Busy kitchen was her dream job – except for nagging wrist pain

Being a doctor can be a stressful job but I wouldn’t trade the surgery for a kitchen. I had a chef in to see me last week and she told me about her typical day. She worked lengthy hours in a hot, busy kitchen, and had to manage a full menu made with perishable ingredients. It’s not the job for me, but she loved it. One thing had begun to bother her, though. She had begun to develop a painful tingling sensation in her right hand. It started in her index and middle finger and then spread to her thumb. The pain had started with a tingling then had gotten worse and had over time begun to spread up her forearm. She felt it a little when she was chopping and cutting in the kitchen, but typically the symptoms were worse at night. Raising her hand and shaking it gently provided a bit of relief – but oddly painkillers didn’t seem to touch the pain. That pointed to something called Carpal Tunnel Syndrome. Your median nerve gives you feeling in the thumb, index and middle fingers, some of the ring finger and the nearby palm area in your hand. This nerve travels down your arm and through a route between the bones and ligament in your wrist. The bones are called the carpal bones, and the wee passage is called the carpal tunnel. With Carpal Tunnel Syndrome this route becomes narrower and restricts the blood supply to the median nerve, leading to the symptoms experienced by our chef. The cause can vary, from genetic inheritance to arthritis to pregnancy. Generally we advise people with this condition to not overuse their wrist by gripping and squeezing too much. This wasn’t much of an option for my patient, though. I prescribed her a wrist splint instead. Use of this for a few weeks can help settle the aggravated carpal tunnel region and give the median nerve a rest. If that doesn’t help, we might try a steroid injection to the area. After that, surgery may help to open up the carpal tunnel so the median nerve isn’t being squeezed so much. In pregnancy, drastic treatment isn’t usually needed at all – the symptoms tend to disappear after mum gives birth.