A Light at the End of the Carpal Tunnel
by Pamela Israel
Picture it. You’re going about your day and you come to a door with a knob that you need to turn. No problem, right? Just reach out, grab it, and twist. But when you turn the doorknob, you feel a tightening in your wrist. Before you can react, you feel a distinct “POP”, just at the base of your hand, followed by tingling and numbness radiating out toward your thumb and first two fingers. No, your body isn’t falling apart. You’ve got the beginnings of Carpal Tunnel Syndrome (CTS). But what exactly is CTS and how can you treat it? Well, sit back and relax, because we’re about to tell you.
CTS: What is it?
With the rise of computers, there has also been a significant rise in the number of people affected by CTS. Since CTS is, in large part, caused by repetitive motions – such as typing – people who spend a large amount of time at the keyboard or doing other repetitive tasks are at particular risk. CTS happens because of the way our wrists have evolved. One nerve (called the median nerve) runs down the arm, all the way through the wrist and down to the fingers. On the way, the nerve (along with nine tendons that help control hand and finger movements) runs through an area in the wrist called the “carpal tunnel”. The carpal tunnel is narrow and there’s not a lot of space, which usually isn’t a big deal. But when we do a bunch of repetitive movements or otherwise damage the tendons around the nerve, they become inflamed. When the tendons become inflamed, blood rushes to them and they swell. When they swell, there’s not enough room in the carpel tunnel, so the swollen tendons put pressure on the median nerve, which in turn causes the characteristic pain and numbness in the hands and fingers. At first, the inflammation may be minor and may even disappear on its own. However, if repetitive motions are continued with no intervention, chronic CTS and even permanent nerve damage may result.
Although CTS is very common in our society, it can easily be confused with several other conditions, such as arthritis, muscle spasms, or Thoracic Outlet Syndrome. Therefore, a trip to the doctor is in order, since, as we all know, the first step to treating any condition is a correct diagnosis.
Let’s Talk about Symptoms
The main symptoms of CTS are pain and numbness in the thumb and first two fingers of the hands. There can also be tingling in the hands and a popping sensation in the wrists, such as what is described in the introduction. If left untreated, CTS can eventually lead to loss of movement (paralysis) in the thumb and first two fingers.
What to Do: Prevention and Treatment
Arguably one of the best ways to avoid CTS is to prevent it before it starts by developing good habits when doing repetitive movements. If you have a job that requires you to type or do other repetitive movements, a brief warm-up that includes hand and wrist stretches will go a long way toward preventing CTS. Two basic stretches are the wrist flexor/extensor stretch and the prayer stretch. To do the wrist flexor/extensor stretch, hold one arm out in front of you and use your other hand to gently stretch the first hand down. Hold the stretch while you count to seven (roughly 7-8 seconds). Then gently pull the hand up to stretch the underside of the wrist (see illustration). Hold while you count to seven. A nice variation on this stretch is to make a fist with the hand you are stretching, then use your other hand to gently pull it down, which stretches the back of the wrist. To do the prayer stretch, begin with your arms at your sides. Bring them up to the level of your forehead and bring your hands together, sort of like you’re going to pray or meditate. When your hands meet in front of your face, gently lower them until they are in front of your diaphragm (just above your belly button – see illustration). Again, hold this stretch while you count to seven.
Wrist braces and other supports (such as Ace bandages) are inexpensive treatments for CTS that is caused by repetitive movements. In addition, proper movement techniques that will put less strain on the tendons in the carpal tunnel can be learned. By learning to use the body in such a way that the tendons are not strained, CTS can be relieved and sometimes eliminated.
Sometimes CTS can occur as a symptom of another ailment, like an injury or fluid retention due to pregnancy. If CTS is being caused by something besides repetitive movements, anti-inflammatory drugs such as ibuprofen may be used to relieve symptoms. In order to successfully treat CTS caused by another ailment, the root ailment needs to be diagnosed and treated. Once the root ailment is treated, the CTS should diminish and disappear.
Since CTS is caused by inflammation, anything that will increase circulation, remove local toxins, and decrease inflammation will help relieve the symptoms. Because massage helps with all of these, it is the most highly suggested treatment for CTS. Doctors also suggest that sufferers of CTS massage the affected area themselves between regular professional massage treatments. With regular massage, a CTS sufferer should feel less pain within a few weeks, and a cessation of all symptoms within a few months.
In serious cases of CTS surgery may be indicated, but this should be used as a last option only. While surgery may relieve symptoms in the short term, it does nothing to prevent relapse or treat the actual problem of overusing the hands and wrists. It is, at best, a temporary solution, and puts the sufferer under the strains of recuperating and healing from the surgery, and the stress of the surgery itself.
Overall, with CTS, an ounce of prevention is worth a pound of cure. By using good working habits, like warming up before doing repetitive movements, and treating symptoms with anti-inflammatory drugs, massage, and wrist supports, CTS can be successfully controlled and treated.