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Carpal Tunnel Syndrome, CTS

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Carpal tunnel syndrome is a common problem that affects the use of your hand, and is caused by compression of the median nerve at the wrist. It most often occurs when the median nerve in the wrist becomes inflamed after being aggravated by repetitive movements such as typing on a computer keyboard or playing the piano. It also seems to affect professional artists fairly commonly – in particular, sculptors and printmakers.

carpal-tunnel-syndrome

The “carpal tunnel” is formed by the bones, tendons and ligaments that surround the median nerve. Since the median nerve supplies sensation to the thumb, index and middle finger, and part of the ring finger, and provides motion to the muscles of the thumb and hand, you might notice numbness and weakness in these areas.

Common Symptoms

Thesesymptoms are often exaggerated when the wrist is bent forward. This numbness or pain may be worse at night, and may actually keep you awake. During the day, it may occur more often when you are participating in activities that involve bending of your wrist.

Common Causes of Carpal Tunnel Syndrome

Diseases or conditions that may increase your chances of developing carpal tunnel syndrome include pregnancy, diabetes, menopause, broken or dislocated bones in the wrist, and obesity. Additional causes include repetitive and forceful grasping with the hands, bending of the wrist, and arthritis.

Any repetitive motions that cause significant swelling, thickening or irritation of membranes around the tendons in the carpal tunnel can result in pressure on the median nerve, disrupting transmission of sensations from the hand up to the arm and to the central nervous system.

Diagnosing Carpal Tunnel Syndrome

It is important to seek medical assistance when you first notice persistent symptoms. Do not wait for the pain to become intolerable.

Before your doctor can recommend a course of treatment, he or she will perform a thorough evaluation of your condition, including a medical history, physical examination and diagnostic tests. Your doctor will document your symptoms and ask about the extent to which these symptoms affect your daily living. The physical examination will include an assessment of sensation, strength and reflexes in your hand.

If conservative treatment such as medication or physical therapy does not provide sufficient relief, your doctor may perform diagnostic studies to determine if surgery is an effective option. These diagnostic studies may include:

Conservative (Nonsurgical) Treatments

The main purpose of conservative treatment is to reduce or eliminate repetitive injury to the median nerve. In some cases, carpal tunnel syndrome can be treated by immobilizing the wrist in a splint to minimize or stop pressure on the nerves. If that does not work, patients are sometimes prescribed anti-inflammatory medications or cortisone injections in the wrist to reduce swelling. Your doctor may suggest specific types of hand and wrist exercises, which may be helpful. Treatment for carpal tunnel syndrome may include rest, the use of a wrist splint during sleep, or physical therapy. Conservative treatment methods may continue for up to eight weeks.

When Surgery is Necessary

Only a small percentage of patients require surgery. Factors leading to surgery include the presence of persistent neurological symptoms and lack of response to conservative treatment.

If you experience severe pain that cannot be relieved through rest, rehabilitation or nonsurgical treatment, you may be a candidate for one of several surgical procedures that can be performed to relieve pressure on the median nerve. The most common procedure is called carpal tunnel release, which can be performed using an open incision or endoscopic techniques.

The open incision procedure or carpal tunnel release, involves the doctor opening your wrist and cutting the ligament at the bottom of the wrist to relieve pressure. The endoscopic carpal tunnel release procedure involves making a smaller incision and using a miniaturized camera to assist the neurosurgeon in viewing the carpal tunnel. The possibility of nerve injury is slightly higher with endoscopic surgery, but the patient’s recovery and return to work is quicker.

Recovery After Surgery

After surgery, a dressing will be applied to your hand. You should leave this secured in place until your first office visit following surgery. You may need bandages on one or both wrists depending on your surgery. If this is the case, you may require extra assistance at home with everyday activities. Your stitches can be removed about 10-14 days after surgery. Make sure you avoid repetitive use of the hand for four weeks after surgery and avoid getting the stitches wet. You will notice that the pain and numbness begins to improve after surgery, but you may have tenderness in the area of the incision for several months.

