2012-10-25

Carpal Tunnel Syndrome 101

Carpal Tunnel Syndrome is one of the most frequently self-diagnosed syndromes (thanks to Doctor Google :P). As my prof described yesterday, it seems as if anytime people experience a problem in their hand or wrist, they are having a 'carpal tunnel syndrome' flare-up.  However, yesterday, in my Physical Medicine class, we talked all about this syndrome and what is specifically is required in order for a patient to truly be diagnosed with this condition.

The white horizontal band is the ligament causing carpal tunnel syndrome. Image from Wikipedia; originally from Netter. 

Definition: carpal tunnel syndrome is a compressive neuropathy (meaning a compressed nerve), in which the median nerve is squished by a ligament in the wrist (specifically by the transverse carpal ligament, aka the flexor retinanculum, shown above). Nine tendons and one nerve (the median) pass through this ligament. It often occurs during repetitive gripping, like in those who garden extensively, operate hand tools, knit or sew for a living, hairdressers, and computer users (aka everyone)... to name a few examples only.

Symptoms: When the median nerve is squished, the palm of the hand, the fingernails, the thumb, and index, middle, and half of the ring fingers, will feel numb, weak, tingly, and possibly pain. Only these regions of the hand will be affected as these are the areas innervated by the median nerve (see the image below, they are highlighted in red).

Median nerve innervation in the hand. Image source here.

Treatment: Naturopathically, we would prescribe lots of rest (less texting!), wrist supports, hand massages, hydrotherapy (ice during an acute attack, heat other times, or whatever feels best to the individual patient), and anti-inflammatory herbs. People with chronic carpal tunnel surgery may opt for surgery; however sometimes the surgery doesn't help and some people get better without any surgery at all. The surgery involves cutting the transverse carpal ligament to allow it to expand, reducing the compression/squishing of the median nerve.

Note: please seek out professional and individual health care advice. This blog post is not meant to diagnose or treat.

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