Health Sessions » Carpal Tunnel

Carpal Tunnel Surgery

Editor — Wed, 29 Jul 2009 16:30:08 +0000

An orthopedic surgeon, Dr. Jonathan Cluett, said that carpal tunnel surgery could be done. It is not only available, but also very much effective in terms of treatment.

However, carpal tunnel surgery is not really needed until symptoms showed no improvement after a long period of non- surgical treatment. Also when it restricts normal daily routines because of persistent loss of feeling or coordination in the fingers. Lastly, when the median nerve has been damaged as indicated in test results.

The most common procedure is the carpal tunnel surgery release. It involves making an incision in the fibrous sheath around the carpal tunnel. By releasing tension in the carpal tunnel, the pressure is removed from the nerve.

In order to perform an open carpal tunnel surgery release, the surgeon makes a four- centimeter incision across the middle of the palm. The surgeon carefully dissects the tissues down to the carpal tunnel. The carpal tunnel is opened up to relieve the pressure on the nerve. It only takes about 15 minutes and can be performed under local, regional, or general anesthesia.

There are a lot of individuals who are afraid of the big needles for injections or even dread the smell of hospital. To avoid carpal tunnel surgery, early diagnosis and treatment are important to avoid permanent damage to the median nerve.

A physical examination of the hands, arms, shoulders, and neck can help determine if the patient's complaints are related to daily activities or to an underlying disorder. This can also rule out other painful conditions that mimic carpal tunnel syndrome. The wrist is examined for tenderness, swelling, warmth, and discoloration. Each finger should be tested for sensation, and the muscles at the base of the hand should be examined for strength and signs of atrophy. Routine laboratory tests and X-rays can reveal diabetes, arthritis and fractures.

In conducting the Tinel test, the doctor taps on or presses on the median nerve in the patient's wrist. The test is positive when tingling in the fingers or a resultant shock-like sensation occurs. The Phalen, or wrist-flexion, test involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together. The presence of carpal tunnel syndrome is suggested if one or more symptoms, such as tingling or increasing numbness, is felt in the fingers within one minute.

Often it is necessary to confirm the diagnosis by the use of electrodiagnostic tests. In a nerve conduction study, electrodes are placed on the hand and wrist. Small electric shocks are applied and the speed with which nerves transmit impulses is measured. In electromyography, a fine needle is inserted into a muscle. Electrical activity viewed on a screen can determine the severity of damage to the median nerve. Ultrasound imaging and magnetic resonance imaging are also of big help in determining whether the patient needs to undergo a carpal tunnel surgery.

Carpal Tunnel Yoga Tried and Tested to Work

Editor — Thu, 23 Apr 2009 00:15:02 +0000

In the Cochrane review issued in January 2003, yoga ranks as one of the effective non- surgical treatments for carpal tunnel syndrome.

Cochrane review is compiled by the Cochrane Collaboration, an international organization aimed at helping people make well- informed decisions about health care by undertaking scientific studies of evidence for certain remedies.

They found out that for eight weeks, carpal tunnel yoga can lead to a better short- term pain relief and a five0 fold increase chance of improvement in Phalen's sign that wrist splinting.

Phalen's sign is paraesthesiae ("pins and needles" and tingling) produced within one or two minutes when the wrist is held flexed.

Carpal tunnel yoga also provided a similar improvement to wrist splinting in nocturnal waking, Tinel's sign (paraesthesiae provoked by tapping over the median nerve at the wrist) and grip strength.

Long before all these findings have been found, it has been known to be an ancient practice of health that originated in India. It concentrates on improving the harmony of body and mind by increasing bodily awareness and relaxation.

Over time, there have been several positions developed that are beneficial to repetitive trauma disorders such as tendritis and tennis elbow.

Here are some postures of a carpal tunnel yoga that you can perform at anytime of the day.
1. Staff pose- Sit on a chair with trunk upright while the hands are pressed onto the chair. Press the shoulder blades into back, move the shoulders back and down.

2. Chair twist- Sit sideways in chair with right side against back of the chair. Place the hands on back of chair, twist to the right using hands for additional support.

3. Arms overhead with hands in prayer position- Stand with arms raised to a tee position. Urn the palms up then rotate the arms in small circles with fist forward then back. Lift arms straight overhead, join hands in prayer position, stretch it up and look up at hands.

4. Dog pose with chair- Stand with feet hip width apart and facing the seat of a chair. Bend while placing palms on seat and shoulder width apart. Straighten arms and lift waist, hips and knees a few inches above the chair. Turn arms out and curve trunk back between them. Bring coccyx, sacrum and lumbar spine forward, keeping buttocks tight. Stretch front of the body from the pubis. Raise sternum and ribs. Hold shoulders back. Press shoulder blades and dorsal spine in.

5. Hands in prayer behind back- Stand while bringing palms together behind back and fingers pointing up down. Turn the fingers up and raise them as high as possible between the shoulder blades.

6. 90 degree forward bend to wall- Stand with feet about hip width apart. Raise arms over the head and bend at hips while bringing the hands to rest on the wall.

After doing all of these stance of carpal tunnel yoga, do not forget to simply relax.

Carpal Tunnel Syndrome Prevention

Editor — Tue, 07 Apr 2009 00:15:16 +0000

Since carpal tunnel syndrome is usually caused by multiple factors, including health conditions and activities, the most important step in preventing it is to take good care of your general health. This is by giving much importance on the wellness of your whole being. Carpal tunnel syndrome prevention includes maintaining a desirable weight, clean lifestyle and regular exercise.

Below are other carpal tunnel syndrome prevention tips that you might want to know:

* Keep your arm, hand, or finger muscles strong and flexible. It is better to stop any activity that you think may be causing arm, hand or finger numbness or pain. Do not wait for the condition to get worse for it might get too late.

* Use hand and wrist movements that spread the pressure and motion evenly throughout your hand and wrist. Do some simple exercises before jumping immediately to your work. In between breaks, stand up and stretch those muscles.

* Use the correct posture. Remember that when you get your body used to slouching, it is difficult to let your bones back to the right form. Drink milk to improve the intake of calcium in your body.

* Wear a wrist splint to keep your wrist in a neutral position and relieves stress on the median nerve. This reduces the stress on your fingers, hand, or wrist at times when you cannot control your wrist motion, such as while sleeping.

