Carpal Tunnel Syndrome

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Condition: Carpal Tunnel Syndrome (CTS) refers to a painful problem in the hand and wrist caused by damage to or pressure on a nerve, called the median nerve.

Background: CTS is fairly common, affecting about 3-5% of the population.

Risk Factors: Women have CTS more often than men. Pregnancy and obesity, as well as diseases such as diabetes, hypothyroidism, and arthritis, increase the risk of getting CTS. Jobs where you use your fingers, hands, and wrists a lot may also lead to CTS. 

History and Symptoms: Symptoms of CTS include numbness or tingling in the fingers, or aching pain in the hand and wrist. These problems may get worse at night or when doing certain things like driving or reading.

Physical Exam: Your physician will examine your hands, wrists, elbows and shoulders. He or she may also check to see if tapping on your wrist, having you hold your hands in a certain way, or pressing on the inside part of the wrist causes tingling, pain, or numbness in your hands.

Diagnostic Process: Finding out what causes pain or tingling may help the doctor tell if you have CTS. An ultrasound scan may also be done to visualize the nerves and tendons in the wrist. A test called an EMG will show how well the nerves are working. 

Rehab Management: A physical medicine and rehabilitation (PM&R) physician is uniquely skilled to perform a detailed physical exam of the nerves, muscles, and tendons, and can help diagnose this condition. He or she may also be able to perform ultrasound or EMG tests to aid in diagnosis. A PM&R physician can help guide a rehabilitation plan, which may involve changing how you do things at work or home to take pressure off of your wrists. He or she can also prescribe a wrist splint or hand and wrist exercises. If these things do not work, injections of corticosteroids into the wrist or even surgery may be needed.    

Other Resources for Patients and Families: Your doctor or therapist may help you find out about different kinds of computer keyboards or other tools that will put less strain on your wrists. 


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