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Thyroid dysfunction
Fractures or trauma to the wrist
Diabetes
Autoimmune disorders such as rheumatoid arthritis
Fluid retention from pregnancy or menopause
Numbness, tingling, and pain in your thumb and the first three fingers of your hand
Pain and burning that travels up your arm
Weakness in the muscles of the hand
Wrist pain at night that interferes with sleep
Diagnosis
A doctor can diagnose a carpal tunnel syndrome by doing a physical examination and tests called nerve conduction studies. The physical examination may include a thorough evaluation of your hand, shoulder, wrist, neck or any other parts that can cause pressure in the nerve. The doctor may also check if there are any tenderness or swelling in the wrist. The doctor may further check the sensation of the fingers and the strength of the muscles in your hand.
Surgery
To relieve the symptoms of carpal tunnel syndrome, an orthopedic doctor performs a surgery called Carpal Tunnel Release surgery. The goal of carpal tunnel surgery is to reduce pain, swelling and pressure on the median nerve. This surgery is performed in a hospital operating room under the influence of general or local anaesthesia on an outpatient basis. During the surgery, the orthopedic surgeon makes 1 or 2 small incisions, about ½ inch each, in the palm or wrist area. These small incisions will result in very small scars, which in most cases are unnoticeable.
An endoscope is inserted through one incision. The endoscope has a camera on its end, which allows the doctor to look for any pathology or anomaly. The endoscope presents an image on the television screen that allows the surgeon to see the inside of the hand or wrist directly. The doctor may insert surgical instruments through the second incision to cut the transverse carpal ligament and thus releasing the pressure on the median nerve by expanding the carpal tunnel. After the ligament is cut, the incisions are closed by dissolvable sutures. Carpal tunnel release surgery is much less traumatic to the joint, muscles ligaments, and tissues than the conventional carpal tunnel surgery that is performed with long incisions.
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Overview
Carpal Tunnel Syndrome is a condition in which pain, tingling and numbness occurs in the hands and arm. Carpal tunnel syndrome is a very common problem that affects the hands of people. This condition occurs when the media nerve – one of the major nerves – gets squeezed or compressed while passing through the wrist. The median nerve is responsible for providing sensation to the thumb, index, and the middle fingers. This health condition was first identified in the mid 1800s.Read More
There are 9 tendons which help in bending the fingers and the thumb. These tendons are known as flexor tendons. Carpal tunnel syndrome occurs when the tunnel becomes narrow and the flexor tendons nearby swells up. This puts pressure on the median nerve leading to carpal tunnel syndrome.Facts on Carpal tunnel syndrome:
- Heredity is the most common factor leading to carpal tunnel syndrome. Small carpal tunnels may run in the heredity of a family. If your parents have carpal tunnel syndrome, you are likely to suffer from it too.
- Medical conditions such as thyroid issues, rheumatoid arthritis, diabetes can also cause carpal tunnel syndrome.
- Diagnosis of carpal tunnel syndrome is very important. If not treated on time, it can damage the muscles of the hand permanently.
- Maintaining a healthy weight can reduce the risk of carpal tunnel syndrome.
Signs and symptoms of CTS:
The symptoms are always in connection with the nerve path and the compression of the median nerve. When the hand loses all senses, the hand is considered to ‘fall asleep’. Other symptoms include:- Pain and burning sensation that travels from wrist to the arm
- Wrist pain the increases when the person is asleep
- Weakness in the muscles of the hand
- Numbness and tingling in the thumb and the middle fingers
- A person with CTS may feel the need to shake out the hand
Causes of CTS:
The pain of the carpal tunnel is due to excess pressure on the median nerve. The most common cause of CTS is often an underlying condition that leads to swelling of the wrist. Sometimes, even obstructed blood flow can cause the pain. Other causes include:- Diabetes
- Thyroid retention
- High blood pressure
- Autoimmune disorders such as rheumatoid arthritis
- Fractures or trauma to the wrist
- Fluid retention from pregnancy or menopause
CTS may also be the result of :
- Constant positioning of your wrists of the mouse or keyboard for long hours
- Exposure to vibrations from using power tools
- Repeated movement that overextends your wrist
Who is at risk for CTS?