* If you feel that certain work activities are causing finger, hand, or wrist numbness or pain, talk to your human resources department for information about different ways of doing your job, changes in your equipment, other job assignments, or the possibility of an ergonomics evaluation of your work- space and procedures.

* In daily routines at home or while doing hobbies, consider changing activities in which you make repeated finger, hand, or wrist movements. Train yourself to use other positions or techniques that will not stress your hand or wrist.

If you have mild symptoms, such as occasional tingling, numbness, weakness, or pain in your fingers or hand, follow these carpal tunnel syndrome prevention tips to avoid inflammation.

* Rest your fingers, hand, and wrist. Stop activities that you suspect are causing numbness and pain.

* Ice your wrist for 10 to 15 minutes at a time, as often as once or twice an hour. Take non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce swelling. Although studies have not shown NSAIDs to be effective for carpal tunnel syndrome prevention, they may help to relieve symptoms.

This list of carpal tunnel syndrome prevention will only be of great benefit when you also decide to take utmost discipline. Words are not just enough to remedy the disorder, there needs to have a concrete response on your part.

An Introduction to the Carpal Tunnel

Editor — Wed, 21 Jan 2009 23:40:42 +0000

In the human wrist there is a sheath of tough connective tissue which envelopes and protects one nerve, median and tendons. It is attached to the muscles, wrist and hand bones. It is called the carpal tunnel which is the space between the sheath above and the bones below making up the wrist and hand.

The term carpal tunnel is also used quite commonly to refer to carpal tunnel syndrome. It is a condition where the median nerve is pinched within the tunnel and causes pain. It is also experienced in the numbness of the wrist or hand, once thought to be a result of repetitive motion such as painting or typing. This is a painful condition by continuous flexing or stressing over a lengthy period of time which is caused by pressure on the median nerve that carries nervous impulses back and forth between the hand and the spinal cord.

Carpal tunnel is a fibro- osseous tunnel on the palmar surface of the carpal bones. It transmits a number of tendons and the median nerve from the forearm into the hand. Surface markings are proximally the distal wrist crease or distally the hook of the hamate bone.

Both base and walls of the carpal tunnel are a concave bony channel that is formed by the carpal bones. It is the flexor retinaculum or transverse carpal ligament that forms the roof of the carpal tunnel. It attaches to the scaphoid tubercle and ridge of the trapezium laterally, to the pisiform and hook the hamate medially.

The recurrent thenar branch of the median nerve, the motor branch to the thenar eminence, leaves the median nerve in or beyond the carpal tunnel. It curves back over the flexor retinaculum to reach the thenar eminence. If the incision over the calpar tunnel is made to far laterally, it is dangerous making surgery.

The carpal tunnel transmits to only one nerve, the median, and nine tendons. They are the following: flexor digitorum superficialis which contributes to the four tendons that insert on the middle phalanx; flexor digitorum profundus which contributes to the four tendons that insert on the distal phalanx; flexor pollicis longus; palmaris longus which is a tendon merging with palmar aponeurosis; flexor retinaculum; flexor digitorum superficialis; flexor pollicis longus; flexor digitorum profundus and skin.

Therefore, the carpal tunnel is important because the median nerve can be compressed in cases such as what was mentioned above, carpal tunnel syndrome, wrist dislocations (result of this is that you cannot entirely move your fingers and hands) and bone fractures (it is a minor injury in which the fragments remain not in proper alignment so there is a need for surgical treatments before it can be back to its normalcy).

Carpal Tunnel Massage

Editor — Mon, 24 Nov 2008 11:47:24 +0000

You are knock out on bed because of a hard day's work. Most likely, nothing can awaken you, not even the noisy barking dog of your neighbor or the chilly breeze caressing your skin. However, you wake up to those pins and needles sensation on your right hand. You might still be very lazy to stand up but you just have to shake off the pain away and get back to sleep.

It is actually a typical situation especially for those with CTS. The carpal tunnel of your wrist contains the median nerve that has been compressed while your have flexed your wrist. If you have a condition that leads to swelling, the swelling may in turn pinch the median nerve and thereby bring about CTS.

Over time there have been several treatments for the carpal tunnel syndrome. A lot of people may want to resolve to surgery because of the quick remedy it offers. However, medical practitioners would advise that choosing the conventional is best because it does not have any side- effects that go along with it.

Here are some of the best carpal tunnel massage techniques for relief and relaxation:
NEUROMUSCULAR MASSAGE is a form of carpal tunnel massage that is applied to individual muscles. It is used to increase blood flow, reduce pain and release pressure on nerves caused by injuries to muscles and other soft tissue. Neuromuscular massage helps release trigger points, intense knots of tense muscle can also "refer" pain to other parts of the body. Relieving a tense trigger point in your back, for example, could help ease pain in your shoulder or reduce headaches.

ROLFING seeks to re-educate your body about posture. When posture is poor, it can be reflected in a number of health problems, such as backaches, headaches and joint pain. This type of carpal tunnel massage seeks to realign and straighten your body by working the myofascia, the connective tissue that surrounds your muscles and helps hold your body together. The ten-session, head-to-toe Rolfing program used to be rather painful, but new techniques that employ a therapist's hands and elbows are quite tolerable and just as effective at improving your posture.

HELLERWORK is an offshoot of Rolfing that adds both mental and movement re-education to the physical work. In a series of 11 sessions from this type of carpal tunnel massage, you get instruction on how to break bad posture habits and you also get a massage that focuses on returning your muscles and other tissue to their proper positions. The result can be dramatic.

SWEDISH MASSAGE uses soothing, tapping and kneading strokes to work the entire body, relieving muscle tension and loosening sore joints. Therapists of this carpal tunnel massage use five basic strokes, which anyone can learn and use on themselves and others. They are effleurage (stroking); petrissage(muscles are lightly grabbed and lifted); friction (thumbs and fingertips work in deep circles into the thickest part of muscles; tapotement (chopping, beating, and tapping strokes); and vibration (fingers are pressed or flattened firmly on a muscle, then the area is shaken rapidly for a few seconds).

