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News from Sierra Nevada Memorial Hospital and Hospital Foundation

Submitted by Kimberly Parker


When everything closed down last year, most people did most of their business and personal work on a laptop or computer. Carpal tunnel is caused by pressure on the median nerve which appears at the two roots by the brachial plexus and passes down the middle front of the arm. It’s known as the eye of the hand and is one of three major nerves in the forearm and hand. The brachial plexus is the network of nerves that send signals from the spinal cord to the shoulder, arm and hand.

The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of your hand. When the median nerve compresses, you will feel numbness, tingling, and weakness in the hand and arm. Some people feel pain and burning that travels up the arm, wrist pain at night that interferes with sleep, and weakness in the hand muscles.

Carpal tunnel can exacerbate if the wrist is overextended. Over time, continued motion while using a keyboard or computer mouse, playing the piano, working with hand or power tools, or any repeated movement that overextends the wrist can become problematic.

Certain conditions such as diabetes, high blood pressure, and arthritis increase the risk for carpal tunnel. Lifestyle factors such as smoking, high salt intake, a sedentary lifestyle, and high body mass index (BMI) can also be a cause.

According to the U.S. Department of Labor and Statistics and the National Institute for Occupational Safety and Health, carpal tunnel surgery is the second most common type of surgery with over 230,000 procedures performed annually. Women are two to three times as likely to develop carpal tunnel. Most diagnoses occur between the ages of 30 to 60. Ergonomic disorders are the fastest growing category of work-related illnesses with over eight million people affected each year.

Physicians diagnose carpal tunnel by looking at your medical history, conducting a physical examination, and giving a nerve conduction test. A physician will conduct a detailed evaluation of your hand, wrist and will check for other potential causes of nerve pressure. They will check sensations to the fingers and the strength of the muscles in your hand. Nerve conduction tests measure the speed of your nerve impulses.

Treatment depends on the severity of your case. Managing pain without surgery is the first option. Nonsurgical options include avoiding positions that overextend your wrist, using a wrist splint that holds your hand in a neutral position, mild medication to reduce pain and inflammation, treatment of contributing conditions such as arthritis, and steroid injections.

Surgery may be necessary if there is severe damage to the median nerve. This involves cutting the band of tissue in the wrist that crosses the median nerve to reduce pressure. Treating carpal tunnel with physical therapy and lifestyle changes can lead to long-term improvement. Left untreated, carpal tunnel can lead to permanent nerve damage and loss of hand function so it is important to talk to your physician if you notice symptoms.

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