Carpal tunnel syndrome is caused by compression and irritation of the median nerve; causes pain, numbness, tingling and / or weakness in the hand and wrist. Frequent strains or sprains, fractures, abnormal wrist anatomy, arthritis, and other conditions can lead to a reduction in the internal space of the carpal tunnel and increase the risk of this disorder. Symptoms can often be treated at home, although medical interventions are needed to eliminate them completely.
Steps
Part 1 of 2: Treating Carpal Tunnel Syndrome at Home
Step 1. Avoid compressing the median nerve
The carpal tunnel is a narrow passage inside the wrist, bounded by small carpal bones connected by ligaments. The tunnel protects the nerves, blood vessels and tendons. The main nerve that allows movement and tactile sensitivity of the hand is the median one; He therefore avoids activities that irritate and compress him, such as bending his wrists, lifting heavy objects, sleeping with his wrists bent and punching solid surfaces.
- Make sure the watch and bracelets are quite loose around the wrist - if they are too tight they could irritate the nerve.
- In most cases, it is difficult to identify a single cause; this neuropathy is usually generated by a combination of factors, such as repetitive strain on the wrist in association with arthritis or diabetes.
- Wrist anatomy can make a difference. Many people have a smaller congenital tunnel or carpal bone with an abnormal shape.
Step 2. Do regular wrist stretches
Daily stretching can be helpful in reducing and minimizing the symptoms of carpal tunnel syndrome. In particular, by extending the wrists you can increase the space available for the median nerve within the carpal tunnel to stretch the surrounding ligaments. The best way to simultaneously stretch / straighten both joints is to assume the "prayer position". Place your palms together and bring your hands in front of you, about 6 inches from your chest. Lift your elbows until you feel some tension in both wrists. Hold the position for 30 seconds and repeat the exercise 3-5 times a day.
- Alternatively, grab the fingers of the affected hand and pull them back until you feel some tension in the front of the wrist.
- Stretching may temporarily trigger more carpal tunnel symptoms, but you shouldn't stop it unless you are in real pain. the discomfort will lessen over time.
- In addition to tingling in the hand, other common symptoms associated with this neuropathy are: numbness, throbbing pain, muscle weakness and / or discolouration of the skin (from pale to redness).
Step 3. Shake your hands
If you find that you have lost sensation in your extremities or experience dull ache in your wrists and hands, shaking them vigorously for 10-15 seconds can be a quick, temporary solution; the movement is similar to what you do when you try to shake off the water to dry your hands. This gesture improves blood circulation to the median nerve and temporarily frees you from symptoms. Depending on the type of work you do, you will have to resign yourself to shaking your hands several times a day to check the symptoms of this condition.
- Disorders associated with the disease often manifest (and begin) in the thumb, index finger, middle finger and partially in the ring finger; this is why people who suffer from it frequently drop objects and feel awkward.
- The little finger is the only part of the hand that is not affected by the syndrome because it is not innervated by the median.
Step 4. Wear a specific wrist brace
A semi-rigid wrist brace, splint, or brace can help prevent discomfort, as they keep the joint in a neutral position without causing it to bend. Splints and braces should be worn during activities that could theoretically aggravate the situation, such as typing on a keyboard, carrying shopping bags, driving and bowling. Wrist bands offer support during sleep and can limit nighttime symptoms, especially if you have a habit of sleeping with your hands under your body.
- You may have to wear these devices for several weeks (night and day) to reap any significant benefits. However, for some people, these are negligible benefits.
- Using splints at night is a great solution for pregnant women suffering from carpal tunnel syndrome, because pregnancy increases swelling of the extremities.
- Wristbands, splints, and braces are available at orthopedic stores, most drugstores, and medical supply stores.
Step 5. Consider changing your sleeping position
Some sleep postures can aggravate discomfort, thereby reducing the quantity and quality of rest. Specifically, if you sleep with clenched fists and / or hands under your body with your wrists bent, you assume the worst positions for carpal tunnel symptoms; however, putting your hands above your head is not a better solution. Instead, try to rest on your back or side with your arms close to your body, keep your hands open and your wrists in a neutral position; in this way, you promote normal blood circulation and the transmission of nerve signals.
- As previously described, it may be useful to use braces during the night to counteract postures that worsen neuropathy; however, it takes some time to get used to wearing them.
- Do not sleep prone (on your stomach) with your wrists pressed under the pillow. People who have this habit often wake up with numb and tingling hands.
- Most wristbands are made of nylon and fasten with Velcro, but these materials can irritate the skin. It is worth covering the device with a sock or light cloth to minimize this effect.
Step 6. Observe the work environment carefully
In addition to the posture you assume when you sleep, the symptoms of neuropathy are triggered or aggravated by an inappropriate workplace. If your computer keyboard, mouse, desk, or chair are not in the right position for your height and physical proportions, your wrists, shoulders, neck, and middle back are subjected to stress. Make sure the keyboard is in the right place, so your wrists don't continually extend backward as you type. Consider purchasing an ergonomic keyboard and mouse; the employer could bear the costs.
- Put cushioned pads under your keyboard and mouse to reduce impact on your wrists and hands.
- Ask an occupational therapist to inspect your workstation and suggest custom changes based on your physique.
- People who work at computers or cash registers (such as cashiers) are at a higher risk of developing carpal tunnel syndrome.
