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What is Carpal Tunnel Syndrome?
At the base of the palm is a tight canal
or “tunnel” through which tendons
and nerves must pass on their way from the
forearm to the hand and fingers. The nerve that
passes through this narrow tunnel to reach the
hand is called the Median Nerve. This narrow
passage between the forearm and hand is what we
call “The Carpal Tunnel”.
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The Carpal Tunnel is normally
quite snug and there is just barely enough room
in it for the tendons and nerves that have to
pass through it. If anything takes up extra room
in the canal, things become too tight and the
nerve in the canal becomes constricted or
“pinched”. This pinching of the
nerve causes numbness and tingling in the area
of the hand that the nerve travels to. The
condition that results when the Median Nerve is
being pinched in The Carpal Tunnel is commonly
referred to as “Carpal Tunnel
Syndrome” or
“CTS”.
What Can Cause Carpal Tunnel
Syndrome?
Like many skeletomuscular disorders,
CTS has a variety of causes. It is
most often the result of a combination of
factors. Among these are:
- Genetic predisposition.
Certain people are more likely than others to
get CTS. The amount of natural lubrication of
the flexor tendons varies from person to person.
The less lubrication, the more likely is CTS.
One study has related the cross-sectional shape
of the wrist, and the associated geometry of the
carpal tunnel, to CTS. Certain tunnel geometries
are more susceptible to tendon irritation.
- Health and lifestyle.
People with diabetes, gout, and rheumatoid
arthritis are more prone than others to develop
CTS, as are those experiencing the hormonal
changes related to pregnancy, menopause, and the
use of birth control pills. Job stress has also
been linked to an increased likelihood of CTS.
And CTS seems to be more frequent among
alcoholics.
- Repetitive motion. The most
common cause of CTS that's been attributed to
the workplace is repetitive motion. When you
flex your hand or fingers the flexor tendons rub
against the walls of the carpal tunnel. If you
allow your hand time to recover, this rubbing is
not likely to lead to irritation. The amount of
recovery time you need varies from fractions of
a second to minutes, depending on many
circumstances, including the genetic and health
factors mentioned above, as well as the
intensity of the flexing, the weight of any
objects in your hand, and the extent to which
you bend your wrist during flexing.
- Trauma. A blow to the wrist
or forearm can make the tendons swell and cause
or encourage the onset of CTS.
The
most common cause of Carpal Tunnel Syndrome is
inflammation of the tendons in the tunnel which
can normally be attributed to repetitive use of
the hand and/or wrist. Repetitive Strain Injuries (RSIs) can happen
to anyone whose work calls for long periods of
steady hand movement, from musicians &
dental hygienists to meat cutters &
cashiers. RSIs tend to come with work that
demands repeated grasping, turning and twisting;
they are especially likely if the work requires
repeated twisting or involves repetitive
vibration, as in hammering nails or operating a
power tool. Stressful hand, arm and neck
positions — whether from working at a
desk, long-distance driving or waiting on tables
— only aggravate the potential for damage.
A number of sports can bring on repetitive
stress injuries: Rowing, golf, tennis, downhill
skiing, archery, competitive shooting and rock
climbing are just a sampling of activities that
stress the hand and wrist joints. Injuries and
ailments that cause swelling or compression of
soft tissue on nerves, such as sprains,
leukemia, and rheumatoid arthritis, can lead to
stress injuries. Diabetes, thyroid problems, and
other systemic disorders are also associated
with discomfort from stressed nerves, as is the
fluid accumulation that sometimes accompanies
pregnancy. Some authorities believe that a
pyridoxine (vitamin B6) deficiency can also
induce the symptoms. Fluid retention, a major
contributor to CTS & RSI symptoms naturally
occur with the usage of contraceptive pills.
Post Menstrual Syndrome (PMS) also causes fluid
retention as do many other medical conditions,
all of which can result in Carpal Tunnel
Syndrome symptoms.
Carpal Tunnel
Syndrome Symptoms
- A tingling or numb
feeling in the hand and/or fingers;
- Shooting pains in the
wrist or forearm, and sometimes extending to the
shoulder, neck and chest, or foot;
- Difficulty clenching the
fist or grasping small objects;
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For many
unfortunate sufferers, CTS has a pattern of
flaring up through the night thereby making
sleep difficult. CTS symptoms can also be
expected to arise frequently while performing
the activity that is the cause of the condition
in the first place.
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