CRANIOSACRAL THERAPY focuses on the skull and spinal column. Therapists use very gently pressure no more than the weight of a nickel to massage the bones, membranes and fluids that support and bathe your skull and spinal column. The theory is that the manipulations of this ind of carpal tunnel massage will reduce tension and counteract any physical trauma you may have experienced to your head over the years. .

Carpal Tunnel Symptoms

Editor — Fri, 15 Aug 2008 06:00:50 +0000

Numbness of the hands, pain of the fingers and tingling of the palms are the most common carpal tunnel symptoms. It often occurs in the parts supplied by the median nerve such as the thumb, index finger, middle finger and half of the ring finger. If your little finger is not affected, this may be a sign that the condition is carpal tunnel syndrome, because a different nerve than the thumb and other fingers nerves usually control the little finger.

Carpal tunnel symptoms often occur in both hands, but they are usually worse in one hand than the other. You may first notice it at night- people with those disorder can usually fall asleep, but in the middle of their slumber, they are awakened by the pain.

Those mild carpal tunnel symptoms primarily affect the hand and sometimes the forearm, but they can radiate up to the shoulder. It includes the following:

* Numbness or pain in your hand, forearm, or wrist. Shaking or moving your fingers may ease this numbness and pain.

* Occasional tingling, numbness, "pins-and-needles" sensation or pain. The feeling is similar to your hand "falling asleep."

* Numbness or pain that worsens while using your hand or wrist, especially when gripping an object with your hand or bending your wrist.

* Occasional aching pain in your forearm between your elbow and wrist.

* Stiffness in your fingers when you get up in the morning.

With moderate or severe carpal tunnel symptoms, you may have numbness or reduced strength and grip in your fingers, thumb or hand. It may even be difficult to:
* Do simple hand movements, such as brushing your hair or holding a fork. You may accidentally drop objects.

* Pinch an object between your thumb and first finger.

* Use your thumb while doing simple tasks such as opening a jar or using a screwdriver. With long-lasting carpal tunnel syndrome, the thumb muscles can get smaller and weaker.

Carpal tunnel symptoms may develop gradually over time. It gets shoddier when you do not make a decision to put an end to the activity that is contributing to the disorder. In its early stage, you may occasionally lose some feeling in your hands. Majority of the slight cases of carpal tunnel syndrome gets better with treatments. Usually there is no permanent damage to the median nerve.

The carpal tunnel symptoms may improve by itself when the following happens:
* Fluid buildup decreases, such as after pregnancy.

* You change or stop the activity that has caused your carpal tunnel syndrome.

* The underlying condition that caused or contributed to your carpal tunnel symptoms has improved.

Remember that not all the numbness, pain and tingling are brought about by carpal tunnel symptoms. It may be caused by other disorder so it's best to consult with a specialist to make sure.

Two Kinds Of Carpal Tunnel Syndrome Surgery

Editor — Fri, 13 Jun 2008 05:12:55 +0000

Orthopedics expert, Dr. John Cluett, advised that when usage of anti- inflammatory medications, wrist brace and cortisone injection does not help relieve carpal tunnel syndrome then most likely, there is a need for surgery.

A carpal tunnel syndrome surgery is called "release" which is available and effective in the treatment of such disorder. There are two most common, the carpal tunnel open release surgery and the carpal tunnel endoscopic release surgery. Both will be looked into in the proceeding paragraphs.

* Carpal Tunnel Syndrome Surgery- Open Release
During this kind of carpal tunnel syndrome surgery, the transverse carpal ligament is cut. This is to release pressure on the median nerve and relieves the symptoms of carpal tunnel syndrome.

An incision is made at the base of the palm of the hand. This allows the doctor to see the transverse carpal ligament. After the ligament is cut, the skin is closed with stitches. The gap where the ligament was cut is left alone and eventually fills up with scar tissue.

Open carpal tunnel release surgery is usually done under local anesthetic as an outpatient same-day surgery.

Stitches are removed 10 to 14 days after the surgery. It may be recommended to wear a splint for several weeks. The pain and numbness may go away right after surgery or may take several months to subside. Also, avoid heavy use of treated hand for at least three months.

* Carpal Tunnel Syndrome Surgery- Endoscopic Release
This kind of carpal tunnel syndrome surgery uses a thin, flexible tube with a camera attached (endoscope). The endoscope is guided through a small incision in the wrist or at the wrist and palm. The endoscope lets the doctor see structures in the wrist, such as the transverse carpal ligament, without opening the entire area with a large incision.

The cutting tools used in endoscopic carpal tunnel release surgery are very tiny and are inserted through the small incisions in the wrist or palm.

Endoscopic carpal tunnel release surgery is usually done as a same-day surgery on an outpatient basis.

You can expect a shorter recovery period after an endoscopic surgery than after open surgery. This is because the procedure does not require cutting the palm open and disturbing a large area of the hand. The pain and numbness may go away right after surgery, or it may take several months.

How soon can you return to work depends on whether your dominant hand was involved, your work activities, and the effort that you put into rehabilitative physical therapy.

Carpal Tunnel Procedure

Editor — Sun, 16 Mar 2008 02:50:26 +0000

When the patient's disorder in the hand is already heavily damaged, there is a need to undergo surgery. Carpal tunnel procedure is a major operation that is known as "release." Procedure is of two kinds namely, carpal tunnel open release and carpal tunnel endoscopic release.

Carpal tunnel open release is the traditional procedure used to correct carpal tunnel syndrome. It consists of making an incision up to two inches in the wrist and then cutting the carpal ligament to enlarge the carpal tunnel. This type of carpal tunnel procedure is generally done under local anesthesia on an outpatient basis, unless there are unusual medical considerations.

On the otherhand, carpal tunnel endoscopic release may allow faster functional recovery and less postoperative discomfort. The surgeon makes two incisions (about " each) in the wrist and palm, inserts a camera attached to a tube, observes the tissue on a screen and cuts the carpal ligament. This kind of carpal tunnel procedure is two-portal where it is generally performed under local anesthesia. It is effective and minimizes scarring even scar tenderness, if there is any.

Over 200, 000 cases in the United States have been documented going through carpal tunnel procedure; thus, making it among the most common surgery of the hand.

Until now, the decision whether to have either of the carpal tunnel procedures to correct the syndrome has been puzzling a lot of patients. Electrodiagnostic tests for nerve conduction, ultrasound examination and magnetic resonance imaging scans are used to determine severity. However, there are no tests that can fully determine which patients will benefit most from which of the carpal tunnel procedure.

