Thursday, September 27, 2007

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome: "Several commenters have written about carpal tunnel syndrome and pointed out that carpal tunnel syndrome is not the only condition to cause pain, numbness and weakness in the hand.

It is important to consider other entities, which cause similar symptoms.

Other possible causes include cervical radiculopathy (nerve damage near the cervical vertebrae), impingement of one or more of the cervical nerve roots which can cause pain and numbness radiating from the neck area and also ulnar nerve compression usually at the elbow (cubital tunnel syndrome).

I think it is important again to review some aspects of carpal tunnel syndrome.

Carpal tunnel syndrome is a specific entity. It is compression of the median nerve at the wrist in a closed space called the carpal tunnel. Through that small space course the median nerve and all the flexor tendons.

The median nerve supplies sensation to the thumb, index, middle and the thumb side of the fourth finger. It is thought, but never proven that pressure builds up within that small space and causes compression of the median nerve – the symptoms are activity related and episodic.

Jobs such as packing and typing along with exercise are frequently associated with carpal tunnel syndrome. Individuals usually perform their activity then hours later commonly (at night) they awaken with the hands feeling as if they are asleep and they describe shaking their hands to try to bring back feeling into them.

The ulnar nerve supplies sensation to the fifth finger (pinky) and the pinky side of the fourth finger. The ulnar nerve frequently gets compressed at the elbow in the area known as the “funny bone”.

There is a groove between the medial epicondyle of the humerus the bone in the upper arm and the olecranon process of the ulnar bone in the forearm and the nerve is compressed in that area.

An EMG test is the definitive test to determine and distinguish between the entities affecting the different nerves and nerve roots whether it is the neck, elbow or wrist area. Compression may also inferred or diagnosed by an MRI.

Other entities noted by several bloggers include the repetitive strain injuries one of the buzz words of the 21st century. They include trigger finger, carpal tunnel syndrome and de Quervain disease (tenosynovitis of the first dorsal compartment on the thumb side of the wrist and tennis elbow).

Specifically, trigger finger is a swelling of the first portion of the flexor tendon sheath in the distal palm at the base of each finger. There is a covering that starts over the flexor tendon and extends almost to the end or distal portion of the finger.

This first portion-swelling thickening occurs and prevents the smooth gliding of the flexor tendon hence triggering. Injection of steroid is the first option and then if that fails or it continues to recur after a second injection a surgical release or opening of the first portion of the flexor tendon is performed.

I do not wish to minimize it, but it is a very small surgical procedure easily and quickly accomplished." Writes Dr. Alexander Haselkorn

Carpal Tunnel Syndrome: From carpal tunnel syndrome to repetitive strain injuries, wrist-related pain is one of the most common complaints in today's active workforce. Dr. Alexander Haselkorn shares information and advice on the most common conditions and causes of wrist pain, symptoms, prevention and treatment options.

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