Tag Archives: carpal tunnel syndrome

Straight, No Chaser: Prevention and Treatment of Carpal Tunnel Syndrome

April 20, 2016Occupational Health, Orthopedics/Bones, Health Prevention844-SMA-TALK, Behind the Curtain, carpal tunnel syndrome, median nerve entrapment, neuropathy, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

If you have carpel tunnel syndrome (CTS) or are at significant risk for developing it, you really should learn strategies to either prevent, limit progression or treat the condition. Of course, once you develop it, you’ll be more focused on treatment. Fortunately, very good options exist for all of these, and that’s what we’ll be reviewing in today’s Straight, No Chaser. Feel free to review this previous post on carpal tunnel syndrome, discussing its causes and risk factors.

How can carpal tunnel syndrome be prevented in the workplace?
Here are activities you should employ if you’re at risk for CTS. Your employer (through employee health services or even without such an entity) can develop an ergonomics program. This involves adapting the workplace (e.g. conditions and job demands) to the capability and needs of workers to complete assigned tasks. Components of ergonomics may include the following.

Redesign of workstations, tools and tool handles, and tasks to enable the wrist to maintain a natural position during work
Frequent rest breaks
Job rotation among workers
On-the-job conditioning
Stretching exercises
Use of splints to keep your wrists straight
Use of correct posture and wrist position
Wearing fingerless gloves to keep your hands warm and flexible

Of course if you have high-risk conditions such as obesity, arthritis or diabetes, you will do well to manage these conditions. Doing so will lessen the risk of subsequent development or worsening of CTS.
How is carpal tunnel syndrome treated?
In this post, we will address general, drug and surgical treatments. More detailed treatment considerations are covered at www.sterlingmedicaladvice.com.

General

Treatments for CTS should begin as early as possible and under a doctor’s direction.
Underlying causes such as diabetes or arthritis should be treated first.
Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending.
If there is inflammation, applying cool packs can help reduce swelling.

Drugs

In special circumstances, various drugs can ease the pain and swelling associated with CTS. Nonsteroidal anti-inflammatory drugs (e.g. aspirin, ibuprofen, and other nonprescription pain relievers) may ease symptoms that have been present for a short time or have been caused by strenuous activity.
Other drugs occasionally used include diuretics (“water pills”), meant to decrease swelling. Corticosteroids (such as prednisone) or the drug lidocaine can be injected directly into the wrist or taken by mouth (in the case of prednisone) to relieve pressure on the median nerve and provide immediate, temporary relief to persons with mild or intermittent symptoms. (Caution: persons with diabetes and those who may be predisposed to diabetes should note that prolonged use of corticosteroids can make it difficult to regulate insulin levels. Additionally, some studies show that vitamin B⁶ (pyridoxine) supplements may ease the symptoms of carpal tunnel syndrome.

Exercise and Alternative Therapies

Stretching and strengthening exercises can be helpful in people whose symptoms have abated. These exercises may be supervised by a physical therapist trained to use exercises to treat physical impairments, or an occupational therapist, who is trained in evaluating people with physical impairments and helping them build skills to improve their health and well-being.
Acupuncture and chiropractic care have benefited some patients but their effectiveness remains unproven. An exception is yoga, which has been shown to reduce pain and improve grip strength among patients with carpal tunnel syndrome.

Surgery

Carpal tunnel release is one of the most common surgical procedures in the United States. Generally recommended if symptoms last for 6 months, surgery involves cutting the band of tissue around the wrist to reduce pressure on the median nerve. Surgery is done under local anesthesia and does not require an overnight hospital stay.
Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take months. Complications may include infection, nerve damage, stiffness, and pain at the scar. Occasionally the wrist loses strength because the carpal ligament is cut. Patients should undergo physical therapy after surgery to restore wrist strength. Some patients may need to adjust job duties or even change jobs after recovery from surgery.
Recurrence of carpal tunnel syndrome following treatment is rare. The majority of patients recover completely.

