Reliev­ing pain in your hand

The Star Malaysia - Star2 - - Healthy Bones - Dr Gopinath Matha­van. Dr Lim Li Aik.

DOES your hand feel numb? Does the numb­ness only in­volve the hand area (palm and fingers) and not the arm? If so, you are prob­a­bly ex­pe­ri­enc­ing carpal tun­nel syn­drome.

Carpal tun­nel syn­drome is caused by pres­sure on the me­dian nerve at the wrist. Be­lieved to be caused by too much pres­sure or work us­ing the hands, the syn­drome is com­monly ex­pe­ri­enced by mu­si­cians, car­pen­ters, con­struc­tion work­ers and peo­ple who use com­put­ers for many hours through­out the day.

In its early stages, symp­toms may in­clude tin­gling or numb­ness in your thumb, in­dex fin­ger, mid­dle fin­ger and outer bor­der of your ring fin­ger.

What causes numb­ness?

“Carpal tun­nel syn­drome hap­pens when the space in the carpal tun­nel be­comes smaller or the ten­dons in the tun­nel thicken, plac­ing pres­sure on the me­dian nerve. Anatom­i­cally, the carpal tun­nel is a nar­row pas­sage­way at the palm side of your hand (near the wrist),” ex­plains Dr Lim Li Aik, con­sul­tant or­thopaedic and trauma sur­geon of Ori­en­tal Me­laka Straits Med­i­cal Cen­tre.

“Through this open­ing passes the me­dian nerve and sev­eral ten­dons used to bend the fingers. In carpal tun­nel syn­drome, there could be some swelling and nar­row­ing of this open­ing, thus com­press­ing the me­dian nerve.”

Symp­toms of carpal tun­nel syn­drome in­clude pins and nee­dles – a numb­ing, burn­ing or tin­gling sen­sa­tion – in your thumb, in­dex and mid­dle fingers.

In ad­di­tion, you may feel pain that moves up your arm to your el­bow or ex­pe­ri­ence pain that wors­ens at night, in­ter­rupt­ing sleep.

“You may also ex­pe­ri­ence hand weak­ness and difficulty grip­ping ob­jects with your hands or drop­ping ob­jects eas­ily,” adds Dr Lim.

Other con­di­tions or risk fac­tors such as di­a­betes and heavy al­co­hol drink­ing are also as­so­ci­ated with carpal tun­nel syn­drome.

“In­flam­ma­tion caused by rheuma­toid arthri­tis and in­fec­tions can also af­fect the wrist ten­dons pass­ing through the carpal tun­nel pas­sage­way,” ex­plains Dr Gopinath Matha­van, con­sul­tant or­thopaedic and trauma sur­geon of Ori­en­tal Me­laka Straits Med­i­cal Cen­tre.

“Other health con­di­tions, such as preg­nancy, obe­sity, kid­ney fail­ure and thy­roid dis­eases, can also give rise to ex­cess body flu­ids, thus con­tribut­ing to hand swelling.”

Treat­ment

Surgery is rec­om­mended when a pa­tient does not re­spond to non-sur­gi­cal treat­ments or the syn­drome has be­come se­vere.

Surgery for carpal tun­nel syn­drome is an out­pa­tient pro­ce­dure, which means it does not re­quire an overnight stay in the med­i­cal cen­tre.

“Dur­ing surgery, the sur­geon will make a sin­gle cut in the front of your wrist at the base of your palm. The sur­geon will then open the carpal tun­nel and re­lease the trans­verse carpal lig­a­ment to re­lieve the pres­sure on your nerve,” says Dr Lim.

Dr Gopinath adds, “Af­ter surgery, pa­tients may ex­pe­ri­ence brief dis­com­fort that lasts from 24 to 72 hours. Re­cov­ery time varies de­pend­ing on the pa­tient’s age, gen­eral health, sever­ity of carpal tun­nel syn­drome and the length of time symp­toms have been present.

“Many pa­tients who un­dergo carpal tun­nel re­lease surgery achieve nearly com­plete re­lief of all symp­toms.”

It is im­por­tant to ef­fec­tively treat carpal tun­nel syn­drome as promptly as pos­si­ble. The longer the me­dian nerve re­mains com­pressed, the more dam­aged it can be­come.

If the nerve is com­pressed for too long, it may not re­cover even af­ter the pres­sure is re­lieved. Even­tu­ally, that could lead to per­ma­nent weak­ness and lack of co­or­di­na­tion in your fingers and thumb.

Carpal tun­nel syn­drome is caused by pres­sure on the me­dian nerve at the wrist. Be­lieved to be caused by too much pres­sure or work us­ing the hands, the syn­drome is com­monly ex­pe­ri­enced by mu­si­cians, con­struc­tion work­ers and peo­ple who use com­put­ers for many hours through­out

the day.

For more in­for­ma­tion, call Ori­en­tal Me­laka Straits Med­i­cal Cen­tre at 06-315 8911.

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