Here are the findings of candidates that are less likely to respond to conservative therapy and might end up benefiting more from the carpal tunnel procedure:
* Older than 50 years.
* Symptoms have lasted 10 months or longer.
* Continual numbness.
* The muscles in the base of the palm have begun to atrophy (shrink).
* Symptoms occur within 30 seconds during a Phalen's test.

A study conducted in 2002 revealed that if one of those factors mentioned above are present, then conservative therapy, such as wearing wrist splints and taking anti- inflammatory agents, are effective in about two- thirds of the candidates. It was also found that the traditional approach was not proven effective in some of 60 patients if only one of those said factors were present.

Not only those with carpal tunnel syndrome need to know but also the general public that carpal tunnel procedure does not totally cure the syndrome. There is the notion that because the carpal ligament is permanently cut, some wrist strength is lost. A lot of orthopedic specialists suggest aggressive conventional treatment before choosing the more invasive option.

What You Should Know About Carpal Tunnel Syndrome

Editor — Wed, 20 Feb 2008 11:54:13 +0000

Day in and day out from 8am up to 5pm, you are right in front of your computer, tapping your fingers on the keyboard as fast as you can just so to beat the deadline of those articles that have to be done. You are working at your desk, trying to ignore the tingling or numbness you have had for months in your hand and wrist. Suddenly, a sharp, piercing pain shoots through the wrist and up your arm. "This maybe just a passing cramp", you thought to yourself as you are still feeling the ache of it. Think twice, lady because most likely you have carpal tunnel syndrome.

Carpal tunnel syndrome is a painful progressive condition caused by compression of a key nerve in the wrist. It occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers, as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.

Sometimes, swelling from irritated tendons or other kinds of thickening narrows the tunnel and causes the median nerve to be compressed. The effect may be soreness, weakness, or numbness in the hand and wrist that goes up the arm. Although painful sensations may indicate other conditions, carpal tunnel syndrome is the most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed or traumatized.

Did you know that women are three times more likely than men to develop carpal tunnel syndrome? You heard it right. This is not to scare the ladies out there but for awareness sake as proven by science. It is because the carpal tunnel itself may be smaller in women than in men. The dominant hand is usually affected first and produces the most severe pain. Persons with diabetes or other metabolic disorders that directly affect the body's nerves and make them more susceptible to compression are also at high risk but it usually appears to the adults.

The danger of developing carpal tunnel syndrome is not limited to a certain demographic of people like those in a single industry such as manufacturing, sewing, finishing, cleaning and poultry packing. Truth is, carpal tunnel syndrome is three times more common among assemblers than among data-entry personnel. A 2001 study by the Mayo Clinic found heavy computer use (up to 7 hours a day) did not increase a person's risk of developing carpal tunnel syndrome.

During 1998, an estimated three of every 10,000 workers lost time from work because of carpal tunnel syndrome. Half of these workers missed more than 10 days of work. The average lifetime cost of carpal tunnel syndrome, including medical bills and lost time from work, is estimated to be about $30,000 for each injured worker.

Carpal tunnel syndrome is somewhat similar to the mustard seed principle where it starts small that you hardly even notice it but can end up really big as to paralyzing those arms.

Carpal Tunnel Treatment

Editor — Thu, 17 Jan 2008 05:44:21 +0000

The goal of carpal tunnel treatment is to allow you to return to the daily normal functions and routinary activities. This is also to address other health conditions if they are aggravating your symptoms of carpal tunnel syndrome.

More than the above is to reduce any inflammation of tissues in the wrist that puts pressure on the median nerve. It is also to determine the causes of your carpal tunnel symptoms. You can then identify whether there are certain dealings for you to avoid or do differently and ways you can help prevent the condition. Another is also to prevent nerve damage and loss of muscle strength in your fingers and hand.

Carpal tunnel treatment is based on the seriousness of the condition, whether there is any nerve damage and whether other remedies have helped. Options include with surgery or without surgery.

* Carpal tunnel treatment without surgery

If your symptoms are not severe, expect your health professional to recommend nonsurgical kind of carpal tunnel treatment to see whether symptoms improve. This includes the following:

1. Evaluating any other medical conditions that might contribute to carpal tunnel syndrome, and changing your treatment for those conditions if necessary.
2. Changing or avoiding activities that may be causing symptoms, and taking frequent breaks from repetitive tasks.
3. Wearing a wrist splint to keep your wrist straight, usually just at night. See an illustration of a wrist splint.
4. Using nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation. Although studies have not shown NSAIDs to be effective for carpal tunnel syndrome, they may help you to relieve symptoms.
5. Doing exercises to stretch and strengthen the muscles in the hand and arm.
6. Learning ways to protect your joints as you go through your daily activities.

* Carpal tunnel treatment with surgery

Surgery is sometimes recommended when other carpal tunnel treatment has not helped- if a carpal tunnel condition has continued for a long time

or the risk of nerve damage. Surgery is usually successful. In some cases it does not completely relieve the numbness and pain in the fingers or hand. This may be the case if there has been permanent nerve damage caused by long-standing carpal tunnel syndrome or by underlying conditions such as diabetes.

The two kinds of surgery are:

1. Open carpal tunnel release is the traditional procedure used to correct carpal tunnel syndrome. It consists of making an incision up to two inches in the wrist and then cutting the ligament to enlarge the carpal tunnel. This procedure is generally done under local anesthesia on an outpatient basis, unless there are unusual medical considerations.

2. Endoscopic carpal tunnel release may allow faster functional recovery and less postoperative discomfort than the other one. The doctor make two incisions in the wrist and palm, inserts a camera attached to the tube, observes the tissue on a screen and cuts the carpal ligament.

Carpal Tunnel Syndrome Disability

Editor — Wed, 19 Dec 2007 21:06:53 +0000

Several people in the United States have been affected by CTS, which is also considered as an "occupational disorder in the 90's". It has pushed many to resign from their work because they have become victims of the carpal tunnel syndrome disability.