People who are related to activities or jobs that involve repetitive finger use are at higher risk of CTS. Other risk factors include:- Heredity (smaller carpal tunnels can run in families)
- Alcoholism
- Pregnancy
- Hemodialysis (a process where the blood is filtered)
- Arthritic diseases such as rheumatoid arthritis and gout
- Thyroid gland hormone imbalance (hypothyroidism)
- Wrist fracture and dislocation
- Hand or wrist deformity
- Diabetes
- A mass (tumor) in the carpal tunnel
- Older age
- Amyloid deposits (an abnormal protein)
Diagnosis
The problem of CTS is diagnosed by an orthopedic doctor. The doctor examines the hands, shoulders, arms, and the neck to find out the underlying cause of the pain. The doctor may rule out other conditions too that mimic CTS. He or she would further diagnose the hand for any tenderness, swelling or dislocation. The doctor may recommend you to undergo X-rays and other imaging tests to reveal if there is any fracture or arthritis which can damage the nerve. The doctor may ask you to do an ultrasound to see if there is any abnormal size of the median nerve. To check the anatomy of the wrist, you might be recommended to do a magnetic resonance imaging (MRI). In electromyography, a fine needle is inserted into a muscle and the electrical activity viewed on a screen can determine the severity of damage to the median nerve.Treatment
Non-surgical treatments
- Splinting – A splint is worn at night for initial treatment.
- Avoiding activities that may provoke pressure – Avoid prolonged hours of activities which put pressure on the hand and provoke the symptoms. Give your hand some rest.
- Icing – If the swelling is visible and the hand is red, try applying ice packs.
- OTC drugs – Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and other nonprescription pain relievers, may provide short-term relief from the pain in the wrist and hand.
- Therapies – Therapies such as acupuncture and chiropractic have benefited many people from the pain. But, this relief is temporary and not long lastin
Surgery
There are two major types of surgeries done to release carpal tunnel syndrome: Open surgery – This is the traditional process of surgery. The orthopedic surgeon in this method, makes an incision up to 2 inches in the wrist. After that, the surgeon cuts the carpal ligament to enlarge the tunnel. The doctor generally uses local anesthesia to carry out the process and the surgery is done on an outpatient basis. Endoscopic surgery – The surgeon makes minute incisions on the palm and the wrist. Through the incisions, a camera is inserted which is attached to a tube. Through the camera, the surgeon observes the ligament, and tendons on the monitor. Factors such as age of the patient, duration of the symptoms and severity of the injury determines the success or failure of the surgery.Prevention
- People at the workplace can perform stretching exercises in between work or take short breaks and give the hand some rest.
- Wearing fingerless gloves can help the hand stay flexible.
- Workstations can be redesigned to support rest to the wrists of the employees.
Ayurvedic tips for CTS:
- Apply Mahanarayana taila (herbal oil) on the wrist and palm.
- Do gentle wrist movements after applying the oil.
- Practice heat therapy
- You can take salt heat therapy. Tie salt in a cloth, heat it on a pan and apply in your hand.
- Health and lifestyle management
- Do not smoke or consume too much alcohol
- Take care of basic health
- Eat balanced diet
- Do regular exercises to keep the body fit and flexible
- Keep a check on your diabetes and arthritis
All humans deserve equal treatment but everyone cannot afford costly treatments at multispeciality or super-specialty hospitals.
In India, many people don’t even have mediclaim to deal with medical emergencies. Also, there is a lack of experienced professionals to consult for a second opinion in case of surgery. Surgicare & ICU is built keeping in view the above points. It offers surgery and post-surgery critical care.
Surgicare & ICU Hospital is well equipped for all kinds of surgeries and offers one of the best ICU teams of Vadodara to take care of critical patients. It offers help to all those patients who do not have mediclaim but need treatments. Surgicare & ICU offers the opportunity for second opinions.