Carpal tunnel syndrome is caused by compression of the nerve that is inside the wrist tunnel, which is made up of the carpal bone and the transverse carpal ligament. This compression causes pain, numbness, tingling and / or weakening of the joint and hand. Repeated sprains or sprains, unusual wrist anatomy, old fractures, and other medical ailments can increase the risk of suffering from them. The aim of the treatment is to create more space for the main nerve in the hand, so that it does not become irritated or inflamed. Home remedies can help, but sometimes a doctor (and even surgery) is needed to relieve symptoms.
Steps
Part 1 of 3: Managing the Syndrome at Home
Step 1. Avoid irritating the median nerves
The carpal tunnel is a narrow passage made up of small bones and ligaments; it is intended to protect the nerves, blood vessels and tendons that go towards the hand. The main nerve that reaches the hand is called the median nerve; avoid activities that squeeze and irritate him, such as repeated bending of the wrist, lifting heavy loads, sleeping with bent wrists, and punching solid objects.
- Wearing tight bracelets or watches can be a risk factor, so make sure you leave enough space between your wrist and these accessories.
- In most cases it is difficult to identify a single cause responsible for the disorder; very often there is a combination of factors, such as arthritis or diabetes associated with repetitive strain on the wrists.
- The anatomy of the wrist may differ from person to person: in some the passage may be narrower by nature or the carpal tunnel may be at an abnormal angle.
Step 2. Stretch your wrist
You can regularly stretch the joint to effectively reduce or minimize symptoms. In particular, wrist extension can help increase the space available to the median nerve within the tunnel by stretching the ligaments that connect the carpal bones. The simplest way to extend and lengthen both wrists at the same time is to place the hands in the "prayer position", with the palms joined together. Place your palms against each other in front of your chest and lift your elbows until you feel a pleasant stretch in your wrists; hold the position for 30 seconds and repeat 3-5 times a day.
- You can also grab the fingers of the affected hand and pull them back until you feel a stretch on the front of the wrist. You may feel more temporary tingling in your hand with this exercise, but don't stop unless you feel pain.
- In addition to tingling, you may experience other symptoms typical of this syndrome: numbness, throbbing pain, muscle weakness, and a change in skin color (too pale or too red).
- The only part of the wrist and hand that is typically spared from symptoms is that of the little finger, since it is not innervated by the median.
Step 3. Take over-the-counter anti-inflammatories
Symptoms of the syndrome are often associated with inflammation of the wrist, which directly irritates the median nerve, and swelling that compresses it. Therefore, taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Moment, Brufen) or naproxen (Momendol) can be very helpful in reducing discomfort in the short term. You can also take pain relievers like acetaminophen (Tachipirina), but they only work on pain and don't help reduce swelling.
- Anti-inflammatories and analgesics should only be considered as a temporary remedy to manage pain; there is no scientific evidence that these drugs are able to control symptoms in the long term.
- Taking too many NSAIDs or taking them for too long can greatly increase the risk of stomach irritation, ulcers and kidney failure.
- Taking acetaminophen too much or for too long can cause liver damage.
- Alternatively, you can rub a natural pain reliever ointment on your wrist and hand. menthol, camphor, arnica, and capsaicin are all useful ingredients for relieving mild to moderate pain.
Step 4. Use cold therapy
If your wrist is sore and appears or feels swollen, you can apply a bag with crushed ice (or something cold) to reduce inflammation and "numb" the pain; this remedy helps minimize the symptoms of the syndrome. Cold therapy is most effective for soft tissue injuries that involve some sort of edema, because it reduces blood circulation to the area. Ice your wrist for about 5-10 minutes, 3-5 times a day, until symptoms subside.
- You can keep the compress snug against your wrist by using a compression band or an elastic bandage, which are also more effective at fighting inflammation.
- Always wrap the ice in a thin cloth before placing it on your skin to avoid skin irritation or chilblains.
- If you don't have any crushed ice on hand, you can use a large cube, a gel ice pack, or a bag of frozen vegetables.
- In some cases, cold therapy can aggravate the symptoms of the syndrome; if it happens to you too, avoid ice.
Part 2 of 3: Changing Habits
Step 1. Put on a wrist splint
A stiff brace or splint that keeps the wrist in a neutral position throughout the day can reduce compression or irritation in the median nerve and soothe symptoms. Constricting cuffs or braces worn during some activities can actually aggravate symptoms, for example if you work on a computer or have to carry or move loads of goods. However, you can wear them while you sleep to relieve nocturnal discomfort, such as tingling and numbness in your hands, especially if you have a habit of bending your wrists.
- You may need to wear a brace for several weeks (day and night) to get significant relief; however, some people find the benefits of such devices almost insignificant.
- It may be a good idea to wear the splint at night if you are pregnant and suffer from carpal tunnel syndrome, as your hands and feet tend to swell more during pregnancy (edema).
- You can buy such orthoses and braces at major pharmacies and orthopedics stores.
Step 2. Change your position when you sleep
Some postures can aggravate the symptoms of the syndrome. The habit of sleeping with clenched fists and flexed wrists is the worst, but sleeping with your arms stretched above your head is also not a good idea. Instead, you should rest on your back or on your side with your arms at your sides and try to keep your hands open with your wrists in a neutral position; in this regard it is very useful to wear a brace or splint, although it takes some time to get used to it.
