Frank Gerratana, M.D., orthopedic surgeon [November 07 2013]
Nothing can hamper productivity or dampen recreation quite like chronic pain. One minute you may be answering emails and the next minute massaging your wrist due to a recurring sharp, throbbing pain running up the arm.
If this scenario sounds familiar, you aren't alone. Whereas a variety of conditions can be attributed to this symptom, the most common is carpal tunnel syndrome, affecting four to 10 million Americans. The condition is caused when the median nerve running from the forearm into the palm is compressed at the wrist, or more specifically, the narrow carpal tunnel comprised of ligament and bones housing the median nerve and other tendons.
The median nerve is responsible for controlling sensations and impulses to the palm side of the thumb and other fingers, though not the little finger. When pressure is applied to this nerve, a tingling, numbing or burning sensation is most commonly felt. If left unchecked, the symptoms of carpal tunnel syndrome will gradually progress to include:
• itching numbness, especially in the palm, thumb, index and middle fingers
• fingers feeling swollen, though little to no swelling is evident
• night awakening to “shake out” the hand as most people sleep with flexed wrists, causing pressure to build in the carpal tunnel
• decreased grip strength
• in chronic or severe cases, inability to decipher hot or cold by touch
Depending on condition severity, varied treatments may be prescribed to reverse or minimize the damage imposing upon the median nerve. Your healthcare provider is likely to suggest one or a combination of these treatments:
• resting the hand and wrist for at least two weeks
• immobilizing the wrist in a splint
• avoiding activities known to aggravate symptoms
• applying cool packs if there is inflammation
• taking nonsteroidal anti-inflammatory drugs like ibuprofen to reduce swelling and alleviate pressure
• stretching and strengthening exercises under the direction of a physical therapist
• either open release or endoscopic surgery (if symptoms have been lasting for more than six months)
The earlier treatment is applied, the better the recovery. Just because carpal tunnel symptoms appear doesn't mean they have to stay. Catch it in time and you'll soon be waving goodbye to all its annoying and irritating cramps and pains.
Dr. Frank Gerratana is a member of The Hospital of Central Connecticut (HOCC) medical staff. For referrals to HOCC physicians, please contact our free Need-A-Physician referral service by phone at 1-800-321-6244 or online, www.thocc.org.