Carpal tunnel syndrome is a common form of repetitive stress injury, which usually occurs when a person's wrists are exposed to continuous strain on a regular basis. Tissues surrounding the wrist tendons become so enlarged that they compress the median nerve, which runs through a passage in the wrist known as the carpal tunnel. The compression caused the following problems:

* Numbness, tingling and pain in the hand, wrist and forearm
* Impaired or lost nerve function
* Reduced muscle control
* Reduced grip strength

Due to the mushrooming dilemma, the government of Illinois thought of a solution for those who have been stricken by the carpal tunnel syndrome disability. Their officials then passed a bill under the Workers' Compensation Act.

According to their Supreme Court, "even if CTS develops gradually and not as the result of a sudden mishap", those with carpal tunnel syndrome disability can be compensated from the onset of the disorder under the Workers' Compensation Act.

The law states that the person is entitled to receive a 100 percent share of all medical expenses that are deemed reasonable and necessary to treat the condition.

It is also of great benefit to the casualty because they are not forced to pay any deductions with no dollar limitations placed on the treatment. While under diagnostic, the person with carpal tunnel syndrome disability still has temporary total compensation. This is based on a percentage of the average weekly wage, including overtime.

Under the provisions of the Illinois Workers' Compensation Act, the person with carpal tunnel syndrome disability's employer or the insurance company is legally required to begin the payment within 14 days of the date that the individual reported the onset of CTS.

When he or she returns from work after days of medication, he or she is allowed to collect a salary for the permanent partial loss of use of the affected hands and arms as a result of contracting CTS while on the job. Such compensation is called permanent partial disability compensation (PPD), and is received as the result of a settlement agreement between the person with carpal tunnel syndrome disability and the employer or as the result of the decision of the arbitrator assigned to the claim.

If it is necessary to accept a lower-paying job because of inability to perform the responsibilities of the usual and customary employment, he or she may be entitled to added benefits equal to two-thirds (2/3) of the salary difference based on the average gross weekly wage earned before the development of CTS.

Carpal Tunnel Herbs and Vitamins

Editor — Thu, 06 Dec 2007 21:03:39 +0000

Do you ever wonder why you experience those pins and needles tingling on your foot when you squat in Indian position for quite a while? Bad circulation, you answer. That is the very reason why it pays to stand up right away to stomp it out and gets the blood moving again.

Truth is, it does not have much to do with the flow. The numbness occurs when a nerve, not the vessel, is compressed. That is also the very same thing that happens in different parts of the body, especially when someone has carpal tunnel syndrome (CTS).

Over time, there have been several treatments of carpal tunnel syndrome, may it be surgical or not. Still, a lot of medical practitioners will advise to try the conventional manner. Here we will look into the some carpal tunnel herbs and vitamins that can soothe those repetitive stress injuries.

Carpal tunnel herbs and vitamins: B6
Vitamin B6 seems to help relieve the symptoms of CTS, says Jill Stansbury, N.D., assistant professor of botanical medicine and chair of the botanical medicine department at the National College of Naturopathic Medicine in Portland, Oregon.

Vitamin B6 seems to work best on mild to moderate cases of CTS, says Thomas Kruzel, N.D., a naturopathic doctor in Portland, Oregon. To end the tingling, take 50 milligrams of B6 each day, he suggests, and give it time to work. It usually takes 12 weeks to get the full benefit.

Carpal tunnel herbs and vitamins: St. John's wort
Widely known for its ability to treat depression, St. John's wort also helps nerves recover when they are damaged, inflamed or strained, says Dr. Stansbury. Thousands of years before doctors coined the term carpal tunnel syndrome, the relaxing herb was used to heal nerve pain and tingling, she says.

Its sedative effect helps to reduce pain, while its anti-inflammatory activity can help shrink swollen tendons. Don't expect the kind of quick pain relief that comes from popping a pharmaceutical like aspirin or ibuprofen, though. St. John's wort typically takes a few weeks to start working.

Carpal tunnel herbs and vitamins: Pineapple
For relief with fewer side effects, you have the option of trying some supplements that can be very effective. One of these is bromelain, an enzyme found in pineapple that is nature's anti-inflammatory medicine. This hungry enzyme can take a bite out of pain and swelling and help you heal faster, says Dr. Kruzel.

When the tingling pain of CTS strikes, take two 500-milligram tablets or capsules of bromelain between meals two or three times a day, says Dr. Kruzel. Bromelain is measured in milk-clotting units (mcu) or gelatin-dissolving units (gdu).

Carpal tunnel herbs and vitamins: Flaxseed Oil
You can also soothe the inflamed nerve and tissues with flaxseed oil, a supplement rich in omega-3 essential fatty acids, says Ellen Potthoff, D.C., N.D., a chiropractor and naturopathic doctor in Pleasant Hill, California. Any type of inflammation responds well to essential fatty acids because no matter where it hurts, they interrupt the process of inflammation early.

You should feel better in two to four weeks if you start taking one tablespoon of flaxseed oil every day, says Dr. Potthoff. Taste is one way to tell if you're getting good-quality flaxseed oil. "It should have a really nice, nutty flavor and a dark amber color," she says.

Carpal tunnel herbs and vitamins:
Turmeric is a herb that contains a powerful anti-inflammatory chemical called curcumin. The herb has traditionally been used in India's Ayurvedic medicine to treat pain and inflammation.

The effect of turmeric has been compared to that of cortisone, the pharmaceutical sometimes used to treat CTS symptoms. Although turmeric's pain-fighting power is not as strong as cortisone's, the herb is a lot easier on your system, says Dr. Kruzel.

Carpal Tunnel Syndrome Symptoms

Editor — Wed, 14 Nov 2007 16:08:14 +0000

As mentioned in the previous article, the disorder follows the mustard seed principle where you hardly even recognize it stinginess. It starts so small and end up blowing bigtime. Yes, you feel the pain but there is a tendency of simply brushing it off.

Jonathan Cluett, an orthopedic doctor, said that there are two most common carpal tunnel syndrome symptoms which are tingling sensations and numbness feeling of both fingers and hands. Carpal tunnel syndrome symptoms usually start gradually, with frequent burning or itching deadness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers.

Some of those who already have experienced say their fingers feel useless and swollen, even though little or no thickening is apparent. The carpal tunnel syndrome symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist.

