Get help for hand pain
December 5, 2017
Americans are notorious for not being proactive when it comes to their health. This is true even when it comes to their hands. Whether it creeps up during your holiday baking and gift wrapping, or it's an everyday occurrence don't ignore that nagging ache or the recurring pins-and-needles. It may seem like no big deal, but stop and consider what you would do if one of your hands lost function… Typing at work, cooking dinner for your family, working out at the gym… Many of your daily activities would suddenly become next to impossible. So if your hands are trying to tell you something – listen!
Among the hand conditions commonly experienced are arthritis, triggering (also known as trigger finger), and fractures or cuts caused by injury or accident. However, one of the most common hand ailments is Carpal Tunnel Syndrome. "Carpal Tunnel Syndrome is a common condition affecting about 3 percent of the population and can lead to significant pain and disability if untreated," explains SNMH orthopedic surgeon Dr. Mario E. Luna.
This condition occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes pressed or squeezed at the wrist. The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand that houses the median nerve and tendons. When the tendons are irritated, thickening or swelling can occur which causes the compression on the nerve that is associated with CTS. Carpal Tunnel Syndrome can cause pain, weakness or numbness in the hand and/or wrist. The sensation can radiate up the arm. Symptoms of CTS often start gradually with burning, tingling, itching or numbness in the palm, thumb or index and middle fingers.
People often report feeling their symptoms while they sleep or when they first wake up in the morning (this is because many people flex their wrists during sleep), while driving or while holding a phone to their ear.
As symptoms progress, people might feel tingling or a pins-and-needles sensation more during the day. As the condition worsens, sufferers may notice decreased grip strength. Eventually, if left untreated the muscles at the base of the thumb may flatten due to atrophy.
Luna recommends treating CTS in the early stages, noting nonsurgical management can provide relief to many patients, especially with mild cases. The more damage that is done to nerves, the more intense the treatment will be, with longer recovery period and lowering degree of success.
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In the early stages, Carpal Tunnel Syndrome can be treated with rest, anti-inflammatory medication, a wrist splint, or – in some cases – a low dose steroid injection, or even therapy.
SNMH's Hand Therapy Department is home to the only Certified Hand Therapists (CHTs) in the community. Occupational Therapist and CHT, Kathy Kinney explains "A well instructed exercise program, modality treatment, splinting and changes in activities can often be the only treatment necessary if people are seen early. Other hand pain from arthritis and tendon conditions, also benefit greatly from many of the treatments we offer."
If the condition worsens or is left untreated for a significant period of time, surgery may be necessary. "Surgery for CTS is a simple outpatient procedure with up to 90 percent of patients having immediate and lasting relief of their symptoms," says Luna. Surgery to treat Carpal Tunnel Syndrome involves an incision at the base of the thumb where the surgeon will release the ligament, relieving pressure on the nerve. Recovery from the surgery occurs in two stages: 1) Surgical recovery, which takes 2-3 weeks and involves recovering from the anesthesia and allowing the incision wound to heal; and 2) Nerve recovery, which can vary from a couple months to 6-12 months, depending on the damage to the nerve.
If Carpal Tunnel Syndrome is allowed to progress, untreated, for a couple years or more it can cause permanent nerve damage.
Talk to your primary care doctor about any of these symptoms.