Carpal Tunnel Syndrome

According to a recent New York Times health report, evidence suggests that about 3% of women and 2% of men will be diagnosed with carpal tunnel syndrome during their lifetime, with peak prevalence in women older than 55. This is a condition, occurring mostly in patients between 30 – 60 years old, caused by pressure on the median nerve. This is the nerve in the wrist that supplies feeling and movement to parts of the hand. The area in the wrist where the nerve enters the hand is called the carpal tunnel, a very narrow passage. Any swelling there can pinch the nerve and cause pain, numbness, tingling or weakness.

Determining how many people actually have it is very difficult. Many people report carpal tunnel syndrome symptoms but have normal test results. Others have no symptoms and abnormal test results. Some studies have shown that women have a significantly higher risk for carpal tunnel syndrome than men do. The explanation for this greater risk is unknown, but it may be related to the smaller size of women’s carpal tunnel. And, hormonal changes appear to play a role.

Symptoms and Diagnosis

To diagnose carpal tunnel syndrome, Dr. Leah Urbanosky, Hinsdale Orthopaedics, will check for the following:

• Problems with fine finger movements (coordination) in one or both hands
  
• Wasting away of the muscle under the thumb (in advanced or long-term cases)
  
• Weak grip or difficulty carrying bags
  
• Weakness in one or both hands
  
• Numbness or tingling in the thumb and next two or three fingers of one or both hands
  
• Numbness or tingling of the palm of the hand
  
• Pain extending to the elbow
  
• Pain in wrist or hand in one or both hands
  
• Night hand pain
  

Dr. Urbanosky may further recommend the following diagnostic tests:

• Electromyography
  
• Nerve conduction velocity
  
• Wrist x-rays to rule out other problems (such as wrist arthritis)
  

Causes

Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel. Other causes include:

• Sewing
  
• Driving
  
• Assembly line work
  
• Painting
  
• Writing
  
• Use of tools (especially hand tools or tools that vibrate)
  
• Sports such as racquetball or handball
  
• Playing some musical instruments
  

Treatment

The first line of defense in treating carpal tunnel syndrome is alternating hot and cold compresses. If that doesn’t provide relief, Dr. Urbanosky may recommend a splint at night for several weeks in addition to anon-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Cortisone injections into the carpal tunnel area may also offer period relief. Finally, there is a surgical procedure that treats the ligament that is pressing on the nerve.

Symptoms often improve with treatment, but more than 50% of cases eventually require surgery. Most surgery is successful, but outcomes depend on how long the nerve compression has been occurring and its severity.
If the condition is treated properly, there are usually no complications with surgery. However, if untreated, the nerve can be damaged, causing permanent weakness, numbness, and tingling.

If you feel that you have symptoms of carpal tunnel syndrome and would like to schedule an appointment with Dr. Urbanosky, a specialist in hand conditions, please call her office at: (815) 462-3474.

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Wrist Conditions
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Carpal Tunnel Syndrome
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