As it worsens, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and untreated cases, the muscles at the base of the thumb may waste away. Some people are even unable to tell a temperature, between hot and cold by touch.

What are the causes of these carpal tunnel syndrome symptoms?

Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Most likely the disorder is due to a congenital predisposition where the carpal tunnel is simply smaller in some people than in others.

Other contributing factors include trauma or injury to the wrist that cause swelling. They are as follows sprain or fracture; overactivity of the pituitary gland; hypothyroidism; rheumatoid arthritis; mechanical problems in the wrist joint; work stress; repeated use of vibrating hand tools; fluid retention during pregnancy or menopause; or the development of a cyst or tumor in that part of the body. There are even cases that it just cannot be identified.

There is little clinical data to prove whether repetitive and forceful movements of the hand and wrist during work or leisure activities can cause carpal tunnel syndrome symptoms. Repeated motions performed in the course of normal work or other daily activities can result in repetitive motion disorders such as bursitis and tendonitis.

Writer's cramp is a condition in which a lack of fine motor skill coordination, ache and pressure in the fingers, wrist or forearm is brought on by repetitive activity. It is not one of the carpal tunnel syndrome symptoms.

Dr. Nortin Hadler

Editor — Sat, 27 Oct 2007 00:18:58 +0000

The Opposition Party

A rheumatologist and professor of medicine at the University of North Carolina, Dr. Nortin Hadler has been known to rigorously examine the statistics generated by his medical colleagues' practices for over three decades now. Afterwhich, he arrives at startling conclusions about their effectiveness.

Dr. Nortin Hadler is also credited by leading a complete re- thinking about the treatment of back pain, which he finds excessive. He then wrote an editorial accompanying a landmark study in The Journal of the American Medical Association two years ago. He suggested that the benefits of surgery for back pain are overrated.

In his book entitled The Last Well Person: How To Stay Well despite The Health- Care System, Dr. Nortin Hadler took his case about cardiac care and other health issues to the public. He has also taken on heart treatment, testifying before the Congress and the Social Security Advisory Board and publishing papers arguing the every little data back up on the value of modern treatments such as bypass surgery and angioplasty.

Aside from all of those belief in resistance, Dr. Nortin Hadler is also recognized as one of those who strongly oppose other doctors' claim that repetitive stress injuries are brought about by the use of computer keyboards. This is because, according to them, people spend many hours in the same position doing the same task without breaks or variation, giving no time for stressed tissues to recover. Over how many period, such behavior can induce crippling changes in the sensitive areas of both the wrist and hand.

New York Times have run several articles regarding the subject. There were high rates of injury reported among data of entry workers, telephone operators and mediamen who do a lot of tapping on the computer keyboard for many hours.

The American Academy of Orthopedic Surgeons estimated in 1984 that the problem cost the nation more than $27 billion a year in lost wages and medical care. It is an amount that could well have doubled at present since there has been more than a doubling in reported cases.

Repetitive stress injury has been dubbed by Dr. Marvin Dainoff, a psychologist of the Center for Ergonomic Research at Miami Univeristy in Ohio, as the "occupational disease of the 1990's." So it is with Dr. Laura Punnett, an ergonomist and epidemiologist at the University of Massachusetts, said that "many workers did not realize that the problem as being job- related."

With all those words from fellow practitioners in the medical field, this urged Dr. Nortin Hadler to dispute whether the problem is real. He then found out that musculoskeletal activity that is "reasonable, comfortable and customary and which can be repeated without undue distress," such as typing on a computer, is unlikely to result in tissue damage.

Carpal Tunnel Recovery Reminders

Editor — Sat, 13 Oct 2007 09:18:26 +0000

After undergoing either of the open or endoscopic release surgery, it is time to get acquainted on how to recuperate from the major operation. It does not mean that when the carpal ligament is cut off, the patient is all too fine. In fact, some wrist strength is lost.

The carpal tunnel recovery depends on what type of anesthesia has been injected. If it is local and has been injected around the site of operation, the area and the nearby fingers will remain numb for up to ten hours after surgery. As this effect wears off, it may well be worth taking some pain-killers. Your carpal tunnel pain at night should settle immediately. Any tingling in the fingers may take some weeks to disappear.

Carpal Tunnel Recovery Reminder #1

Hand elevation is important to prevent swelling and stiffness of the fingers. Please remember not to walk with your hand dangling or to sit with your hand held in your lap. It is fine, however, to lower your hand for light use and you should get back to normal light activities as soon as possible as guided by common sense. There are a number of exercises you should do to prevent stiffness.

Carpal Tunnel Recovery Reminder #2

You have been discharged with a supportive dressing, consisting of gauze, wool and a crepe bandage. Do not forget to remove the entire dressing after five days and inspect the wound. There obviously will be some swelling and bruising. Look out for any redness or tenderness in the area around the wound that might indicate an infection. Do not apply antiseptic, for all you know, it is quite safe to leave the wound open. If you have any worries, do not hesitate to contact your doctor right away.

Carpal Tunnel Recovery Reminder #3

At this stage it is safe to get the hand wet in a bath or shower. The wound and the surrounding skin often become very dry and will be more comfortable if a moisturizer is applied. An easy way of doing this is to briefly immerse your hand in some warm water to which some Johnson's baby oil has been added. Alternatively, apply an unscented moisturizing cream to the skin.

Carpal Tunnel Recovery Reminder #4

You can drive if you are comfortable and have regained full finger movements especially, if you have sufficient power to control the vehicle. Timing of your return to work is variable according to your occupation which should be discussed by your doctor and employeer.

Carpal Tunnel Recovery Reminder #5

Stitches will be removed at about two weeks after the operation. Following this, the scar will be somewhat lumpy, firm and tender. The scar will settle after about three months, but massaging the area firmly with moisturizing cream can help this.

Carpal Tunnel Wrist Brace

Editor — Mon, 08 Oct 2007 02:02:20 +0000

A carpal tunnel wrist brace is a splint or support that looks like a fingerless glove. It stabilizes your wrist in a straight and sometimes slightly bent- back position. It keeps

Wearing a carpal tunnel wrist brace minimizes pressure on the median nerve and allows you a period of relative rest from movements that worsen the carpal tunnel syndrome. It keeps the wrist from bending and preventing pressure on the median nerve. It intentionally designed for different purposes such as for particular jobs or for wearing at night. The carpal tunnel wrist brace is most effective if they it is used as soon as symptoms of such disorder are noticed, or even by those brought about by other causes.

