Carpal tunnel syndrome: The invisible threat

by Admin-Phmp

Text by Henrylito D. Tacio

Photos: my.clevelandclinic.org and Wikipedia

Computers have certainly expanded man’s horizons and given him the ability to perform lightning-like calculations. Unknowingly, constant computer use can be hazardous to one’s health. There is such a potentially disabling condition as carpal tunnel syndrome (CTS).

“Carpal tunnel syndrome results from pressure or compression on the median nerve as it passes through the tight ‘carpal tunnel’ located at the wrist area immediately proximal to the palm,” explains Dr. Sandra Navarra, head of Rheumatology at the University of Santo Tomas and St. Luke’s Medical Center.

“If not treated, CTS may result in muscle weakness. Such people may find difficulty in using their hands like holding a cup, turning pages in a book, typing or even carrying a basket. They also tend to drop things,” says Professor Pao Hsii Feng, a clinical professor at the National University of Singapore.

CTS can occur at any age, but most commonly among people over the age of 50. It can also affect younger people, especially if they do work or other activities that require frequent, forceful use of the hands. “Regardless of age, CTS occurs more often in women than in men,” the Arthritis Foundation bares.

In today’s computer-intensive offices, among those who are most likely to experience CTS are people who are ignorant to the warning signs, on a binge on computer use (writing deadlines, reports, and project proposals), don’t take regular rest breaks, having poor posture, and operating incorrect keyboard and/or mouse height positioning.

CTS is also linked to other things. “Pregnant women and people who have diabetes, an underactive thyroid gland, gout, or rheumatoid arthritis are at increased risk of developing carpal tunnel syndrome,” says the second home edition of ‘The Merck Manual of Medical Information.’

Illustration of Carpal Tunnel Syndrome

Symptoms

The symptoms can be minor or severe and sometimes disabling. “Carpal tunnel syndrome typically starts gradually, with a vague aching in your wrist that can extend to your hand or forearm,” says the Minnesota-based Mayo Clinic.

Medical science shares these common signs and symptoms:

  • Tingling or numbness in the fingers or hand, especially the thumb, index, middle, or ring fingers, but not the little finger. This sensation often occurs while driving a car or holding a phone or a newspaper, or upon awakening.
  • Pain radiating or extending from the wrist up the arm to the shoulder or down into the palm or fingers, especially after forceful or repetitive use. This usually occurs on the front (palm) side of the forearm.
  • A sense of weakness in the hands and a tendency to drop objects. People with CTS have trouble performing simple tasks such as tying their shoes or picking up small objects.
  • A constant loss of feeling in some fingers. Many patients with CTS are unable to differentiate hot from cold by touch.

According to Dr. Steven Barrer, a clinical assistant professor of neurosurgery at the Medical College of Pennsylvania in Philadelphia, carpal tunnel pain “is usually worse at night, when body fluids collect in wrists and other body parts.” He adds, “In fact, loss of sleep due to the pain of CTS is probably the most bothersome symptom of the disease.”

“CTS may affect one or both hands, and symptoms typically come and go at first,” says the Arthritis Foundation. “Early in the course of CTS, symptoms may be affected by the way you use your hands and wrists as well as how often you use them. For example, driving or slicing fruits may bring on symptoms. When your hands are at rest, symptoms are often relieved. As the condition worsens and pressure on the median nerve becomes greater, you may experience continuous pain or numbness.”

If you experience any symptoms mentioned above, talk with your doctor. Be sure to describe the location of your pain to your doctor. Don’t forget to mention the activities which aggravate and relieve your pain. 

“Your doctor will examine your hand and look for changes in muscle contour and sensibility,” the American Academy of Orthopedic Association says. “He may order blood tests and X-rays of the hands and wrists.”

Treatment

Treatment aims to relieve the symptoms of carpal tunnel syndrome by reducing the pressure on the median nerve. “If your CTS is related to your job, taking a five-minute break from the offending chore every hour or so will make a big difference in your condition,” notes Dr. Barrer. “Even a few minutes’ rest can often relieve the pain you feel. Of course, if possible, try to completely avoid the activity causing the trouble.”

Oftentimes, people find temporary relief from symptoms by hanging their arm out of the bed at night or by shaking their hands vigorously with a flicking action. Mild symptoms may also be relieved by applying ice packs to the wrist (ice should not be applied directly to the skin) and by resting the hands and wrists regularly. Wrist splints can be used, either at night or both day and night.

Non-steroidal anti-inflammatory drugs can reduce swelling and so relieve pain. However, there is little scientific evidence to suggest that these are effective for carpal tunnel syndrome. There are possible side effects, including nausea, stomach upsets, and stomach ulcers.

There are other medicines available that may help reduce the symptoms of CTS, but these need to be prescribed by a doctor.

If the above is not successful, surgery may be required to relieve symptoms and avoid permanent nerve or muscle damage. The procedure, called carpal tunnel release, involves cutting the carpal ligament to make more space for the nerves and tendons in the carpal tunnel.

“Carpal tunnel syndrome doesn’t follow a predictable course,” says the United Kingdom-based Repetitive Strain Injury Association. “In around one in three people with the syndrome, the condition gets better without any treatment. Some people have symptoms that get progressively worse, while others only have symptoms from time to time. If treated early, mild cases usually get better without surgery.”

Variety is the key to avoid CTS. If you use a keyboard, structure your workdays to include a mix of activities each hour. For example, instead of typing all morning and filing all afternoon, mix typing and filing throughout the day.

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