Your doctor may conduct one or more of the following tests to determine whether you have carpal tunnel syndrome:

• Physical exam. Your doctor will want to test the feeling in your fingers and the strength of the muscles in your hand, because these can be affected by carpal tunnel syndrome. Pressure on the median nerve at the wrist, produced by bending the wrist, tapping on the nerve or simply pressing on the nerve, can bring on the symptoms in many people.
• X-ray. Some doctors may recommend an X-ray of the affected wrist to exclude other causes of wrist pain, such as arthritis or a fracture.
• Electromyogram. Electromyography measures the tiny electrical discharges produced in muscles. A thin-needle electrode is inserted into the muscles your doctor wants to study. An instrument records the electrical activity in your muscle at rest and as you contract the muscle. This test can help determine if muscle damage has occurred.
• Nerve conduction study. In a variation of electromyography, two electrodes are taped to your skin. A small shock is passed through the median nerve to see if electrical impulses are slowed in the carpal tunnel.

The electromyogram and nerve conduction study tests are also useful in checking for other conditions that might mimic carpal tunnel syndrome, such as a pinched nerve in your neck.

Your doctor may recommend that you see a rheumatologist, neurologist, hand surgeon or neurosurgeon if your signs or symptoms indicate other medical disorders or a need for specialized treatment.

Treatments and drugs

Some people with mild symptoms of carpal tunnel syndrome can ease their discomfort by taking more-frequent breaks to rest their hands and applying cold packs to reduce occasional swelling. If these techniques don't offer relief within a few weeks, additional treatment options include wrist splinting, medications and surgery. Splinting and other conservative treatments are more likely to help you if you've had only mild to moderate symptoms for less than 10 months.

Nonsurgical therapyIf the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome. Methods may include:

• Wrist splinting. A splint that holds your wrist still while you sleep can help relieve nighttime symptoms of tingling and numbness. Nocturnal splinting may be a good option if you are pregnant and have carpal tunnel syndrome.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may help relieve pain from carpal tunnel syndrome in the short term. There's no evidence, though, that these drugs can actually improve the carpal tunnel syndrome itself.
• Corticosteroids. Your doctor may inject your carpal tunnel with a corticosteroid, such as cortisone, to relieve your pain. Corticosteroids decrease inflammation and swelling, which relieves pressure on the median nerve. Oral corticosteroids aren't considered as effective as corticosteroid injections for treating carpal tunnel syndrome.

If carpal tunnel syndrome results from an inflammatory arthritis, such as rheumatoid arthritis, then treating the underlying condition may reduce symptoms of carpal tunnel syndrome, but this hasn't been proved.

SurgeryIf your symptoms are severe or persist after trying nonsurgical therapy, surgery may be the best option.

The goal of carpal tunnel surgery is to relieve pressure on your median nerve by cutting the ligament pressing on the nerve. During the healing process after the surgery, the ligament tissues gradually grow back together while allowing more room for the nerve than existed before. The surgery may be done a couple of different ways. Either technique has risks and benefits that are important to discuss with your surgeon before surgery.

• Endoscopic surgery. Carpal tunnel surgery can be done using an endoscope, a telescope-like device with a tiny camera attached to it that allows your doctor to see inside your carpal tunnel and perform the surgery through small incisions in your hand or wrist.
• Open surgery. In other cases, surgery involves making a larger incision in the palm of your hand over the carpal tunnel and cutting through the ligament to free the nerve.

In general, your doctor will encourage you to use your hand after surgery, gradually working back to normal use of your hand while avoiding forceful hand motions or extreme positions of your wrist. Soreness or weakness may take from several weeks to as long as a few months to resolve after surgery. If your symptoms were very severe before surgery, symptoms may not go away completely after surgery.

Lifestyle and home remedies

These steps may help you gain at least temporary relief from your symptoms:

• Take quick breaks from repetitive activities involving the use of your hands.
• Rotate your wrists and stretch your palms and fingers.
• Take a pain reliever, such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others).
• Try wearing a wrist splint at night. Wrist splints are generally available over-the-counter at most drugstores or pharmacies. The splint should be snug but not tight.
• Avoid sleeping on your hands to help ease the pain or numbness in your wrists and hands.

If pain, numbness or weakness recurs and persists, see your doctor.

Alternative medicine

Alternative forms of therapy can be integrated into your regular health plan to help you deal with the signs and symptoms of carpal tunnel syndrome. You may have to experiment to find a treatment that works for you. Still, always check with your doctor before trying any complementary or alternative treatment.

• Yoga. Yoga postures designed for strengthening, stretching and balancing each joint in the upper body, as well as the upper body itself, may help reduce the pain and improve the grip strength of people with carpal tunnel syndrome.
• Hand therapy. Preliminary evidence suggests that certain physical and occupational hand therapy techniques may help improve symptoms of carpal tunnel syndrome.
• Ultrasound therapy. High-intensity ultrasound can be used to raise the temperature of a targeted area of body tissue to reduce pain and promote healing. A course of ultrasound therapy over several weeks may help improve the symptoms of carpal tunnel syndrome.

Prevention

Reduce your force and relax your grip. Most people use more force than needed to perform many tasks involving their hands. If your work involves a cash register, for instance, hit the keys softly. For prolonged handwriting, use a big pen with an oversized, soft grip adapter and free-flowing ink. This way you won't have to grip the pen tightly or press as hard on the paper.There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on your hands and wrists by taking the following precautions:

• Take frequent breaks. Give your hands and wrists a break by gently stretching and bending them periodically. Alternate tasks when possible. If you use equipment that vibrates or that requires you to exert a great amount of force, taking breaks is even more important.
• Watch your form. Avoid bending your wrist all the way up or down. A relaxed middle position is best. If you use a keyboard, keep it at elbow height or slightly lower.
• Improve your posture. Incorrect posture can cause your shoulders to roll forward. When your shoulders are in this position, your neck and shoulder muscles are shortened, compressing nerves in your neck. This can affect your wrists, fingers and hands.
• Keep your hands warm. You're more likely to develop hand pain and stiffness if you work in a cold environment. If you can't control the temperature at work, put on fingerless gloves that keep your hands and wrists warm.