These following guidelines should be aptly considered when using a carpal tunnel wrist brace.

* When worn to stabilize the wrist during sleep, a wrist splint can reduce pain and pressure on the median nerve.

* A wrist splint is not a substitute for good workplace design and proper body mechanics. Some experts advise against wearing a wrist splint while working, because doing so can strain the hand's tendons.

* A wrist splint is a helpful short-term treatment for carpal tunnel syndrome. However, long-term use can cause your muscles to weaken. During and after a period of splint use, exercising and slowly increasing hand and wrist movements will help prevent your wrist muscles from weakening.

Carpal tunnel wrist brace are available in drugstores and pharmacies without a prescription. It is also sold by recommendation from an orthopedic doctor by some medical supply houses. Physical and occupational therapists can make custom-fit splints from lightweight materials that are more comfortable to wear.

Here are some carpal tunnel wrist brace brands that you can find in the market designed to personally suit your style.

* Universal wrist wrap provides protection and support for the wrist during periods of activity. Ambidextrous wrap design with velcro closure.

* Support wrist splints are designed to prevent re- injury or stabilize the wrist following injury.

* SportAid wrist brace are pre- shaped removable aluminum palm stay that is covered with suede stay pocket.

* Mueller wrist supports are elastic in a unique knit that give even compression and allow full range of movement during activity. This fits either right or left hand.

* Ace Plus wrist wraps are pre- shaped that protects and supports injured wrist during strenuous activities. Hook or loop fastener for easy adjustment. Adjustable strap helps immobilize wrist.

* Pil- O wrist splints are adjustable. It is shaped for maximum healing benefits by gently immobilizing the wrist, hand and fingers in a neutral position. Unique design prevents you from holding your hand in a harmful position while sleeping. Velcro strap allows for easy adjustment with a soft foam cotton lining.

Varied Kinds of Carpal Tunnel Syndrome Treatments

Editor — Mon, 24 Sep 2007 04:21:29 +0000

Carpal tunnel syndrome treatments usually begin conservatively. It moves to more aggressive and invasive techniques if the symptoms of such disorder persist. Before undergoing a release or endoscopic surgery, the initial carpal tunnel treatments include some medications and splints that are just done in sheer organics while others are scientifically enhanced.

Here are those highly recommended carpal tunnel syndrome treatments by orthopedic doctors:

* Physical therapy techniques include ultrasound, hydrotherapy and stretching. Ultrasound uses high- pitched sound waves to create heat that helps decrease pain in the soft tissues. Hydrotherapy involves immersing the wrist in both hot and cold water for three minutes to increase circulation to the wrist. Stretching the hands before work will help prepare for repetitive movements.

* In mild cases of carpal tunnel syndrome, rest and wearing a splint at night may be enough to relieve symptoms. Splints keep the wrist from bending and prevent pressure on the median nerve. These are designed for different purposes such as for particular jobs or for wearing at night. It is most effective if they are used as soon as symptoms are noticed.

* Retraining is learning new ways of doing things. Ergonomic considerations is having your body in the correct posture and position and using equipment that is right for your strength and ability. Both retraining and ergonomic considerations may not only relieve the symptoms of carpal tunnel syndrome but also may prevent them from coming back.

There are also complementary and alternative carpal tunnel syndrome treatments that are sometimes used to nurse tingling, numbness, weakness and pain of the fingers and hands. They are as follows:

* Acapuncture has been suggested as a useful carpal tunnel treatment. It is commonly used, the U.S. National Institutes of Health is currently studying the effectiveness of acupuncture for treating such disorder.

* Yoga can be beneficial in relieving pain and improving grip strength in the hand. One study showed that yoga was more effective than wrist splinting.

* Chiropractic involves realignment of joints and bones by twisting, pulling or pushing movements in the wrist and in the forearm, upper arm, shoulder, upper back and neck.

* Vitamin B6 can also be of big help in carpal tunnel treatments. However, small studies have revealed mixed results. High doses of it can cause neuropathy so consult first your doctor before taking those supplements.

Before going into all these kinds of carpal tunnel syndrome treatments, remember that it should be under a health professional's direction and guidance. Underlying causes such as diabetes or arthritis should be treated first. Initial treatment generally involves resting the affected hand and wrist for at least two 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.

No matter how advanced technology is, natural is still the best.

Carpal Tunnel Ergonomics

Editor — Tue, 11 Sep 2007 17:39:28 +0000

The study of how to adapt man to a machine or environment is a way that is not stressful is called workplace ergonomics. A lot of individuals think that workplace ergonomics has something to do with computer. Yes it has but it is not just the focus. It also looks into the many causes of job- related pain.

Here, the basic concept of carpal tunnel ergonomics will be discussed in order for it to be applied. It is to keep those energy levels up then lessen the twinge and throb.

As a recap, the carpal tunnel is an area in the wrist and palm where the nerves and tendons of your forearm and hand pass. When this area is aggravated, it swells, putting pressure on the nerves thus, causing pain. Most people feel this pain at night when they sleep with bent wrists or awkward positions for a long time. It can even awake them at the middle of the night because of those pins and needles tingling sensations. When they are fully up, many people ignore the pain until permanent nerve damage occurs.

To prevent the eventual intense pain, here are simple carpal tunnel ergonomics' tips. These will be of great help to extend the comfort stage while working.

* You can buy gel pads at almost everywhere. This for the keyboards and mouse you use everyday in the office.

* Wrap all vibrating tools with paddings. Most of the hardware stores have it for a few bucks a roll.

* Adjust your chair to a position where your wrists are straight on the keyboard. Wrong posture starts the trigger for an eventual carpal tunnel syndrome.

* Even if you have a deadline to beat, it is best to take a rest. If you are so much in a hurry that you tend to forget, download a software that will just instantly pop- up out of your monitor and give you a reminder.

* Wrist braces keep your wrists from bending or being flexed. Supports and splints have been proven effective. This can be bought at medical supply houses even without a doctor's prescription.

* Every so often, perform wrist exercises such as limbering and curls. You can tie a gallon of water to a towel, roll it over and grasp it tightly. This is a good alternative if you do not have any dumbbell.

