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Health Tip Carpal Tunnel

     Carpal tunnel syndrome (CTS) is a painful nerve problem that interferes with the use of your hand. It occurs when tissue or bone puts pressure on the nerve that runs from your neck down the arm and through your wrist to your fingers. At first, you may have numbness, tingling, or burning in your hand. Shooting pain in your wrist or forearm may follow, and your grip may become weak.
     Bounded by bones and ligaments, the carpal tunnel is a narrow passageway — about as big around as your thumb — on the palm side of your wrist. This tunnel protects a main nerve to your hand and nine tendons that bend your fingers. When pressure is put on the nerve — the median nerve — it produces the numbness, pain and, eventually, hand weakness that characterize carpal tunnel syndrome.  It is also possible for similar symptoms to occur from having pressure on the nerves as they pass from the neck through the shoulder or elbow areas.  This is the most common.  When the pressure is isolated to the area of the wrist it is then properly called Carpel Tunnel Syndrome.
      Carpal tunnel syndrome is common, particularly in women, but can occur in anyone. Certain conditions, such as obesity , diabetes and rheumatoid arthritis have been associated with an increased risk of carpal tunnel syndrome. Activities such as cigarette smoking and forceful and repetitive use of the hands and wrists also have been linked to the condition. However, the evidence is not clear on exactly which types of activities cause the syndrome. In particular, and contrary to much popularly held belief, there isn't strong scientific evidence to link computer use to carpal tunnel syndrome. The evidence is stronger for a connection to specific kinds of heavy and repetitive assembly line work and work involving prolonged, heavy gripping and use of vibrating tools.
      Fortunately, for most people who develop carpal tunnel syndrome, proper conservative treatment usually can relieve the pain and numbness and restore normal use of the wrists and hands.  Proper “adjustments” of the bones of the wrist by a qualified chiropractor is the best course of care followed by exercises to strengthen and relieve stress on the wrist and hand.

  Signs and Symptoms

Carpal tunnel syndrome typically starts gradually, with a vague aching in the wrist that can extend to your hand or forearm. Other common signs and symptoms include:

Tingling or numbness in your fingers or hand, especially the thumb, index, middle or ring fingers, but not your little finger. This sensation often occurs while sleeping, driving a vehicle or holding a phone or a newspaper.

Pain radiating or extending from your wrist up your arm to your shoulder or down into your 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 your hands, and a tendency to drop objects.

A constant loss of feeling in some fingers. This can occur if the condition is at an advanced stage.

  Treatment

This is not something that should be left unattended.  If it is suspected see your chiropractor for proper care soon to avoid permanent damage to the nerves in that area.

  Prevention

There are no proven strategies to prevent carpal tunnel syndrome, but to protect your hands from a variety of ailments, the following precautions are reasonable:

·         Reduce your force and relax your grip. Studies show that most people use four to five times more force than they need to perform most tasks involving the hands. If your work involves a cash register, for instance, hit the keys softly. If you frequently write by hand, use a big pen with an oversized, soft grip adapter and free-flowing ink. This way you will not have to grip the pen tightly or press hard on the paper.

·         Take frequent breaks. Every 15 to 20 minutes give your hands and wrists a break by gently stretching and bending them. Alternate tasks when possible. Type for 15 minutes then do some phone work for 5 minutes. If you use equipment that vibrates or on which you exert a great amount of force, taking breaks is even more important.

·         Watch your form. Avoid bending your wrist all the way up or down. A relaxed middle position is best. If you use a keyboard, keep it at elbow height or slightly lower.

·         Improve your posture. The tendency to roll the shoulders forward shortens the neck and shoulders muscles, compressing nerves in the neck. This, in turn, can affect the wrist, fingers and hand.

·         Keep your hands warm. You're more likely to develop hand pains and stiffness if you work in a cold environment. If you can't control the temperature at work, put on fingerless gloves that keep your hands and wrists warm.

  Self Care

Quick breaks, stretching, and the exercises below may relieve your symptoms temporarily.  Proper nutrition such as balanced B-vitamins are also very important.

You might also want to try wearing a wrist splint at night and avoid sleeping on your hands to help ease the pain or numbness in your wrists and hands. The splint should be snug but not tight. If pain, numbness or weakness recurs and persists for more than several weeks, see your chiropractor.  You also do not want to get dependant on a splint as weakening the muscles can create further problems.

In many cases I have instructed patients to place the affected hand in warm water for four minutes, and then cold water for one minute (three to five times a day). Each position (see figures 1 and 2) for mobilizing the median nerve was maintained for seven seconds, and repeated five times at each session, for a total of three to five sessions per day.

  Positions for extension tendon gliding exercises: (see Figure 2)

A.     wrist is in neutral, with the fingers and thumb in flexion;

B.      wrist is in neutral, with the fingers and thumb extended;

C.     wrist and fingers are extended, with the thumb in neutral;

D.     wrist, fingers, and thumb are extended;

E.      wrist, fingers, and thumb are extended, with the forearm in supination; and

F.      wrist, fingers and thumb are extended, the forearm is in supination, and the other hand gently stretches the thumb.

     In addition to the above exercises using a rubber band around the finger tips and streaching outward can help balance the over used muscles.

Yours for better Health.
Dr. Bradley C. Shapero, D.C.

Dr.Bradley Shapero
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