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Treatment of Wrist Pain / Carpal Tunnel Syndrome

As name suggests , there is a tunnel or passage way between your palm and wrist. Inside the tunnel ,is the median nerve and tendon, which is connected to your palm and forearm.

Action or activities such as overuse of hand, repetition of work like typing, putting hand under head while sleeping, these all can cause nerve compression.

What are the symptoms?

  • Feeling of numbness or tingling over thumb, index finger, middle finger
  • Sharp pain radiating up to your arm
  • Symptoms are most prominent before bedtime and waking up in the morning.
  • Many people sleep with their wrist bend, and symptoms may awake you from sleep.
  • During the day time, you may experience tingling and pain , while lifting an object, such as phone or book

What are the symptoms?

  • Feeling of numbness or tingling over thumb, index finger, middle finger
  • Sharp pain radiating up to your arm
  • Symptoms are most prominent before bedtime and waking up in the morning.
  • Many people sleep with their wrist bend, and symptoms may awake you from sleep.
  • During the day time, you may experience tingling and pain , while lifting an object, such as phone or book

Which age group is commonly affected?

  • Women are 3 times more likely than men
  • 20% pregnant women experience median nerve symptoms.

Risk factor

  • Sports activity, where hands are exposed to repetitive motion.
  • Computer workers, due to improper desk.
  • Job in which you have to do same motions with your hand, arm or wrist, over and over such as cashier, baker, musicians, painters
  • Rheumatoid arthritis
  • Diabetic patients.

What triggers the symptoms?

  • Median nerve , which is under the wrist tunnel , is compressed by above risk factors
  • Trauma like fracture, condition such as arthritis, ganglion, collagen disease Or Flexor Tendon Teno-synovitis can trigger the syndrome.

What happens , if you don’t take treatment?

Wasting of  the thumb muscle, which  is known as atrophy. Pain radiates more towards your hand to shoulder.

Which hands are generally affected?

It can occur bilaterally, but it is mostly seen in dominant hand.

What your doctor will do?

Doctor will check strength of the muscle, by bending your wrist. By doing tapping on the path of the nerve, symptoms are triggered.

How can we diagnose accurately this CTS:

Nerve Conduction Study:

It is a diagnostic modality to diagnose accurately.

Two electrodes are taped to skin. A small shock is passed through the median nerve to see if electrical impulses are slowed down in the carpal tunnel.

Electromyography : it is done to measure tiny electrical discharges, produced in muscle. This test can identify damage to the muscle, controlled by median nerve.

Treatment:

PRP is a FDA approved non-invasive medical treatment. The Platelet-Rich –Plasma is extracted from a patients vein, which usually takes only 15 minutes.

Then this PRP is then injected into area of the hand and wrist— which is affected by CTS.

The plasma contains higher concentrated healing properties, that ignite the repair of the damaged median nerve.

Othe therapies of CTS?

CTS is a slow progressive condition that does not go away without doing any Intervention.

Traditional treatment of CTS includes:

  • NSAIDS
  • Physical therapy
  • Ergonomic changes to work-place.

Cortisone injection:

With the use of USG ( Ultrasound machine), accurate injection of cortico-steroid can be delivered to the median nerve. It decreases inflammation and swelling, which relieves pressure on the median nerve.

Prevention of CTS

  • Take shorts, frequent breaks
  • Reduce your force and relax your grip
  • Avoid bending your wrist, all the way up and down. A relaxed middle positon is best.
  • Improve your posture while working and avoid putting your hand  underneath your head.
  • Change your computer mouse; it should be comfortable and does not strain your wrist.