hgazette.com, Haverhill, MA

May 2, 2013

A doctor's advice on preventing carpal tunnel syndrome

Tips on taking care of your wrists and hands

By Pamela Jones
MD

---- — Editor’s note: The Gazette publishes occasional columns from doctors and other medical professionals at Merrimack Valley Hospital. This is one of those columns.

Spring is here, and all that gardening and yard work can injure your wrists and hands.

If you find you have persistent pain, weakness, numbness and tingling in your fingers or hand, you could have carpal tunnel syndrome.

Carpal tunnel syndrome is caused from pressure on the median nerve in the wrist, which, along with several tendons, runs from the forearm to the hand through a small space in the wrist called the carpal tunnel.

The median nerve controls movement and feeling in the thumb and all fingers except the little finger. Anything that makes the carpal tunnel smaller can cause pressure on the nerve. Some things that can lead to carpal tunnel syndrome include swelling, wrist injury, bone spurs, arthritis, obesity, thyroid problems, pregnancy and overuse — making the same hand and wrist movements over and over, especially if the wrist is bent in a manner where the hand is lower than the wrist.

Symptoms are tingling, numbness, weakness or pain in the hand or fingers — most often in the thumb, index finger, middle finger and half of the ring finger. Some people also experience pain in the arm between the hand and elbow, and it is not uncommon to first notice symptoms at night and get relief by shaking your hand.

To differentiate carpal tunnel syndrome from other conditions, tell the doctor if you recently hurt your wrist, arm or neck, and he or she will likely do an exam to check the feeling, strength and appearance of your neck, shoulders, arms, wrists and hands. The doctor may also ask about health problems such as arthritis, hypothyroidism, diabetes and pregnancy, and suggest tests such as blood work to see if any health problems could be causing symptoms, and nerve testing to see if the median nerve is working properly.

The good news is that mild symptoms can sometimes be treated at home, but starting treatment early is best because there is less chance of long-term damage to the nerve.

Things that can be done at home to lessen the severity of symptoms include:

• Stopping activities that cause discomfort.

• Resting wrists between activities.

• Icing the wrist for 10 to 15 minutes once or twice a day.

• With the advice of your doctor, trying nonsteroidal anti-inflammatory drugs to relieve pain and reduce swelling.

• Wearing a wrist splint at night to keep the wrist in a neutral position.

If symptoms don’t get better after one to two weeks of home care, see a doctor for medication, a referral to physical therapy or surgery.

During surgery, the doctor cuts the ligament at the top of the carpal tunnel to increase room and relieve pressure on the nerve. Surgery usually works, but sometimes does not completely get rid of numbness or pain.

To keep carpal tunnel syndrome from coming back, take care of your wrists and hands by:

• Trying to keep your wrist in a neutral position.

• Using your entire hand to hold objects – not just your fingers.

• Keeping your wrists straight when you type, with your hands a little higher than your wrists.

• Relaxing your shoulders when your arms are at your sides.

• Switching hands often to prevent overuse.

Orthopedic surgeon Pamela Jones, MD, is a board-certified orthopedic surgeon and board-certified hand surgeon who is on staff at Merrimack Valley Hospital. You can find more information about her at www.steward.org/merrimack-valley by clicking on DoctorFinder.