- You don't have to sleep on your back with your hands / wrists pressed under the pillow; people who assume this posture often wake up with numbness and tingling in the hands.
- Most wrist orthoses are made of nylon and closed with Velcro, which could irritate other parts of the body; Consider covering the brace with a stocking or thin cloth to reduce irritation.
Step 3. Change the workplace
Carpal tunnel disorders can be caused or aggravated by a poorly designed workplace. If your computer, keyboard, mouse, desk and / or chair are not positioned correctly for your height and shape, they could trigger strain in your wrists, shoulders, neck and mid-back. Make sure the keyboard is low enough so that your wrists aren't constantly bent upward as you type on the computer. Consider using an ergonomic keyboard and mouse designed specifically to take pressure off your wrists and hands.
- Placing padded mats under the keyboard and mouse can reduce the impact on the extremities of the upper limbs.
- Talk to an occupational therapist to show them the positions you take while doing your job.
- People who work on computers for many hours a day are very likely to suffer from this syndrome.
Part 3 of 3: Undergo the Treatments
Step 1. Make a doctor's appointment
If you find that symptoms in your wrists and hands persist for more than a few weeks, see your doctor for a checkup. They may order an x-ray and blood test to rule out other causes of pain, such as rheumatoid arthritis, osteoarthritis, late stage diabetes, microfractures, or vascular problems.
- Usually, electrodiagnostic studies (electromyography and nerve conduction velocity) are done to confirm the diagnosis.
- Your doctor will likely want to find out if you are able to perform certain movements that are typically difficult in the presence of the syndrome, such as clenching your fist or pinching your thumb and forefinger to manipulate small objects with precision.
- They may also ask you for more details about your profession, as certain jobs carry a higher risk: carpenters, cashiers, assembly line workers, musicians, mechanics, and people who work on computers for long hours.
Step 2. Learn about corticosteroid injections
Your doctor may recommend that you inject corticosteroid medications, such as cortisone, directly into the carpal tunnel area to relieve pain, inflammation, and other symptoms. They are powerful, fast-acting anti-inflammatory drugs that quickly reduce swelling in the wrists, relieving pressure in the median nerve. Another option is taking corticosteroids by mouth, but they are not considered as effective as injections, in addition to the fact that they cause significant side effects.
- Some corticosteroids that are often used for this disorder are prednisolone, dexamethasone, and triamcinolone.
- Among the possible complications of taking these medications consider local infections, bleeding, weakening of the tendons, localized muscle atrophy, and irritation / damage to the nerves; for these reasons, injections are usually performed for no more than two years.
- If this class of drugs is not beneficial and does not reduce symptoms, surgery is considered.
Step 3. Consider surgery as a last resort
If with all the other remedies and treatments you have not obtained positive results, the doctor may recommend this procedure, which should only be considered as a "last resort", not before having tried all the other alternatives. However, surgery allows for complete symptom relief with minimal risk, so you shouldn't consider it as a solution with little chance of success. The goal is to relieve pressure on the median nerve by cutting the ligaments that compress it. The surgery can be performed in two different ways: endoscopic or open.
- Endoscopic surgery involves the use of a telescopic device with a small camera at the end (endoscope) that is inserted through a tiny incision in the wrist or hand. The endoscope allows the surgeon to see the inside of the carpal tunnel and cut the ligaments that are creating problems.
- Typically, this procedure involves less pain and faster healing times.
- Open surgery consists of a larger incision in the palm of the hand that opens the wrist to reach and sever the problematic ligaments, thereby unraveling the nerve.
- Risks of this procedure include: nerve damage, infections, and scar tissue formation.
Step 4. Be patient during your recovery
After the surgical procedure (which is usually done as a day surgery), your doctor may ask you to frequently raise your hand above the height of the heart and move your fingers to reduce swelling and prevent stiffness. Be prepared that after surgery you may experience moderate pain, swelling and stiffness in the palm and wrist for up to six months, while it can take up to a year to heal completely. During the first 2-4 weeks you may need to wear a brace or splint, although you will be encouraged to use your hand.
- In most people, symptoms improve considerably after the surgical procedure, but the healing process is often slow and gradual; on average, normal hand strength returns to normal levels two months after the operation.
- Sometimes, the syndrome can recur (in about 10% of cases) and may require an additional surgical procedure.
Advice
- Not all hand pain is caused by carpal tunnel syndrome; arthritis, tendonitis, strains and strains can trigger similar symptoms.
- The median nerve is responsible for the sensitivity of the palm side of the thumb and adjacent fingers, but not the little finger.
- Vitamin B6 supplements have been found to relieve symptoms of the syndrome in some people, although the mechanism or reason for offering such benefits is not known.
- If you have to use tools that cause vibrations or require a lot of strength, take more breaks.
- Most people with this syndrome who have never worked in the office or done repetitive manual work have other risk factors, and the disease has other causes.
- In cold environments, you are more likely to experience pain and stiffness in your hands, so keep them warm.
- After surgery, you may experience numbness during your recovery and up to three months after surgery.
