Carpal Tunnel Syndrome is misunderstood. You don’t get it from using a computer, and it’s not an incurable disease you’re forced to life with for the rest of your life. Let’s start from the beginning. What is Carpal Tunnel Syndrome?
Carpal Tunnel Syndrome, or CTS, occurs when the tendon — that goes through the wrist and into the fingers — becomes swollen or inflamed. That swelling creates pressure, that pressure causes pain and that pain often leads to surgery. “It has nothing to do with finger motion — it’s all about the wrist,” says Dr. Mark DeHaan of the OAM Hand & Upper Extremity Center. “The wrist motion — inflection or extension — is what makes CTS worse. The best prevention is to try not to move your wrist repetitively in the course of an activity.” Athletic and exercise activities specifically are ripe for all sorts of injuries, and Carpal Tunnel Syndrome is no exception. “Weight-lifting, power pulse, fitness classes — any motions that put weight-intense pressures on the wrist could cause tendonitis, which often leads to CTS,” says Dr. DeHaan. For example, when curling a dumbbell, it’s important to keep the wrist in an unkinked, neutral position to avoid excess stress. Stages of Symptom Intensity While for some patients CTS comes and goes, “you want to get evaluated as soon as possible, so we can use some preventative measures to stop it from getting worse,” advises Dr. DeHaan. People who suffer from CTS experience various degrees of symptom intensity, and below are Dr. DeHaan’s treatment recommendations for each.
- Numbness or tingling – The classic symptom of CTS is a fingertip tingle. Wear a wrist brace available at any pharmacy to maintain your wrist in neutral position.
- Pain that wakes you up at night – CTS tends to be aggravated while you sleep, because you might bend your wrists while you curl up. Wear the wrist brace and take an anti-inflammatory medication, like Ibuprofen, Advil or Motrin, to help control the swelling.
- Pain exceeds pain medication – When Motrin-type medications no longer work, a steroid injection — basically a very powerful anti-inflammatory — will completely bring the swelling down and last for 3-4 months. The symptoms will come back eventually, but for a time, they will be controlled significantly.
- Extended or unmanageable pain – There’s no manipulation, vitamins, therapy or injection that will cure CTS, only surgery. By cutting a ligament in the wrist, pressure is released as space opens up for the tendons and nerve.
There are two types of Carpal Tunnel Syndrome release surgery: the open technique (fig. 1) and the endoscopic technique (fig. 2). “With the open technique, you have a larger scar, stitches that need to be removed, and the recovery time is dramatically longer,” says Dr. DeHaan. “With the endoscopic, a small incision is made in the wrist, there are no stitches, and you can use your hand immediately after surgery.” The endoscopic surgery technique started in the United States in the 1990s. Dr. DeHaan was not only one of the first to use the technique, but also assisted in its development. He traveled nationally promoting the technique and lecturing on best practices. “At OAM, we’ve been performing this type of surgery longer than any center in West Michigan. I personally have been longer than anyone else in the region — for over 22 years. A lot of people come to see us from various areas because of our experience.” Carpal Tunnel Myths Understanding CTS is key in taking preventative measures and knowing when to advance to the next level of treatment. Here are some common myths that need debunking, according to Dr. DeHaan:
- CTS is caused by using a computer – CTS isn’t caused by using a computer, but it can aggravate the problem. We recommend keeping wrists as neutral or straight as possible to decrease the symptoms.
- Tough luck for pregnant women with CTS – Around the third trimester, women will often get CTS. Many times by the end of the pregnancy, it will resolve, but until then, it can be extremely painful. A steroid shot could solve the problem.
- Endoscopic surgery is more dangerous – Basically, the endoscopic and open techniques both do the same thing. Both are equally safe, and endoscopic has a quicker recovery time and less pain.
- CTS comes back after surgery — With surgery, you’ll never need another one — it’s unusual to have it done twice.
- After surgery, forget about ever returning to work – Usually most people can go back to doing the same activities they did before the surgery without any serious problems.
- Ergonomics aren’t effective – We weren’t designed to put our bodies in a chronic compromised position, and not move. I think proper ergonomics at the job site are good. Stretching exercises are good. Getting up and walking during the workday is good. All those things help create healthy living patterns that can prevent more serious problems.
To learn more about Carpal Tunnel Syndrome, go to mycarpaltunnel.org