Carpal Tunnel Syndrome By Amy Otis, RN and Dave Otis, COTA/L
A trip to the supermarket didn't used to rank high on the list of 34-year-old Wanda Woods concerns. But now, everyday chores like pumping gas and carrying groceries are ordeals for her.
Woods can't can't grip her groceries to keep them from falling out of her hands, she can't hold a pen in order to write a check. The pain is so bad that it’s even keeping her awake at night.
Like Woods, an increasing number of Americans are experiencing the sudden onset of one of several cumulative trauma disorders affecting the hands, according to James McGlothlin, Ph.D., a research hygienist at the National Institute for Occupational Safety and Health in Cincinnati. Doctors often call them repetitive strain injuries (RSIs).
RSI is a catch-all term used to refer to many painful conditions, such as trigger finger, nerve spasms, and carpal tunnel syndrome. They can cause stiffness, swelling, tingling, weakness, numbness, and, in some cases, irreversible nerve damage.
Carpal tunnel syndrome is the most frequently reported RSI according to the U.S. Public Health Service.
It occurs when tissues on the palm side of the hand swell, compressing or entrapping the important median nerve, which runs through this area. Numbness and tingling usually start in the wrist, and can radiate down to the thumb and fingers, or up to the elbow. Many patients feel pins and needles when their wrist is tapped. Weakness occurs on effort. For example, patients may suddenly drop objects they are holding.
RSIs are self-limiting conditions that result from excessive use of the muscles and tendons of the hands, wrists and forearms. Auto workers, cashiers, journalists, keyboard operators, computer programmers, and others who spend long hours at repetitive chores are particularly vulnerable.
Researchers have investigated the use of omega-3 fatty acids, found in fish oils and in flax seed oil, to help suppress the disease by curtailing production of prostaglandins, a series of hormone-like substances associated with inflammation that occurs in arthritis.
Today the best bet for carpal tunnel patients is to cope with the syndrome in ways similar to patients with arthritis. Keep in mind to treat the cause of the symptoms rather than the symptoms themselves.
Such coping skills include resting the hand, protecting and caring for their joints, and using when necessary using OTC drugs such as aspirin or ibuprofen (Advil, Nuprin, Motrin IB) for mild to moderate symptoms or prescription. If a person can’t take these due to the side effects Tylenol is helpful for pain, but not inflammation.
A general practitioner can treat most patients with exercise, rest, aspirin, or NSAIDs. It’s amazing what resting the injury can do for it in many cases. If relief does not occur within a few weeks, the physician may refer the patient to a specialist.
Occupational therapists can also help patients with these disorders to practice "joint protection," according to Jan Chmela, director of Sheltering Arms Day Rehabilitation Program in Richmond, Virginia.
Chmela, herself an occupational therapist, said that patients can learn to use their hands in "non-deforming positions." For example, instead of grabbing a key with a thumb and twisting, patients can learn to turn a key with adaptive equipment. They can learn to use their largest joints for a job, rather than their smaller, more vulnerable ones, for
opening a jar, for example. She advocates teaching patients to use their hands closest to their anatomical position, outstretched as much as possible instead of twisting and turning them, because bending the hands stresses the joints. As with most other disorders, however, prevention,
is the best cure.
It's important that people whose symptoms last longer than several weeks see their physician immediately. In some cases of moderate to severe carpal tunnel syndrome, early treatment can prevent significant permanent damage to nerves.
While surgery is an option that may be successful, it’s important to know that one third of the patients who had undergone the operation found that symptoms had returned within two years.
Natural Remedies for Carpal Tunnel:
Use a simple splint, available at a pharmacy to immobilize the hand and to relieve pain until the other measures begin to take effect.
A heating pad, or warm moist compresses can help relieve pain and strain.
If you work at repetitive tasks, stop occasionally and make slow circles with your hands to restore circulation and relive pressure.
Acupuncture can be very helpful in eliminating the pain of carpal tunnel syndrome.
Daily Supplements: Vitamin B6: Talk to your doctor about this vitamin as it can become toxic when used daily. Vitamin B2 100 mg. daily Vitamin B12: 1,000-mcg daily in tablet form dissolved under the tongue. Folic Acid: 800-mcg daily