Carpal tunnel ergonomics also looks into how to stop shoulder pains. There are times that the ache brought about by the carpal tunnel syndrome will reach to the arms and towards the upper back.

Here is a carpal tunnel ergonomics exercise: put your thumbs down and arms out straight. Lean forward a bit and bring your pinkies up high and back far. Hold this for a five counts and release a few times.

Branches of Carpal Tunnel Therapy

Editor — Fri, 31 Aug 2007 07:49:02 +0000

There are several ways to remedy repetitive hand injuries but the most recommended by orthopedic doctors is the carpal tunnel therapy. It may be the conventional way but it is sheer natural so it does not have any side- effects.

Manual treatment that includes deep friction massage can help manage the swelling that is a factor in nerve compression. This is combined with manual stretches to the tendons to the fingers and wrist. Another modality of treatment is ultrasonic therapy, which in some cases may work as a carpal tunnel therapy by itself.

Here are four stemming branches of carpal tunnel therapy:
* Localized steroid injections

Steroid injections can be quite effective for temporary relief from symptoms of carpal tunnel syndrome for a short time frame while a patient develops a long term strategy that fits with his or her lifestyle. In certain patients, an injection may also be of diagnostic value. However, this carnal tunnel therapy is not appropriate for extended periods. In general, medical professionals only prescribe to localized steroid injections until other treatment options can be identified. For most patients, permanent relief requires surgery.

* Prioritizing hand activities and ergonomics

Any forceful and repetitive use of the hands and wrists can cause upper extremity pain. While avoiding activities that cause repetitive stress is an option that can help avoid the pain, it causes people to curtail their careers, forfeit earnings and give up whole segments of their lives.

More frequent rest can be useful if it can be orchestrated into one's schedule, but rest is not very practical in today's active work and play environments. It has been shown that taking multiple mini breaks during the stressful activity is more effective than taking occasional long breaks. Exercises that relax and strengthen the muscles of the upper back can reduce the risk of a double crush of the median nerve. Spinal manipulations performed by an osteopath or chiropractor may be appropriate to relieve compression of the nerve. It goes to show that this kind of carpal tunnel therapy will not just be beneficial to the CTS but also in a holistic manner.

* Dietary changes and medication

Dietary changes can provide the body with the necessary nutrients needed to repair nerves and help reduce inflammation. With this, pressure on the nerve can be reduced, thus allowing it to heal. Certain vitamins and nutrients can also be taken to repair nerve damage, such as amino acids, vitamin B complex and hypercium. No specific vitamin or nutrient has been shown to have a noticeable anti-inflammatory effect, but taking a diverse multivitamin may have a noticeable effect on reducing inflammation in the body. One could argue that this carpal tunnel therapy have a small effect on carpal tunnel syndrome, similar to placebo. Their effect would certainly be negligible in anything but the most mild of cases.

* Carpal tunnel release surgery

When visiting a hand surgeon, the first step would be examination of the hands and a review of the symptoms. If a condition other than carpal tunnel syndrome is present, the doctor will suggest the appropriate treatment. If CTS is suspected, depending on the severity and the situation, the doctor will first prescribe non-operative treatment with splinting and anti-inflammatory drugs. A test conducted on the nerve will positively determine whether or not it is compressed and if carpal tunnel syndrome is indeed the diagnosis.

If all the symptoms go away with splinting and medication, then this kind of carpal tunnel therapy will not be necessary. If not, then carpal tunnel release surgery is recommended. In general, milder cases can be controlled for months to years, but severe cases are unrelenting symptomatically and likely will come to surgical treatment.

Simple Carpal Tunnel Exercises

Editor — Mon, 27 Aug 2007 17:58:23 +0000

In preventing carpal tunnel syndrome to worsen, there should be necessary measures to be taken. Surgery should not be the immediate remedy because it is not a grave major disorder. However, it should not be the reason for it to be ignored. Remember that this involves a very essential part of your body, so it should be dealt with utmost consideration.

Keeping your wrists strong and flexible can alleviate strain on the carpal tunnel. It is by stretching your wrists often during the day that will help prevent injury. Doing carpal tunnel exercises reduces the amount of pressure on the median nerve in the carpal tunnel and prevents injury.

Here are carpal tunnel exercises that can be made on the comforts of your own office chair. These should be done by individuals who execute hand-intensive jobs.

Carpal tunnel exercises should be performed at the start of each workday and during a break carried out three to five times a week. Discussed below are also few reminders on how to avoid carpal tunnel syndrome.

1. Limbering Up

Massage the inside and outside of hand with thumb and fingers. Grasp the fingers and gently bend back wrist. Hold for five seconds. Gently pull thumb down and back until you feel the stretch. Hold for five seconds. Clench fist tightly, then release to fan out fingers. Repeat five times.

2. Wrist Rotation

Stand or sit with your elbows close to your waist, your forearms extended in front of you and parallel to the floor with your palms facing down. Make fists with both hands and make circles with your fists in one direction. Do 10 repetitions then reverse the direction. Next, open your hands, extend your fingers and repeat the entire sequence.

3. Wrist Curl

Stand or sit with your elbows close to your waist, your forearms extended in front of you and parallel to the floor with your palms facing down. Grasp a one-pound dumbbell in each hand and slowly bend your wrists down, holding for five seconds. Do 10 repetitions. If you do not have dumbbell, you can utilize a 16 ounce soft- drink bottle or a can of food.

4. Sideways Wrist Bend
Stand or sit with your elbows close to your waist, your forearms extended in front of you and parallel to the floor with your palms facing down. Grasp a one-pound dumbbell in each hand. Keeping your forearms still, slowly bend your wrists from side to side, moving the weights toward then away from one another in a windshield wiper-like motion. Do 10 repetitions.

5. Wrist Twist
Stand or sit with your elbows close to your waist, your forearms extended in front of you and parallel to the floor with your palms down. Grasp a one-pound dumbbell in each hand and slowly turn your wrists and forearms until your palms are facing up then turn them down again. Do 10 repetitions.

This set of carpal tunnel exercises is very much recommended by orthopedic doctors because it is in its pure natural form. It does not have any side- effects whatsoever. So bring your way up with carpal tunnel exercises.