Carpal Tunnel Syndrome (CTS) is a common hand and arm condition caused by the compression of median nerve – the narrow passageway on the palm side of your wrist. It occurs when the median nerve becomes pressed or squeezed at the wrist. The condition, which causes numbness, pain and tingling sensations, can occur in one or both of your hands and most commonly affects the thumb, index finger and middle finger. Symptoms of CTS develop slowly and become worse during the night. Leading healthcare and pain management centers in Brooklyn, NYC offer a combination of treatment modalities to reduce the pain associated with CTS and improve functionality.
A type of repetitive stress injury, CTS occurs due to repeated motions of your wrist, which progressively causes swelling and compression of the median nerve. Holding the wrist in an unhealthy position for a long period of time can lead to CTS. Medical conditions such as diabetes, high blood pressure, autoimmune disorders like rheumatoid arthritis, and fractures or trauma to the wrist can also cause CTS. It is estimated that women (between the ages of 30 and 60 years) are three times more likely to develop CTS than men.
CTS pain can range from mild to severe and differ from one person to another. As the intensity of the pain increases, it can become difficult to hold an object or even perform routine manual tasks. Common symptoms include –
- Swollen feeling in the fingers
- Pain in the wrist, palm or forearm
- Pain and/or numbness that gets worse at night or interrupts sleep
- Numbness or tingling sensation in the hand or fingers
- Dryness of the skin in the fingers
- Difficulty gripping objects with the hands or dropping objects
Chronic CTS can also lead to atrophy of the hand muscles.
Tips to reduce CTS Pain
There are no definite strategies to prevent CTS, but you can minimize stress on your hands and wrists with these strategies –
- Improve posture – Incorrect posture rolls your shoulder forward, shortening your neck and shoulder muscles and compressing your nerves in your neck. This can directly affect the nerves in your wrists, hands and fingers.
- Take frequent rest – Giving your arms frequent rest in between is one of the first steps towards recovery. Gently stretch and bend hands and wrists periodically. However, avoid using the affected hand or wrist for a couple of weeks as this would give the inflamed tissue inside the carpal tunnel a chance to heal more quickly.
- Watch how you hold your wrist – Avoid bending your wrist all the way up or down. A relaxed middle position is best. If your job involves frequent use of a keyboard, always keep your keyboard at elbow height or slightly lower. Make sure that your computer mouse is comfortable and doesn’t strain your wrist.
- Keep your hands warm – People who happen to work in a cold environment generally develop hand pain and stiffness. Using fingerless gloves will keep your hands and wrists warm.
- Wear a wrist splint – Using a strap or wearing a wrist splint (braces) can reduce stress on the injured arm. A splint immobilizes the wrist in a neutral (unbent) position and reduces discomfort. An unbent wrist maximizes the size of carpal tunnel, thereby reducing pressure on the median nerve and relieving symptoms. A splint can be worn even while sleeping or throughout the day.
- Ice or heat application – Applying heat and ice packs can provide short-term relief for pain and numbness. Ice packs reduce muscle spasm and swelling, whereas heat application relaxes the muscles.
If these measures don’t work to improve pain and swelling in the fingers, consult a pain management physician. In leading multispecialty healthcare centers in Brooklyn, NYC, pain management physicians work with other healthcare professionals to diagnose and treat musculoskeletal conditions like CTS. Treatment modalities for CTS may include TENS, physical therapy, Ice and Heat application TENS, chiropractic care and pain injections.
Physical therapy consists of therapeutic exercise programs like – gentle stretching; strengthening and aerobic exercises that help improve normal function and movement of joint. In TENS, low-voltage electrical current is delivered through the skin via electrodes placed near the source of pain to prevent the pain signals from reaching the brain. Corticosteroids injections reduce inflammation and swelling, which relieves pressure on the median nerve. Chiropractic treatment includes gentle manipulation of the wrist, elbow and cervical spine. Anti-inflammatory drugs such as ibuprofen (Advil, Motrin IB, others), may provide short-term pain relief.
If CTS symptoms do not respond to these nonsurgical treatments, surgery will be recommended. Surgery involves cutting through the carpel tunnel ligament to relieve pressure on the median nerve.