If you focus on the prevention strategies, the need for surgery will be lessened, and treatments will be guided by your physician. Your first job should be to discuss the safety of your work environment and ensure you’re doing what’s needed to minimize your risk.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Carpal Tunnel Syndrome

April 19, 2016Neurology, Occupational Health, Orthopedics/Bonescarpal tunnel syndrome, 844-SMA-TALK, Behind the Curtain, neuropathy, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Do you spend much time typing at work? Are you a construction worker who operates a jack hammer? Do you have arthritis that affects your wrist? Do you have occasional or constant numbness or tingling in your hand or wrist or pain that shoots up your wrist into your arm? If so I’d hope that you’ve had at least a passing conversation about carpal tunnel syndrome (CTS), a fairly common condition associated with work activities. CTS is part of a class of disorders called entrapment neuropathies.
Let’s review CTS by addressing common questions about the syndrome.

What is carpal tunnel syndrome?
CTS is basically a squeezing of the nerve (median nerve) that extends from the forearm to the palm; the pressure on the nerve occurs at the level of the wrist. The carpal tunnel is an area at the base of the hand (on the side of the thumb) that houses tendons and the median nerve. Because it is such a small space, irritation such as that which occurs from inflammation or injury can compress and/or pinch the median nerve.

What are the causes of CTS?
Your anatomy sets the table for CTS in some cases. Some individuals simply are predisposed to CTS because of a smaller carpel tunnel. Beyond this, conditions that cause injury to the wrist and result in swelling are likely culprits; that said, in some cases no cause is identified. Known causes and/or contributors include the following.

Development of a cyst or tumor in the canal
Fluid retention during pregnancy or menopause
Fracture or sprain
Hypothyroidism
Overactivity of the pituitary gland
Repeated use of vibrating hand tools
Rheumatoid arthritis
Work stress

Interestingly and contrary to the popular narrative, there is little clinical data to prove that repetitive and forceful movements of the hand and wrist during work or leisure activities can cause CTS. However, it does stand to reason that if you have CTS, these activities can exacerbate the situation.

What are the symptoms of carpal tunnel syndrome?
Symptoms are easy to figure out if you view your nerve as electrical conductors of various signals caused by stimulation. Frequent burning, tingling, or itching starts gradually, as does numbness in the palm of the hand and the fingers, especially the thumb, index and middle fingers. Symptoms may begin at work or during the night (if you sleep with your wrists cupped). Other symptoms may include a sensation of hand swelling without visual evidence, hand tingling that progressively worsens throughout the day and decreased grip strength. Over time, some untreated patients may lose the ability to distinguish between hot and cold sensations by touch. Symptoms are usually first seen in the dominant hand.
Who is at risk of developing carpal tunnel syndrome?

Women are three times more likely than men to develop CTS.
Diabetics or those with other disorders directly affect the body’s nerves are more susceptible to nerve compression.
CTS usually occurs only in adults.
CTS is especially common in those performing assembly line work , such as manufacturing, sewing, finishing, cleaning and packing (e.g. meat, poultry, or fish). In fact, CTS is three times more common among assemblers than among data-entry personnel.

The next Straight, No Chaser will address prevention and treatment of carpal tunnel syndrome.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Text Neck and Other Smart Phone/Computer Related Difficulties

December 16, 2015Musculoskeletal System, Health Prevention, General Health and Wellness844-SMA-TALK, Behind the Curtain, carpal tunnel syndrome, Disorders, health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Text NeckJeffrey Sterling, MD

It shouldn’t be too much of a chore to be mindful of your future as you unwrap your new technologic gadget this holiday season. You really should think more about your quality of life during your golden years. Arthritis (aka degenerative joint disease) is inevitable if you live longer enough, but that doesn’t mean you need to accelerate the process. Live your life with longevity in mind. There is no reason you can’t maintain a high level of function for years to come. In general the way you’re built represents a position of comfort. Your body best accommodates movements that maintains these positions. With that in mind, this Straight, No Chaser will discuss some simple ergonomic considerations to keep you just a bit safer over the long-term.
Computer use

This is simple. Take ten minutes to set up your workstation so it isn’t damaging your spine.

Place your computer monitor so it is directly in front of you as you type.
Place your monitor at eye level to prevent having to hunch over.
Place your keyboard at elbow level; this aligns your arms and shoulder.
Placing padding in front of your keyboard aligns your wrist and helps prevent carpal tunnel syndrome.
Find an adjustable chair as a means of providing low back support.
Find a footrest to further stabilize your lower back.

An additional consideration for computer use is remembering to take breaks. Your eyes are able to accommodate computer use, but the constant glare causes eyestrain and dryness, which can be irritating and reduce productivity.

