Carpal Tunnel Syndrome

QUESTION: I thought to use some spare time in a useful way, and returned to
my favorite hobby of carpentry, only to develop a painful wrist and a burning
feeling in my fingers. My physician has made a diagnosis of "Tunnel
Syndrome," but I need some explanations. Will you please discuss this
disease?
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ANSWER: Both your history and the description of your complaints make the
diagnosis of "Carpal Tunnel Syndrome" a most likely one. The condition is a
common and painful one that affects people in their 50's and 60's most often,
and usually is seen in women more often than men. It is caused by pressure on
the median nerve which passes through a structure called the "carpal tunnel,"
which is formed by the bones of the wrist (carpal bones) and a tough, fibrous
ligament which attaches to these bones. The median nerve carries impulses to
the muscles that control the action of the thumb and sensations from the
thumb, index and middle finger, and half of the ring finger. After unusual or
unaccustomed activity of a repetitive nature, like using a hammer, the
symptoms of this condition may develop. Although your history is typical,
some testing is necessary to assure the diagnosis and help direct the therapy.
A test that measures the speed of nerve impulses in the median nerve
(electromyography) can confirm the diagnosis with great accuracy. You will
have to give up your hobby for a while, and probably wear a splint to provide
support to your wrist for as long as three weeks. Your physician may choose
to inject a cortisone like steroid into the carpal tunnel, or attempt to
reduce the inflammation with oral medications, such as nonsteroidal
anti-inflammatory drugs (NSAIDs). Vitamins (B6) are sometimes of help as
well. If these treatments do not help after a 6 month period, or if the
condition worsens, a surgical procedure the cuts the tunnel open may be
necessary. The treatment offers almost immediate relief of the pain and is a
permanent cure.