Carpal Tunnel Syndrome Treatment in Arizona

The median nerve offers movement and feeling to the thumb side of the hand, including the index and middle finger, palm, and thumb. The carpal tunnel is in the wrist where the hand wrist carpal tunnel pain photonerve enters the hand. This tunnel is somewhat narrow, but any swelling and inflammation can pinch the median nerve, which causes numbness, pain, weakness, and tingling. When the tunnel is constricted, it is called carpal tunnel syndrome.

How common is carpal tunnel syndrome?

According to studies, carpal tunnel syndrome is quite common, affecting 1 in every 2,000 persons.

What causes carpal tunnel syndrome?

Carpal tunnel syndrome is caused by repetitive use of the hand and wrist over and over. Studies have not proven carpal tunnel is caused by working, using a computer, or playing a musical instrument, but these activities tend to increase a person’s risk for developing the condition. Factors that may lead to carpal tunnel syndrome include:

  • Bone fractures
  • Arthritis of the wrist
  • Alcohol abuse
  • Infections
  • Obesity
  • Tumor or cyst that grows in the wrist
  • Swelling during pregnancy
  • Menopause
  • Rheumatoid arthritis

How common is carpal tunnel syndrome?

Carpal tunnel syndrome tends to affect more women than men. It occurs most often in people ages 30 to 60 years.

What are the symptoms of carpal tunnel syndrome?

The symptoms of CTS include:carpal tunnel anatomy picture

  • Pain extending to the elbow
  • Clumsiness of the hand when gripping objects
  • Tingling and numbness in the thumb and next 2-3 fingers
  • Pain of the hand or wrist
  • Problems with fine finger movements (coordination)
  • Wasting of the muscle under the thumb
  • Weak grip or problems carrying bags
  • Weakness in one or both hands

How is carpal tunnel syndrome diagnosed?

During a physical examination, the doctor will check for:

  • Numbness of the thumb, palm, index finger, middle finger, and thumb side of ring finger
  • Tapping over the median nerve at the wrist causing shooting pain from wrist to hand
  • Weak hand grip
  • Pain bending the wrist forward all the way for 60 seconds
  • Tests used include nerve conduction velocity, electromyography, and wrist x-rays.

How is carpal tunnel syndrome treated?

Treatment of carpal tunnel involves:

  • Wearing a splint at night or during the day
  • Avoiding sleeping with the wrists curled up
  • Placing cold and/or warm compresses on the wrists
  • Taking anti-inflammatory medicines (naproxen and ibuprofen)

The doctor may recommend that you use special devices to alleviate pain, such as cushion pads in front of the keyboard, different types of computer mouses, keyboard drawers, and other. You may also want to change your work duties or recreational activities.

What surgery is used to treat carpal tunnel syndrome?

When conservative measures fail, you may decide to have carpal tunnel release surgery. With this procedure, the surgeon cuts into the ligament (releases it) that is pressing on the carpal tunnel syndrome wrist pain photomedian nerve. The procedure can be done via endoscopic methods or open surgery.

With endoscopy, a small scope with camera is inserted into the wrist area, and with open surgery, the surgeon makes a large incision in the palm of the hand and cuts through a ligament to free the nerve. Carpal tunnel surgery is successful most of the time, and this depends on how long the nerve compression has occurred.

What can I expect after carpal tunnel surgery?

During the healing process after carpal tunnel surgery, the ligament tissues grow back gradually, allowing more room for the nerve than before. Your doctor may encourage you to use your hand following surgery, but you must avoid forceful hand motions and extreme wrist positions. It takes several weeks to months to recover following the procedure. You will likely work with a physical therapist to regain strength and function of the wrist.

Resources

Huisstede BM, Hoogvliet P, Randsdorp MS, Glerum S, van Middlekoop M, Koes BW. Carpal tunnel syndrome. Part I: effectiveness of nonsurgical treatments — a systematic review. Arch Phys Med Rehabil . 2010;91:981-1004.

Huisstede BM, Randsdorp MS, Coert Jh, Glerum S, van Middlekoop M, Koes BW. Carpal tunnel syndrome. Part II: effectiveness of surgical treatments — a systematic review. Arch Phys Med Rehabil . 2010;91:1005-1024.

Keith MW. American Academy of Orthopaedic Surgeons clinical practice guidelines on the diagnosis of carpal tunnel syndrome. J Bone Joint Surg Am . 2009;91(10):2478-2479.

Keith MW. American Academy of Orthopaedic Surgeons clinical practice guidelines on the treatment of carpal tunnel syndrome. J Bone Joint Surg Am . 2010;92(1):218-219.

Most Common Types of Fractures

There are many ways to categorize bone fractures. Certain types of fractures are more common in populations than others. Mechanically speaking, there are two major types of fractures: stress fractures and compression fractures.

Stress Fractures

A stress fracture is just a crack within the bone. This type of break is a partial fracture, which is referred to as a microfracture. Stress fractures often occur from repetitive stress on the bone, or from overuse of an extremity. These breaks result from any increased intensity or amount of activity that occurs quickly and doesn’t give the bone a chance to stress-fracturesadjust.

Every day, your bone cells work to strengthen the entire bone structure, or they allow a bone to become less strong, depending on the forces at play on and in the body. The body makes new bone every day, which replaces broken down or stressed bone. The body ideally produces enough bone to replace that lost from everyday activity. However, if bone breakdown exceeds new bone formation, the bone becomes weak and prone to microfractures.

Many people develop stress fractures because he/she has increased activity too fast, and the stress of the increased load puts pressure on the bone. The body cannot adapt, and the bone is not accustomed to the new load, so a stress fracture occurs. More than half of all stress fractures occur in the tibia, which is the largest bone (shin bone) of the lower leg.

Compression Fractures

A compression fracture is actually a complete bone break, unlike a stress fracture. With this break, the bone tissue is disrupted and collapses. The spinal vertebral body (vertebrae MRI VCF compression fractureof the spine) is the most likely site of compression fracture. Most all compression fractures are associated with osteoporosis, occurring mostly in elderly people. However, a vertebral compression fracture can occur as a result of severe trauma.

Some compression fractures go unnoticed, while others are quite painful. A compression fracture will heal on its own within 10-12 weeks. According to a United States study of osteoporotic fractures, around 18% of Caucasian women develop a compression spine fracture between the ages of 68 and 84 years. Rates for this fracture are lower for men and women of other ancestry (Asian, African, and Native American).

Compression fractures of the spine occur due to bone collapsing. The occurrence of one vertebral spinal fracture is associated with further fractures. Studies show that 20% of older women who have one spine fracture will have another within 12 months. Multiple vertebral compression fractures cause a dowager’s hump (kyphosis) with noticeable loss of height.

Other Fractures

Some less common types of fracture are:

  • Greenstick fracture – An incomplete break where the bone is bend. This type of fracture occurs most often in children.
  • Oblique fracture – When a break has a sloped or curved pattern.Wrist Fracture
  • Transverse fracture – When a broken piece of bone is at the right angle to the bone’s axis.
  • Comminuted fracture – When the bone breaks in several pieces.
  • Buckled fracture – A break where ends are driven into each other. Also called an impacted fracture.
  • Pathological fracture – A fracture caused by a disease that weakens the bones, such as osteosarcoma.

The severity of a fracture is dependent upon its location and the amount of damage done to the tissue and bone near the break. Serious fractures must be treated promptly, as complications include damage to nerves/blood vessels and infection. Recuperation following a fracture varies, and depends on the health and age of the patient, as well as the type of fracture.

 

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