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Carpal
Tunnel Syndrome: A Cause of Hand Discomfort
Carpal Tunnel Syndrome
(CTS) results from entrapment of the nerves which go from the wrists into
the hands. The wrist contains many structures in close proximity, all
of which pass through a very narrow area, not unlike a tunnel. When crowding
of this "tunnel" occurs, the structures become compressed, and
damage to the nerve results. The median nerve is most commonly involved.
This nerve begins in the neck, runs through the arm, and into the hand.
It supplies movement and feeling for the thumb, the index finger, and
part of the middle finger. Burning, tingling, and numbness of the fingers,
often at night, are the usual symptoms of CTS. This discomfort may initially
be relieved by shaking or exercising the hand. Some patients also find
that the numbness radiates up the arm. If left untreated for long periods
of time, weakness, loss of muscle in the hand, or even paralysis may occur.
Inflammation or swelling
of the structures within the wrist often produce this syndrome. The more
common causes include: arthritis, tendinitis, thyroid disease, injury
to the wrist, and even fluid retention associated with pregnancy. Due
to its frequent association with arthritis and inflammation, carpal tunnel
syndrome is considered a rheumatologic disorder.
Once a diagnosis
of CTS has been established, the initial treatment is often conservative.
Included in the treatment is the use of anti-inflammatory medications
and splinting of the wrist at night. If these measures should fail, an
injection of medication into the area is often helpful. In the non-responsive
forms of this disorder, surgery may be a consideration.
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All medications have potential side effects, risks
and interactions with other medications as well as over the counter drugs.
Not all medications are right for all patients. You should always check
with your physician or health care provider prior to the use of any medication.
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