General Information
DEFINITION--A nerve disorder that causes pain, loss of feeling and loss of strength in the hands. It may greatly decrease athletic performance in sports that require strong hand or wrist action, such as tennis, racquetball, squash, golf, skiing, weight-lifting, baseball, football, horseshoes, bowling, archery, rowing, wrestling, boxing, gymnastics, hockey, judo or water-skiing. Carpal-tunnel syndrome is most common in women between ages 29 and 62.
SIGNS & SYMPTOMS
Tingling or numbness in part of the hand.
Sharp pains that shoot from the wrist up the arm, especially at night.
Burning sensations in the fingers.
Thumb weakness.
Frequent dropping of objects.
Poor performance in any sport that requires a strong grip.
Inability to make a fist.
Shiny, dry skin on the hand.
CAUSES & RISK FACTORSPressure on the median nerve of the wrist caused by swollen, inflamed or scarred tissue. The sources of pressure include:
Inflammation of the wrist-tendon sheaths, a likely result of any sport that requires gripping or squeezing.
Fracture of the forearm.
Sprain or dislocation of the wrist.
Arthritis. Contributing factors include:
Diabetes mellitus.
Hypothyroidism (underactive thyroid gland).
Raynaud's disease (a circulatory disorder that affects blood circulation to fingers).
Menopause.
Pregnancy.
HOW TO PREVENTCannot be prevented at present.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Electromyograms (See Glossary).
X-rays of the hand and wrist.
SURGERYNecessary sometimes to free the pinched nerve in the wrist.
NORMAL COURSE OF ILLNESS
Usually curable -- sometimes spontaneously, sometimes with surgery.
POSSIBLE COMPLICATIONSPermanent pain, numbness and a weak thumb or fingers in the affected hand.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENTSurgery or medications listed below.
HOME TREATMENT
Discomfort improves by shaking hands or dangling arms. If you awaken at night with pain in your hand, hang it over the side of the bed; rub or shake it.
Consult your doctor about wearing a splint on the affected wrist at night.
MEDICATIONYour doctor may prescribe:
Diuretics to decrease fluid retention that causes swollen tissue.
Anti-inflammatory drugs to reduce inflammation.
Corticosteroid injections at the wrist to reduce inflammation.
ACTIVITYStay as active as your strength allows. If surgery is necessary, allow 4 weeks for recovery. Resume normal activities gradually during that time. Exercises may be prescribed for the hand.
DIETEat a normal, well-balanced diet that is low in sodium. This will help prevent fluid retention that aggravates the condition.
CALL YOUR DOCTOR IF
You have symptoms of carpal-tunnel syndrome that don't disappear in 2 weeks.
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