Let's start with an anatomy lesson. The small bones in the wrist are known as the carpal bones. They are connected by a series of tendons and ligaments which provide the ability to use our fingers and especially our thumb. This all is stimulated by two large nerves, the ulnar and the median, which carry the messages from the brain to those muscles. If anything puts pressure on these nerves, tingling, pain, and numbness can result.
Also at the wrist, is a thick band of fibrous tissue called a ligament. With the bones of the wrist, it forms a tunnel, the carpal tunnel. The nine tendons and a large nerve, the median nerve, used to bend our fingers, run through the carpal tunnel.
It is obvious that if swelling occurs in this area--whether because of injury or inflammation-there will be pressure on the median nerve. With the pressure comes the tingling, numbness and pain of carpal tunnel syndrome.
The cause of most cases of carpal tunnel syndrome (CTS) is not known, although several things are known to be associated with CTS. Repetitive movements, broken or injured bones in the wrist, arthritis, diabetes, thyroid disease, and hormonal changes associated with both pregnancy and menopause all can be involved.
To help diagnose CTS, your doctor may recommend a nerve conduction study. This measures the speed at which nerve impulses are carried along the median nerve. When the diagnosis is made and the extent of the problem is outlined, the doctor can then prescribe treatment.
Treatment usually starts with the least invasive. Some forms of exercise and using a splint to rest the wrist help many people. Anti-inflammatory drugs such as Advil and Motrin can relieve symptoms. Injections of corticosteroid drugs into the joint help for a time but wear off after several months.
If the pressure on the nerve is very serious and the patient gets no relief from non-invasive therapies, then the doctor may recommend 'release' surgery. This type of surgery is done on an out-patient basis under a local anesthetic. The ligament that is causing the pressure is cut, relieving the pressure on the nerve. This surgery is usually very effective and the recovery time short.
In this case as in so many others, we have to have a lot of information in order to make an informed decision about health care. Here at HealthWise, we try to help with that process. We appreciate our viewer's interest and look forward to more or your questions.
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