Take a break after 45 minutes of computer use. During your break, make a point of staring at something far off in the distance to relax your eye muscles.
If your eyes get easily irritated, consider using clear tears to keep them lubricated.
If you’re a heavy computer user and wear glasses, you can compound your problem if you aren’t getting frequent checks to make sure your prescription is accurate.

Smartphone/Cell phone use
There’s been a lot of chatter lately about “text neck,” which basically points to the dangers of leaning your neck forward over a prolonged period of time. The way your head, neck and shoulders are constructed means you create less stress and strain when your head is centered and your eyes are pointed forward. Consider the following:

When your spine is in a neutral position, the head weighs about 10-12 pounds.
When you lean your head just 15 degrees forward, the neck feels the strain of 27 pounds.
When you lean your head 45 degrees forward, the neck feels the strain of 49 pounds.
When you lean your head 60 degrees forward, the neck feels the strain of 60 pounds.

This level of stress on your neck for hours at a time every day plant the seeds for chronic neck pain, muscle spasms, numbness and tingling in your hands and even misalignment and/or herniated discs.
It’s not just your neck that’s at risk. Have you ever wondered why you have two thumbs and eight fingers? Your thumbs are stabilizers, and really aren’t built for the type of massive work that your smart phones impose on them. Over time such use can cause tendonitis.
The good news is smartphones are accommodating these considerations, but you need to be smart and take advantage of them.

Use earphones and avoid holding the phone up by lodging it between your ear and shoulder.
Use the option that allows you to send texts by speaking instead of typing.
Try to text using your fingers instead of your thumbs.
Use the predictive text functions, which suggest words for you as you type on your phone.
Don’t forget that you could just pick up the phone, and make a call…

So here is a pretty simple consideration for you that works whether you’re on the computer or using a smart phone. Whenever you can, increase the space between your chin and your chest. This action alone optimizes the position of your neck and shoulders, and it avoids any pinching of the nerves in your neck. Additionally, if you find yourself uncomfortable, take a break and stretch. Get a message. Don’t forget to stay hydrated because your bones bathe in fluid.
Remember, technology is meant to work for you, not against you. Use these tips, and enjoy the advantages your technology is offering. Type you later.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: Text Neck and Other Smart Phone/Computer Related Difficulties

December 17, 2014General Health and Wellness, Health Prevention, Musculoskeletal System844-SMA-TALK, carpal tunnel syndrome, Disorders, health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Text NeckJeffrey Sterling, MD

This is simple. Take ten minutes to set up your workstation so it isn’t damaging your spine.

Place your computer monitor so it is directly in front of you as you type.
Place your monitor at eye level to prevent having to hunch over.
Place your keyboard at elbow level; this aligns your arms and shoulder.
Placing padding in front of your keyboard aligns your wrist and helps prevent carpal tunnel syndrome.
Find an adjustable chair as a means of providing low back support.
Find a footrest to further stabilize your lower back.

Take a break after 45 minutes of computer use. During your break, make a point of staring at something far off in the distance to relax your eye muscles.
If your eyes get easily irritated, consider using clear tears to keep them lubricated.
If you’re a heavy computer user and wear glasses, you can compound your problem if you aren’t getting frequent checks to make sure your prescription is accurate.

When your spine is in a neutral position, the head weighs about 10-12 pounds.
When you lean your head just 15 degrees forward, the neck feels the strain of 27 pounds.
When you lean your head 45 degrees forward, the neck feels the strain of 49 pounds.
When you lean your head 60 degrees forward, the neck feels the strain of 60 pounds.

Use earphones and avoid holding the phone up by lodging it between your ear and shoulder.
Use the option that allows you to send texts by speaking instead of typing.
Try to text using your fingers instead of your thumbs.
Use the predictive text functions, which suggest words for you as you type on your phone.
Don’t forget that you could just pick up the phone, and make a call…

So here is a pretty simple consideration for you that works whether you’re on the computer or using a smart phone. Whenever you can, increase the space between your chin and your chest. This action alone optimizes the position of your neck and shoulders, and it avoids any pinching of the nerves in your neck. Additionally, if you find yourself uncomfortable, take a break and stretch. Get a message. Don’t forget to stay hydrated because your bones bathe in fluid.
Remember, technology is meant to work for you, not against you. Use these tips, and enjoy the advantages your technology is offering. Type you later.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Prevention and Treatment of Carpal Tunnel Syndrome

