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| Carpal Tunnel Syndrome |
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Carpal tunnel syndrome refers
to the compression of the median nerve in the wrist. The median
nerve passes through a small tunnel in the wrist that can become
inflamed and irritated, thus resulting in the numbness and tingling
into the hand and fingers. The severity of the symptoms can be
determined by performing a nerve conduction test in the office.
The treatments are generally non-surgical, using nonsteroidal
medications, wrist splints, therapy, and occasional injections
into the carpal canal.
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One of the most common causes of carpal tunnel
syndrome is the repetitive use of the wrists or hands, such as
when using a computer keyboard. Often, the repetitive nature
of a job cannot be avoided; however, applying appropriate ergonomics
can certainly help to reduce the risk of developing carpal tunnel
syndrome.
One of the most common complaints of patients with carpal tunnel syndrome is
numbness and/or tingling in the wrists and hands, usually into the thumb and
index fingers. Often there is pain which sometimes radiates into the elbow or
shoulder. X-rays of the wrists are usually normal, so the diagnosis relies more
on a clinical presentation and electrodiagnostic testing.
A thorough work up also needs to eliminate the cervical spine as the cause of
the symptoms. A disc lesion in the neck can compress one of the nerve roots and
cause numbness and tingling into the fingers. Sometimes, an MRI may reveal a
cervical lesion which is contributing to the symptoms. The most helpfull diagnostic
test to delineate between median nerve compression in the wrist and a cervical
radiculopathy, is the EMG/Nerve Conduction Study. The EMG/NCS demonstrates any
nerve damage, and aids in the selection of surgical cases.
Once the diagnosis of carpal tunnel syndrome is made, the treatment is usually
non-surgical. Nonsteroidal antiinflammatory medication, carpal tunnel splints,
wrist exercises, and occasionally injections usually will suffice. If pain persists,
surgery may be the ultimate treatment.
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