Carpal Tunnel Syndrome

GENERAL INFORMATION:

What is it? The carpal (kar-pull) tunnel is a small area in the wrist. Tissue, like blood vessels and the median nerve pass through the carpal tunnel from the arm into the hand. Carpal tunnel syndrome is when the ligaments that make up the carpal tunnel become swollen and irritated. This causes painful pressure on the median nerve.

How did I get carpal tunnel syndrome? Moving your wrist in the same way over and over can cause swelling in the tunnel. This swelling puts pressure on the median nerve and causes carpal tunnel syndrome. A wrist injury, arthritis, diabetes (di-uh-b-tees), or pregnancy can also put pressure on the median nerve.

Signs and Symptoms: You may have one or more of the following symptoms if you have carpal tunnel syndrome.

• Dull aching discomfort in the hand, forearm, or upper arm.
  
  
• Sharp pain shooting from the wrist up the arm, usually at night.
  
  
• Stiffness of the wrist in the morning or cramping of the hands.
  
  
• Tingling, burning, or numbness in the hand, usually in the thumb, index, and middle fingers.
  
  
• You may not be able to make a fist.
  
  
• Thumb weakness or clumsiness of the hand (dropping things).
  
  
• Dry skin, swelling, or color changes in the hand.

What can be done once I have carpal tunnel syndrome? You may need an electromyography (e-lek-tro-mi-ah-gruh-fee) "EMG" or nerve conduction studies "NCS" to help caregivers learn about your wrist problems. These tests measure electrical activity of muscles at rest and when they are in use. An EMG also tests the nerves that control muscles. Carpal tunnel syndrome may clear up by itself. Or, you may need a splint or medicine to treat the problem. Sometimes, surgery may be needed to free the pinched nerve.

What can I do to help prevent carpal tunnel syndrome?

• Changes in the way you work: Following are some things you can do while at work to help prevent carpal tunnel syndrome.
  
  
  • When grabbing something, keep your wrist straight and use your whole hand instead of just your fingers.
    
    
  • Keep your wrists straight when working at a keyboard.
    
    
  • Try to avoid doing repetitive (repeating) actions. Alternate tasks that require different movements and postures.
    
    
  • Give your hands short rests at least once an hour to give them a chance to recover from repeat activities.
    
    
  • Be careful when you do things that require force, like pushing open doors, lifting heavy objects, and opening jars.
  
  
• Exercises: Following are some exercises to help strengthen your hands and wrists and prevent carpal tunnel syndrome. If you already have carpal tunnel syndrome, do not do exercises until your caregiver says it is OK.
  
  
  • Hand massage: Gently massage your palm and the back of each hand in a circle motion.
    
    
  • Clench and fan: Hold your hands out in front of you with your palms down. First make a fist and hold for 5 seconds. Then spread out the fingers as far apart as you can. Hold for 5 seconds. Repeat up to 5 times for each hand.
    
    
  • Thumb stretch: Gently grasp the thumb of one hand and pull out and down until you feel the stretch. Hold for 5 to 20 seconds. Repeat 3 to 5 times with each thumb.
    
    
  • Wrist stretch: Hold your hand palm up. Bend back the wrist of one hand by pressing the fingers down with your other hand. Hold for 5 seconds. Then switch hands.
    
    
  • Wrist circles: Hold your hands in front of you with your elbows at a comfortable angle. Gently turn your wrists in a circle. Repeat 5 times in each direction.
    
    
  • Arm circles: Hold your arms straight out at your sides level with the ground while standing up. Move your arms in a circle with your elbows locked. Repeat 5 to 10 times in each direction.
    
    
  • Shoulder rolls: Let your arms relax at your sides while you are sitting or standing. Raise your shoulders and roll them up and back in a circle. Repeat up to 5 times. Then change direction.
    
    
  • Neck stretch: Sit with your shoulders down and relaxed. Gently let your head fall forward as far as you can. Stay in that position for 5 to 10 seconds. Gently raise your head and repeat up to 5 times.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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