Step 7. Take an over-the-counter medication
Symptoms of this neuropathy are often related to inflammation and swelling of the wrist that irritate the median nerve and surrounding blood vessels. Taking over-the-counter anti-inflammatory drugs (NSAIDs), such as ibuprofen (Brufen, Moment) or naproxen (Aleve), can prove very useful in minimizing discomfort, at least in the short term. Pain relievers, such as acetaminophen (Tachipirina), are used to combat the pain that accompanies the syndrome, but have no effect on inflammation and edema.
- NSAIDs and analgesics should only be considered as short-term solutions for pain control. There is no evidence that these drugs can cure or improve carpal tunnel syndrome in the long run.
- Prolonged use of NSAIDs (or excessive dosage) significantly increases the risk of gastritis, ulcers and kidney failure. Always read the leaflet to know the dosage.
- An abuse of acetaminophen or prolonged intake causes liver damage.
Part 2 of 2: Undergo Medical Treatments for Carpal Tunnel Syndrome
Step 1. Make an appointment with your family doctor
If you experience the symptoms described above for more than a few weeks, call your doctor's office to schedule a visit. Your doctor will check your wrist and hand, order x-rays and blood tests to rule out other conditions with similar symptoms, such as rheumatoid arthritis, osteoarthritis, diabetes, stress fracture in the wrist, or vascular problems.
- Electro-functional tests (electromyography and nerve conduction) are often done to confirm the diagnosis because they can measure the function of the median nerve.
- You will likely be asked to perform movements or actions that typically make people with this neuropathy difficult, such as tightening the wrist, pinning thumb to index finger, or moving small objects with precision.
- Your doctor may ask you questions about your work, as some are at high risk for this disorder; for example, carpenters, cashiers, assembly line workers, musicians, mechanics and individuals who work a lot on computers are particularly susceptible to carpal tunnel syndrome.
Step 2. Get examined by a specialist, such as a physiotherapist or massage therapist
- Physiotherapist: In most cases, carpal tunnel syndrome can be treated conservatively. This professional will evaluate the condition of the joints, muscles and ligaments to understand the underlying cause of the disorder. The treatment could include shockwave sessions to reduce inflammation and promote healing, exercises to improve flexibility and strength of the affected muscles, but also ergonomics "lessons" to evaluate the workplace, the daily tasks and make appropriate changes in order to reduce any stressors.
- Physiotherapist: some symptomatic pictures are associated with myofascial pain syndrome, a disease related to the presence of "muscle knots". Research has shown that muscle knots are common in patients with carpal tunnel syndrome; in addition, another study found that treatments for these knots improve the condition of the hands.
Step 3. Try corticosteroid injections
Your doctor may recommend that you have localized injections of these drugs (such as cortisone) to relieve pain, inflammation, and other symptoms. These are strong, fast-acting medicines that reduce edema and relieve pressure on the median nerve. Alternatively, you can take them by mouth, but it is believed that they are not as effective as injections; moreover, systemic therapy has more obvious side effects.
- Corticosteroids often used for carpal tunnel syndrome are prednisolone, dexamethasone and triamcinolone.
- However, injections can cause some complications, such as local infections, bleeding, weakening of the tendons, muscle atrophy and nerve damage. Also, it is not possible to have more than two injections per year.
- If you don't get the desired effect with cortisone injections, you should consider surgery.
Step 4. Consider carpal tunnel surgery as a last resort
If none of the home and medical remedies have been successful, your doctor may recommend this solution. This invasive method is the last card to play, because it involves the risk of greater damage, although it has proved to be decisive for a good percentage of patients. The goal of surgery is to eliminate the pressure exerted on the median nerve by cutting the ligament that is most responsible for it. There are two main procedures: endoscopic and open.
- Endoscopic surgery uses a small telescope-like instrument (endoscope), equipped with an equally small video camera, which is inserted into the carpal tunnel through an incision in the wrist or hand. The endoscope allows the surgeon to see the inside of the wrist and cut the problematic ligament.
- This procedure typically causes less pain and side effects; it also allows a quick convalescence.
- Otherwise, the open procedure involves making a large incision in the palm of the hand and wrist to sever the ligament and debride the median nerve.
- The risks related to the surgery are: nerve damage, infection and development of scar tissue - all consequences that could worsen the neuropathy.
Step 5. Be patient during your recovery
After undergoing an outpatient surgery, you will need to frequently hold your hand higher than your heart, as well as move your fingers to reduce swelling and prevent stiffness in the limb. Over the next six months, expect to experience some pain; in addition, the hand and wrist will be inflamed and stiff. Full recovery takes up to 12 months. In the first 2-4 weeks after the surgical procedure, you will need to wear a wrist brace, although you will be encouraged to use your hand.
- Most patients experience relief after surgery; however, recovery is slow and gradual. Hand strength typically returns to normal after 2 months.
- The post-operative relapse rate is around 10% and these patients need a "touch-up" after many months or a few years.
Advice
- Most people with carpal tunnel syndrome do not work on computers and do not perform repetitive manual tasks. There are other causes and risk factors.
- If you use a vibration tool, you run a higher risk of developing this disorder, so take more breaks while working.
- In cold environments, you are more likely to experience symptoms in your hands and wrists, so keep your extremities warm as much as possible.
- Vitamin B6 supplements have been shown to be effective in relieving neuropathy in some people, although doctors don't know why. However, be aware that an overdose of this vitamin causes numbness and tingling in the limbs.
- After surgery to resolve carpal tunnel syndrome, you may experience numbness for three months while recovering.
