Carpal Tunnel Syndrome definition:-
Carpal tunnel syndrome is a condition in which the Median Nerve is compressed as it travels into the hand. Compression leads to nerve this function which manifests as symptoms the may include numbness, pain, tingling, weakness, and dropping, things. Symptoms are often first noted at night and you may wake up and feel the need to shake your hand or hung it off the bed to try to get it to wake-up.
Causes:-
Carpal tunnel syndrome can be caused by many things, but it usually occurs in patients who are exposed to vibration, frequently use their fingers, or frequently use extreme wrist motions. Carpal tunnel syndrome can be caused by.
- Repetitive motion.
- Use of vibrating hand-held tools.
- Pregnancy.
- Diabetes.
- Hypothyroidism.
- Tumor or cyst in the carpal tunnel.
- Swelling or inflammation around the tendons.
- Work stress.
- Arthritis.
- Trauma of the wrist.
There are many different profession and sports that expose people to the factors of carpal tunnel syndrome. However, most of the causes are from preexisting medical conditions.
Risk factors:-
A number of factors have been associated with carpal tunnel syndrome. Although they may not directly cause carpal tunnel syndrome, they may increase the risk of irritation or damage to the Median nerve.
Nerve-damaging conditions:- Some chronic illnesses such as diabetes increase the risk of nerve damage including damage to the median nerve.
Inflammatory conditions:- Rheumatoid arthritis and other conditions that have an inflammatory component can affect the lining around the tendons in the wrist and put pressure on the median nerve.
Medications:- Some studies have shown a link between carpal tunnel syndrome and the use of anastrozole (Arimidex), a drug used to treat breast cancer.
Obesity:- Being obese is a risk factors for carpal tunnel syndrome.
Other medical conditions:- Certain conditions such as menopause, thyroid disorders kidney failure and lymphedema, may increase the chances of carpal tunnel syndrome.
Body fluid changes:- Fluid retention may increase the pressure within the carpal tunnel irritating the median nerve this is common during pregnancy and menopause carpal tunnel syndrome associated with pregnancy generally gets better on its own after pregnancy.
Sex:- Carpal tunnel syndrome is generally more common in women. This maybe because the carpal tunnel area is relatively smaller in women than in men.
Women who have Carpal tunnel syndrome May also have is smaller carpal tunnels then women who don’t have the condition.
Workplace factors:- 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 exciting nerve damage, specially if the work is done in a cold environment.
Symptoms:
Carpal tunnel syndrome symptoms usually start gradually and include.
Numbness, tingling, burning, pain, shock-like sensation, pain and tingling, hand weakness and clumsiness, and dropping things. Carpal tunnel syndrome is a condition in which the median nerve, which runs from the forearm into the palm of the hand becomes compressed at the wrist.
Diagnosis:
In a variation of electromyography, two electrodes are taped to the skin. A small shock is passed through the median nerve to see if electrical impulses are slowed in the carpal tunnel. This test may be used to diagnose the condition and rule out other conditions.
- Physical examination.
- X-ray.
- Ultrasound.
- Electromyography.
- Nerve conduction study.
Treatment:
Treat carpal tunnel syndrome as early as possible after symptoms start. In the early stages simple things that you can do for yourself may make the problem go away for example.
- Avoid activities that make symptoms worse.
- Apply cold packs to reduce swelling.
- Take more-frequent breaks to rest the hands.
Other treatment options include wrist splinting, medications and surgery, splinting and other conservation treatment are more likely to help if you’ve had only mild to moderate symptoms that come and go for less than 10 months if you have numbness in your hands you need to see a Health Care provider.
Nonsurgical therapy:
If the condition is diagnosed early, nonsurgical methods may help improve carpal tunnel syndrome including.
Corticosteroids: Your provider may inject the carpal tunnel with a Corticosteroid such as cortisone to relieve pain. sometimes the provider uses an ultrasound to guide these injection.
Nonsteroidal anti-inflammatory drugs: (NSAIDs) (NSAIDs), such as ibuprofen (Advil, Mortrin, IB, others) may help relieve pain from carpal tunnel syndrome in the short term.
Wrist splinting: A split that holds the wrist still while you sleep can help relieve night time symptoms of tingling and numbness. Even through you only wear the splint at night, it can also help prevent daytimes symptoms. Night times splinting may be a good option if you’re pregnant because it does not involve the use of any medications to be effective.
Surgery:
Surgery may be appropriate if symptoms or Severe or don’t respond to other treatments.
The surgery may be performed with two different techniques:
Open surgery:
Your surgeon makes an incision in the palm of the hand over the carpal tunnel and cuts through the ligament to free the nerve.
- Incomplete release of the ligament.
- Scar formation.
- Injuries to the nerves or blood vessels.
- Wound infections
During the healing process after the surgery the ligament tissues gradually grow back together while allowing more room for the nerve this internal healing process typically takes several months but the skin Heels in a few weeks.
Your provider generally will encourage you to use the hand after the ligament has healed gradually working back to normal use of the hand while initially avoiding Forceful hand motion or extreme wrist positions.
Endoscopic surgery:
Your surgeon uses a telescope-like device with a tiny camera attached to it (endoscope) to see inside the carpal tunnel your surgeon cuts the ligament through one or two small incisions the hand or wrist some surgeons may use ultrasound instead of a telescope to guide the tool that cuts the ligament.
Endoscopic surgery may result in less pain then does open surgery in the first few days or weeks after surgery.
Prevention:-
There are no proven strategies to prevent carpal tunnel syndrome, but you can minimize stress on the hands and wrists with these methods.
Watch your form: Avoid bending your wrist all the way up or down or relaxed middle position is best keep your keyboard at elbow height or slightly lower.
Take short, frequent breaks: Gently stretch and bend hands and wrists periodically. Alternate takes when possible. This is specially important if you use equipment that vibrates or that requires you to exert a great amount of force. Even a few minutes each hour can make a different.
Improve your posture: Incorrect posture rolls shoulders forward, shortening the neck and Shoulder muscles and compressing nerves in the neck this can affect the wrists fingers and hands, and can cause neck pain.
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 the hands and wrist warm.
Change your computer mouse: Make sure that you computer mouse is comfortable and doesn’t strain your wrist
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By GS India Nursing ……….!!