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Your Health: Nothing to carp at: Carpal Tunnel Syndrome should be taken seriously

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Question: What are the primary symptoms of carpal tunnel syndrome?

Answer: Carpal tunnel syndrome, which is caused by a pinched nerve in the wrist, generally begins with minor aching in the wrist and/or hand. Over time, it progresses and can become very painful. Tingling or numbness in the fingers and hand, especially the thumb and middle fingers, is common. As the condition progresses, you may experience constant numbness. Pain may radiate from the wrist up the arm as far as the shoulder and/or into the palm of the hand and fingers. When you use the hand to do repetitive tasks or work that requires force, the pain increases. You’re also likely to notice weakness in your hands and find yourself dropping objects easily.

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Q. What causes it?

A. Your anatomy may be a factor; for instance, it’s more common in women because their carpal tunnel area is smaller than a man’s. Chronic illnesses, such as diabetes and alcohol, and inflammatory diseases, such as rheumatoid arthritis, may contribute to nerve damage. When your body fluids are altered, such as during pregnancy or from obesity, fluid retention can increase pressure within the carpal tunnel. Workplace repetitive motions may also be a factor. Basically, anything that crowds the nerve in the wrist can lead to carpal tunnel syndrome and many times, no cause can be identified.

Q. Does carpal tunnel syndrome require treatment?

A. This is a progressive condition but in some cases it may resolve itself. Generally, though, it will become more debilitating and painful. Permanent nerve and muscle damage can result. If your symptoms are so acute they compromise your work, normal activities and ability to sleep at night, it’s definitely time to make an appointment with your primary care doctor. Fortunately, proper treatment usually results in pain relief and the ability to normally use your wrist and hand again.

Q. What will the doctor do?

A. Establishing a history of your symptoms helps your doctor determine, first of all, if you do have carpal tunnel syndrome or if your pain may be related to a different condition. Your doctor will also test the strength in your fingers and hands and may order an X-ray. Other possible tests may include an electromyogram, which measures electrical activity of the muscle at rest and when contracted, and a nerve conduction study, which measures electric impulses in the median nerve. Your doctor will show you how to minimize wrist pain and manage your condition better with lifestyle changes. Common medical treatment also includes wrist splints and anti-inflammatory drugs or corticosteroid injections to relieve pain. Ultrasound therapy or hand therapy with a physical therapist over several weeks is another possible form of treatment. Surgery is recommended only if nonsurgical therapy is unsuccessful.

Dr. Katherine Friese works in the occupational medicine department at Sanford Bemidji, 1705 Anne St. Clinic. She received her master’s degree in nursing as a family nurse practitioner from The College of St. Scholastica in Duluth. Friese is certified as a family nurse practitioner by the American Nurses Credentialing Center, a subsidiary of the American Nurses Association and is a member of the Minnesota Nurse Practitioners.

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