Recurrence of symptoms after surgery for carpal tunnel syndrome is rare, occurring in less than 5 percent of patients. A majority of patients recover completely. To avoid injuring yourself again, it may help to change the way you perform repetitive movements, the frequency with which you perform the movements, and the amount of time you rest between periods when you must perform these movements.

Become Pain Free | Pain Specialist in Texas

OVERUSE INJURIES, Workers Compensation Injury, Workers Comp Injury, Work Accident, Job Injury

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Have you been diagnosed with carpal tunnel syndrome, tendonitis, repetitive strain injury or are you having hand or wrist pain? Here is a roadmap to treating these conditions. The first step in healing is recognizing that you have a problem. Some questions you will want to ask yourself are:

  • Do your hands hurt after using the computer?
  • Do you find yourself dropping more items?
  • Are you constantly re-tying your shoelaces?
  • Do your hands hurt when you floss your teeth?
  • Are your hands or wrist hurting when you wake up, after driving, after playing videogames or using your smartphone?

Each of these problems often falls into what we call overuse injuries. Overuse injuries are slowly debilitating conditions that are the product of years of repetitive actions that eventually take a toll of your body. Studies have shown that there is no silver bullet or quick fix for these conditions.

The first step to recovery from these types of injuries is to find a competent hand surgeon, osteopathic physician or neurosurgeon to get a proper diagnosis.  Once you have a diagnosis from your physician, make sure you get a prescription for hand therapy.  Pain medications can have adverse effects, so take these with caution and only as prescribed by your physician. Surgery is a last resort and may only give temporary relief. From hand therapists, occupational therapists and physical therapists you will learn techniques including hot and cold transition baths, paraffin wax treatments, icing, wearing braces, wearing gloves, strengthening exercises, and ergonomics. These are far more useful than creating a dependence on medications. Keeping a log book or diary, documenting your pain and what activities you participated in that day that caused pain or lessened the pain is a helpful step to take. Hand message and relaxing activities come into play to help further your recovery process. Every therapist has a different approach, and some may work better than others for you, so do not hesitate to try a different hand therapist if the one you are using is not helping.  Education is key in treating these overuse injuries. Reading up on carpal tunnel and repetitive strain type injuries can give you the tools to help combat and eliminate your pain on a daily basis. An educated patient will recover quicker. Carpal tunnel syndrome and hand pain recovery will require changes in your life such as how you drive, bike, or even carry handbags or groceries. Any use of your hands will need to be examined and optimized to your new normal. Work changes such as computer ergonomics, different keyboards, input devices, chairs, desks, and other elements that require attention are important to prevent further damage. Electronic devises such as smartphones, iPods, gaming consoles, and computers can contribute to your hand pain. Touchscreens with their swiping gestures can cause undue hardship. Ergonomics and usage reduction are a must. Physician care, hand therapy, lifestyle, and work station changes are a collaborative approach to overuse injuries. All areas must be considered to have successful recovery without reoccurrence. Experts at The BecomePainFree.com medical group can help!

Become Pain Free | Pain Specialist in Texas

Texas Spine Consultants, Board Certified Orthopaedic Surgeon, Spine Fellowship Trained, Dr. Huntly Chapman M.D.

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Dr. Huntly Chapman M.D.

Call Us: (214) 396-3647 | (888) 373-3720  Fax #:  (888 )238-9155 | E-mail Us

Dr. Huntly Chapman is an fellowship trained Orthopedic Spine surgeon, specializing in the treatment of low back and neck pain. Dr. Chapman utilizes both conservative non-operative and surgical treatments.Dr. Chapman received his medical degree from the University of British Columbia, Vancouver Canada. He is a fellow of the Royal College of surgeons of Canada and the diplomat of the American Board of Orthopedic Surgery.

Dr. Chapman is an expert in handling worker’s compensation cases, a certified life care planner and is frequently sought out for his expertise in orthopedic surgery.

Dr. Chapman is an avid golfer and loves to fish.

Locations:

3900 Junius St., Suite 705
Dallas, TX 75246

4461 Coit Road, Suite 101
Frisco, TX 75035

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Address
3900 Junius St., Dallas,Texas, 75246
Call Us: (214) 396-3647 | (888) 373-3720  Fax #:  (888 )238-9155 | E-mail Us
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