Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a disorder that results from dysfunction of one of the nerves in the wrist and hand. The carpal tunnel is a narrow passageway in the wrist through which the median nerves passes from the forearm into the hand. In CTS, as the nerve passes through the wrist, the nerve does not function properly since there is compression due to Repetitive Stress Injury (RSI) or overuse injury.
The earliest sign of CTS is failure to feel textures, tingling and pain in the hand, especially after the regular workday. Left untreated, the symptoms progress to persistent pain and can extend to the elbow and shoulder. CTS can eventually lead to the inability to grip things firmly and to significant weakness and wasting of the muscles of the hand controlled by the median nerves.
CTS and other forms of RSI are most common in middle age and tend to affect women more than men. It affects 0.1% of the general population, and as many as 15% of workers in high-risk industries, such as electronic parts assemblers, data processors, typewriters, musicians, and dental hygienists suffer from the condition.

The symptoms of CTS often first appear as painful tingling in one or both hands during the night. Accompanying this is a tingling or numb feeling in the hand, usually just in the thumb and first three fingers, or swelling. As symptoms increase, tingling may develop during the day, shooting pains in the wrist or forearm, and sometimes extending to the shoulder, neck, chest, and foot.

Many patients with CTS are unable to differentiate hot from cold by touch, and experience an apparent loss of strength in their fingers. They have difficulty clenching the fist or grasping small objects. Sometimes, dry skin and fingernail deterioration appear.

Anything that causes swelling, thickening or irritation of the synovial membranes around the tendons in the carpal tunnel can result in pressure on the median nerves. 
Some common causes and associated conditions are:

• Repetitive and forceful grasping with the hands 
• Repetitive bending of the wrist 
• Broken or dislocated bones in the wrist, which produce swelling 
• Arthritis, especially the rheumatoid type 
• Thyroid gland imbalance 
• Sugar diabetes 
• Hormonal changes associated with menopause 
• Pregnancy 

The carpal tunnel is made up of several bones connected by ligaments. Through the tunnel run nerves, tendons, blood and other soft tissues.

 CTS is different from other kinds of swelling where the result is a simple protrusion. The soft tissues, especially the tendons and the protective sheaths that cover them swell, but have no place to expand since they are encircled by bones and ligaments in the wrist. Consequently, the swelling results in pressure on the main nerve in the hand called the median nerves, and causes it not to function properly.

Your doctor may diagnose this condition by the following symptoms and signs:

• Numbness and tingling in the hands, especially when these symptoms occur at night and after use of the hands 
• Decreased feeling in your thumb, index finger, and long finger t
• The presence in your hand of an electric-like shock or tingling (like hitting your "funny bone") when your doctor taps over the course of the median nerves at the wrist 
• The reproduction of your symptoms by holding your wrists in a bent down position for one minute 

• To avoid the accumulation of fatty deposits, a diet low in hydrogenated fats is recommended.
• It is beneficial to use monosaturated oils such as olive oil and eat plenty of coldwater fish.
• Foods to emphasize are brown rice, whole grains, lentils, sunflower seeds, salmon, tuna, avocado, turkey and fresh fruits and vegetables.
• Eating fresh pineapple can provide an excellent source of bromelain, an enzyme that inhibits inflammation.
• Foods that promote the production of certain acids are discouraged and include red meats, wines, cheeses, and fatty dairy products.
• Avoid a high fat diet, smoking, stress, excess salt and caffeine.

• Use over the counter medications such as aspirin and ibuprofen to help relieve pain. These are non steroidal, anti inflammatory (NSAID) medicines, the continual use of which would involve significant health risks.
• Very mild hand exercises such as rotating the wrists in circles helps to increase circulation and may alleviate some of the tingling. Exercise should be used with caution as resting the wrists is sometimes more effective to control symptoms.
• Using a cold pack may also help to relieve swelling if present.
• Change the position of your hands when crocheting, knitting, typing, holding tools etc to facilitate better circulation.
• It is not uncommon for people to sleep with their wrists bent against the mattress, which can aggravate the symptoms of Carpal Tunnel Syndrome. Before going to bed, use a wrist sling to keep your wrist straight and take stress off the nerves. These splints are usually made of metal with Velcro fasteners and can be purchased at medical supply sources or can be made to fit your hand by a physical therapist.
• Use handles, pencils, pens, curling irons, scissors etc that are substantial in size and easy to operate.
• Rotate repetitive tasks and rest from them from time to time.

• As women commonly do keyboarding and other repetitive wrist motions, this disorder typically affects women.
• Pregnancy and hormonal changes that occur with age can aggravate the problem.
• Learning to rest and relax during repetitive movements is crucial.
• Get in tune with your body’s needs in order to protect it from injury or stress related damage.
• Stop and assess your activities and see whether they are impacting your health.