September 3, 2014Neurology, Orthopedics/Bones, Health PreventionSterling Medical Advice, 844-SMA-TALK, carpal tunnel syndrome, median nerve entrapment, neuropathy, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Redesign of workstations, tools and tool handles, and tasks to enable the wrist to maintain a natural position during work
Frequent rest breaks
Job rotation among workers
On-the-job conditioning
Stretching exercises
Use of splints to keep your wrists straight
Use of correct posture and wrist position
Wearing fingerless gloves to keep your hands warm and flexible

General

Treatments for CTS should begin as early as possible and under a doctor’s direction.
Underlying causes such as diabetes or arthritis should be treated first.
Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms, and immobilizing the wrist in a splint to avoid further damage from twisting or bending.
If there is inflammation, applying cool packs can help reduce swelling.

Drugs

In special circumstances, various drugs can ease the pain and swelling associated with CTS. Nonsteroidal anti-inflammatory drugs (e.g. aspirin, ibuprofen, and other nonprescription pain relievers) may ease symptoms that have been present for a short time or have been caused by strenuous activity.
Other drugs occasionally used include diuretics (“water pills”), meant to decrease swelling. Corticosteroids (such as prednisone) or the drug lidocaine can be injected directly into the wrist or taken by mouth (in the case of prednisone) to relieve pressure on the median nerve and provide immediate, temporary relief to persons with mild or intermittent symptoms. (Caution: persons with diabetes and those who may be predisposed to diabetes should note that prolonged use of corticosteroids can make it difficult to regulate insulin levels. Additionally, some studies show that vitamin B⁶ (pyridoxine) supplements may ease the symptoms of carpal tunnel syndrome.

Exercise and Alternative Therapies

Stretching and strengthening exercises can be helpful in people whose symptoms have abated. These exercises may be supervised by a physical therapist trained to use exercises to treat physical impairments, or an occupational therapist, who is trained in evaluating people with physical impairments and helping them build skills to improve their health and well-being.
Acupuncture and chiropractic care have benefited some patients but their effectiveness remains unproven. An exception is yoga, which has been shown to reduce pain and improve grip strength among patients with carpal tunnel syndrome.

Surgery

Carpal tunnel release is one of the most common surgical procedures in the United States. Generally recommended if symptoms last for 6 months, surgery involves cutting the band of tissue around the wrist to reduce pressure on the median nerve. Surgery is done under local anesthesia and does not require an overnight hospital stay.
Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take months. Complications may include infection, nerve damage, stiffness, and pain at the scar. Occasionally the wrist loses strength because the carpal ligament is cut. Patients should undergo physical therapy after surgery to restore wrist strength. Some patients may need to adjust job duties or even change jobs after recovery from surgery.
Recurrence of carpal tunnel syndrome following treatment is rare. The majority of patients recover completely.

Straight, No Chaser: Carpal Tunnel Syndrome

September 2, 2014Occupational Health, Orthopedics/Bones, Neurology844-SMA-TALK, carpal tunnel syndrome, neuropathy, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Do you spend much time typing at work? Are you a construction worker who operates a jackhammer? Do you have arthritis that affects your wrist? Do you have occasional or constant numbness or tingling in your hand or wrist or pain that shoots up your wrist into your arm? If so I’d hope that you’ve had at least a passing conversation about carpal tunnel syndrome (CTS), a fairly common condition associated with work activities. CTS is part of a class of disorders called entrapment neuropathies.
Let’s review CTS by addressing common questions about the syndrome.

Development of a cyst or tumor in the canal
Fluid retention during pregnancy or menopause
Fracture or sprain
Hypothyroidism
Overactivity of the pituitary gland
Repeated use of vibrating hand tools
Rheumatoid arthritis
Work stress

Women are three times more likely than men to develop CTS.
Diabetics or those with other disorders directly affect the body’s nerves are more susceptible to nerve compression.
CTS usually occurs only in adults.
CTS is especially common in those performing assembly line work , such as manufacturing, sewing, finishing, cleaning and packing (e.g. meat, poultry, or fish). In fact, CTS is three times more common among assemblers than among data-entry personnel.

The next Straight, No Chaser will address prevention and treatment of carpal tunnel syndrome.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress.