These symptoms are often provoked by activities that involve extending the wrist, such as raising the arm while driving, reading, writing, typing, or holding a phone.
It is good to know that CTS often presents bilaterally (in both hands), up to 65% of the time.
Carpal tunnel may follow an alternating pattern with periods of remission and exacerbation. In some cases, there is progression from intermittent to persistent that may even advance to motor loss (strength). In the most severe cases, motor loss involves difficulty holding onto objects, turning keys or doorknobs, or buttoning clothes. One may even see atrophy.
How is it diagnosed? The diagnosis is a clinical one determined by a physician based on some testing and symptoms. The most important clue is nighttime pain or numbness. Standard symptoms include: dull, aching discomfort of the hand, forearm, or upper arm; numbness in the hand, weakness or clumsiness of the hand, any symptom in median distribution.
Some provoking factors include symptoms occurring in the sleep and repetitive actions of the hand. A test called an EMG which is a series of electrodiagnostic studies are needed to make the diagnosis. The EMG results in combination with the physical exam and the clinical history all lead to the diagnosis.
Who is at risk? Risk factors for CTS: obesity, female gender, pregnancy, diabetes, rheumatoid arthritis, diabetes, hypothyroidism, connective tissue disease( ex: lupus), pre-existing CTS, genetic predisposition, use of HIV meds, or workplace factors such as cold temperatures, vibrating tools, or repetitive hand use. As an interesting note, most studies do not support the association between computer usage and developing carpal tunnel.
What is the treatment? Treatment includes splinting, stretches, physical therapy, yoga, injections into the carpal tunnel and finally surgery. For sure there are many treatment options, the success of which usually depends on the severity of the compression. Ask your doctor to discuss the risk and benefits of each. Not all carpal tunnel needs necessarily end in surgery! As well, there are potentially other causes of it other than just overuse.Tweet
Dr. Frank Marinkovich owns and operates Eastside Family Health Center in Kirkland, WA. Serving Kirkland and the Eastside, Seattle, Bellevue, Renton and the surrounding local communities. Specializing in Primary Care, Automobile Accidents and FAA physicals. Visit them online at Eastside Family Health Center or call them at (425) 899-2525.
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