This strange-sounding problem has nothing to do with the kind of
tunnels you drive through. When someone has
carpal
(say:
kar
-pul)
tunnel syndrome
, or CTS, the "tunnel" of
bones
and ligaments in their wrist has narrowed. This narrowed tunnel
pinches a nerve, causing a tingly feeling or numbness in a
person's hand, especially in the thumb and first three
fingers.
Someone with carpal tunnel syndrome may have trouble typing on
the
computer
or playing a video game. In fact, repetitive motions (doing the
same thing again and again) from those activities may be to blame
for causing the carpal tunnel syndrome in the first place.
Where Is This Tunnel?
Take a look at the palm of your hand. Under the skin at your
wrist is the tunnel we're talking about. Nine tendons (tough
bands of tissue that join a muscle with some other part of the
body) and one nerve pass through this tunnel from the forearm to
the hand. The bottom and sides of the carpal tunnel are formed by
wrist bones, and the top of the tunnel is covered by a strong band
of connective tissue called a ligament.
The tendons that run through the tunnel connect
muscles
to bones and help you use your hand and bend your fingers and
thumb. The nerve that passes through the carpal tunnel to reach the
hand is the
median
(say:
me-
dee-un) nerve.
It's pretty tight inside the carpal tunnel. In fact,
there's barely enough room for the tendons and the nerve to
pass through it. If anything takes up extra room in the canal, the
median nerve gets pinched, which causes numbness and tingling in
the area of the hand where the nerve spreads out. Swelling can
occur when someone does the same thing over and over, like typing.
This swelling can pinch the nerve.
Who Gets It?
Millions of Americans have CTS. Kids can get it, too, but
it's not as common. Most people who get CTS are over 30, and
more women than men have it. In fact, three times as many women as
men have CTS. Computer operators, assembly-line workers, and hair
stylists are at risk because they repeat the same hand movements
over and over again.
What Causes It?
Anything pressing on the median nerve can cause CTS. The tendons
passing through the carpal tunnel can become swollen from doing the
same movement over and over, like typing on a computer or playing
video games or a musical instrument for long periods of time.
It's more common in gymnasts, particularly those who do a lot
of handstands, and in people who play racquet sports, like
tennis.
Broken or dislocated wrist bones
or even
sprains
that cause swelling around the carpal tunnel may lead to CTS, too.
Medical problems that increase someone's risk of getting CTS
include
arthritis
,
thyroid problems
, and
diabetes
. CTS is also more common during pregnancy and in people who are
overweight.
How Is It Diagnosed and Treated?
Did you ever wake up and your hand is still asleep - all numb
and giving you pins and needles? That's what it can feel like
to have CTS. One way to tell if you have CTS is to check if your
pinky is also numb. It won't be in a person with CTS. A doctor
who suspects CTS will listen to the person's symptoms and then
do a wrist examination. By tapping on the person's wrists, the
doctor is often able to tell whether the problem is CTS.
A brace or splint can help mild cases of CTS. It is usually worn
at night and keeps a person's wrists from bending. Keeping the
wrist straight opens the carpal tunnel so the nerve has as much
room as possible. Resting the wrist will allow the swollen tendons
to shrink. Medicines like
ibuprofen
can also help reduce the swelling.
In more severe cases, your doctor may recommend
cortisone
(say:
kor
-tih-zone) to reduce inflammation and swelling in the carpal
tunnel. This medicine is given by a shot, or injection. When the
symptoms of CTS have improved, the doctor may suggest the person do
wrist exercises and make changes that can prevent further problems,
such as repositioning the computer and keyboard.
If none of these treatments help, the person may need surgery to
release the pressure on the median nerve. This surgery takes less
than an hour and usually doesn't require a stay overnight in
the hospital. Very few people are permanently injured by CTS. Most
can get better and take steps to prevent the symptoms from
returning.
CTS Prevention
Though not many kids get CTS, it's a good idea to develop
good habits now that can prevent this problem in adulthood. When
you spend a lot of time on the computer, be sure to take breaks and
not overdo it. Just getting up to stretch or do something else for
a while can help. You might even set an alarm clock or a kitchen
timer to go off every hour or so to remind you to take your
breaks.
At the computer, be sure your work area is comfortable. Use a
chair that can be adjusted for your height so that you aren't
sitting down too low or up too high. Your chair, computer screen,
and keyboard should all be in line. And try to follow these rules
while sitting:
- Hold your elbows at your sides with your wrists in front to
set the keyboard height.
- Keep your forearms and wrists straight and don't bend
your wrists up.
- If you use a wrist pad, don't press into it when you
type.
- Place things you use a lot within close reach, with no item
farther than an arm's length away.
When you take these steps, you're treating your wrists just
right. And if you ever get CTS, remember that there's always
light at the end of the carpal tunnel.
Reviewed by:
Mary L. Gavin, MD
Date reviewed: April 2007
Originally reviewed by:
Richard J. Bowen, MD
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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