Many people have heard of carpal tunnel syndrome, but few fully understand the problem and the terrible impact it can have on a person’s life. It affects the median nerve, which runs down the palm side from the forearm to the hand. This nerve is located in a small pathway called the carpal tunnel, and shares limited space with the tendons. This limited space can be impacted by many factors, with the end result being applied pressure on the median nerve. This in turn causes sensations of pain, numbness, burning, and tingling throughout the length of the nerve.
There are a variety of causes and contributing factors that can result in this problem, making it a very common problem that can affect a wide variety of people. According to the CDC’s Morbidity and Mortality Weekly Report (MMWR), in 2010 alone over 3% of employed adults between the ages of 18-64 had a case of carpal tunnel syndrome. The study also found an increased risk for women across all age groups.
Several other factors are known to potentially contribute to the ailment including: wrist sprains, wrist fractures, fluid retention (often found with pregnancy or menopause), obesity, smoking, diabetes, rheumatoid arthritis, hypothyroidism, and bad habits such as repetitive movement. With many of these conditions within the control of each individual, it is possible to reduce the chances of having the problem altogether. The most important trait is to ensure proper stretching, breaks, and positioning of the wrist when doing strenuous work, whether that work involves typing on a keyboard or doing something more physically demanding.
Once the condition does begin, the hardest part in diagnosing the condition is that it starts out slowly and gradually gets more severe over time. This prevents sufferers from immediately realizing it is serious enough to warrant a visit to the Pain Doctors, and they delay treatment until more worrisome symptoms begin to present. As if the symptoms alone are not bad enough, the numbness and lack of feeling can lead to other issues and further damage. While a doctor can usually diagnose the issue just based on the symptoms, it is common to use MRI and x-ray scans to rule out other potential issues such as cysts or bone spurs that can offer similar symptoms.
Once a diagnosis is made, the treatment boils down to first managing the pain and then determining the cause of the condition and extent of the problem. In lesser cases it is often enough to use some combination of braces and therapy to alleviate the pain and rest the injury until it is able to recover naturally. Medications, such as non-steroidal anti-inflammatory drugs (NSAID’s) including aspirin and ibuprofen, are often recommended by pain doctors to be picked up over the counter to help with the immediate issue. These are the most common treatments, as there is very little risk involved and in many cases it is very effective.
If the issue does not resolve on its own, another plan of action is to use cortisone injections in order to eliminate the inflammation effectively. This does, however, require repeat treatments in many cases as the effects only last a few months.
In very extreme cases where nothing else has worked, surgery can be used to force the carpal ligament to release. Although the surgery itself is extremely effective, the dangers of surgery in general often means it is only recommended by pain doctors after symptoms have been extreme for over six months.