CARPAL TUN­NEL SYN­DROME

Road Today - - GUEST COLUMN: HEALTH - Dr Christo­pher H. Singh Chi­ro­prac­tor, runs Trans Canada Chi­ro­prac­tic at 230 Truck Stop in Wood­stock, Ont. He can be reached at 519-421-2024 E.mail: chris_s­ingh@sym­pa­tico.ca

Carpal tun­nel syn­drome is one of the most com­mon con­di­tions that af­fect the wrist and hand. As a re­sult, I think that it is safe to say most of us have heard the term carpal tun­nel syn­drome at some point in our lives. How­ever, many peo­ple do not know ex­actly what it means. In this ar­ti­cle, I am go­ing to dis­cuss carpal tun­nel syn­drome in greater de­tail. Let’s get started.

Carpal tun­nel syn­drome oc­curs when the me­dian nerve in the wrist is com­pressed as it passes through a nar­row pas­sage­way called the carpal tun­nel on its way to the hand. The me­dian nerve pro­vides sen­sa­tion to the palm side of the thumb and first four fin­gers. In ad­di­tion, it pro­vides nerve mo­tor func­tion sig­nals to mus­cles in the thumb.

There are sev­eral po­ten­tial causes of carpal tun­nel syn­drome. Any con­di­tion that causes pres­sure or irritates the me­dian nerve in the tun­nel may lead to symp­toms. Wrist frac­tures, as well repet­i­tive strain in­juries are com­mon causes of the carpal tun­nel nar­row­ing. In my prac­tice, I com­monly see this con­di­tion in the shift hand of pro­fes­sional truck driv­ers. Repet­i­tive shift­ing as well as rest­ing the wrist on the shifter are the most com­mon causes in driv­ers. To add to this, flatbed­ders are at greater risk due to the fact that they must se­cure their loads by repet­i­tively tight­en­ing chains and binders.

The symp­toms of carpal tun­nel vary from per­son to per­son. How­ever, in most cases, symp­toms be­gin grad­u­ally. Symp­toms most of­ten in­clude oc­ca­sional numb­ing and tin­gling in the thumb and first two fin­gers. This sen­sa­tion may ra­di­ate from the wrist up into the arm. Some pa­tients ex­pe­ri­ence an “elec­tric shock” feel­ing in their fin­gers. It is com­mon for in­di­vid­u­als to find re­lief from the symp­toms by shak­ing out their hands. Over time, as the con­di­tion pro­gresses, weak­ness of the thumb mus­cles may oc­cur.

If you sus­pect that you may have carpal tun­nel syn­drome, it is im­por­tant to con­sult with a health pro­fes­sional as per­ma­nent dam­age can oc­cur with­out treat­ment.

Your doc­tor will usu­ally be able to di­ag­nose carpal tun­nel syn­drome by tak­ing a de­tailed med­i­cal his­tory and per­form­ing a phys­i­cal ex­am­i­na­tion. Or­tho­pe­dic test­ing which in­cludes bend­ing the wrist in dif­fer­ent di­rec­tions and press­ing on the nerves in the wrist are usu­ally in­cluded in the phys­i­cal exam. If nec­es­sary, your doc­tor may rec­om­mend fur­ther test­ing such as x-rays to help di­ag­nose the cause of the carpal tun­nel syn­drome.

A nerve con­duc­tion study which mea­sures how well the me­dian nerve is con­duct­ing the sig­nal may also be per­formed.

Once a di­ag­no­sis of carpal tun­nel syn­drome has been reached, your doc­tor will be able to rec­om­mend the proper course of treat­ment. Con­ser­va­tive treat­ments such as life­style and job mod­i­fi­ca­tion are most com­monly the first course of treat­ment. Ice ap­pli­ca­tion and over the counter med­i­ca­tions are of­ten rec­om­mended to help re­duce in­flam­ma­tion. Braces and splints are some­times sug­gested to help im­mo­bi­lize the af­fected wrist. To add to this, phys­i­cal ther­apy is of­ten successful in treat­ing mild cases of carpal tun­nel syn­drome. If con­ser­va­tive treat­ments are un­suc­cess­ful, your doc­tor may sug­gest a cor­ti­cos­teroid in­jec­tion to de­crease in­flam­ma­tion and swelling within the tun­nel. Fi­nally, if all con­ser­va­tive treat­ment op­tions fail, surgery may be rec­om­mended. The most com­mon sur­gi­cal pro­ce­dure is called a carpal tun­nel re­lease. Dur­ing this surgery, the sur­geon cuts through the carpal tun­nel lig­a­ment to re­lieve pres­sure on the me­dian nerve. As the lig­a­ment heals it will leave more room for the nerve to pass through the carpal tun­nel. Recovery from surgery usu­ally takes a few months.

Well, I hope you found this ar­ti­cle in­ter­est­ing and in­for­ma­tive.

Un­til next time, drive safely!

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