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Orthopedics Magazine Articles

Carpal Tunnel Syndrome Common Symptoms:

• Burning, tingling, or numbness in the palm and fingers (particularily the thumb, index and middle fingers)

• Fingers feeling swollen with apparent swelling

• Desire to "shake out" discomfort in hand or wrist, especially in the early morning

• Decrease in grip strength with difficulty grasping small objects.

Eight Myths (or half truths) about Carpal Tunnel Syndrome:

• Caused by too much typing.

• Activity-related pain in the hand and arm is a frequent sign.

• Can be cured by splinting, activity modification, physical therapy, and/or chiropractic treatement.

• Electromyography (EMG) is required to diagnose carpal tunnel syndrome.

• Surgery is often unsuccessful and often needs to be repeated.

• Endoscopic surgery is riskier than traditional open surgery.

• There are no advantages to endoscopic surgery.

• Surgery is followed by a long recovery time.

Carpal Tunnel Syndrome: Forget the Keyboard

Carpal tunnel syndrome comes down to genetics.

Forget the myth about too much typing leading to carpal tunnel syndrome, because it might not have anything to do with a keyboard. Instead, pay attention to your patient’s family medical history; it might lead you to your answer.

Carpal tunnel syndrome refers to the constellation of symptoms felt in the arm and hand consisting of numbness, pain, and weakness, in that order. The numbness is characteristically felt on the palm side of the thumb, index, and middle fingers. In some patients the entire hand and distal forearm are involved, as well.

In carpal tunnel syndrome, compared to other conditions that may cause arm pain, numbness, or loss of feeling in the fingers (at least on an episodic and temporary basis) is almost always present.

Understanding the cause of Carpal Tunnel
Carpal tunnel syndrome is caused by increased pressure on the median nerve, which lies in the base of the palm of the hand. This pressure results in loss of blood supply to the nerve at that location, which interferes with the nerve’s ability to transmit electrical messages. It results in a loss of sensation in the fingertips, and in some cases, diminishes the function of the muscle control at the base of the thumb. This loss also results in a feeling of pain that can extend all the way up the arm to the shoulder. In most cases in early carpal tunnel syndrome, changing the position of the hand or stabilizing the wrist in the neutral position results in decreased pressure around the nerve and improvement in symptoms.

Carpal tunnel syndrome is caused by an anatomic situation whereby the tunnel through which the nerve passes into the wrist is smaller than normal. Hand and wrist activities and vibration exposure can increase swelling in the carpal canal, crowding the median nerve, resulting in increased pressure, loss of blood supply, and the symptoms described.

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