It's all in the wrist!

It all starts with complaints of an aching wrist, hand or forearm. Then there is a feeling that the hand is going to sleep, or there is constant pain in the palm. This could all be as a result of pressure on the nerve that innervates the hands and fingers. The anatomical compartment where the tendons, nerves and arteries go through the wrist to reach the hand is called the carpal tunnel. From athletes to trades people, overuse of the hands by putting in long hours on the tennis court, golf course, on the bike (holding on to the bars), or anything that requires repetitive and strenuous motion can lead to “carpal tunnel syndrome (CTS).” Classified mostly as a sports injury, in fact CTS can happen to anyone when the repetitive stress conditions are right including excessive computer use, electricians, bricklayers, meat cutters, seamstresses and carpenters.

Essentially, the structures in the tunnel run out of space - like too much data through a bandwidth, or six lanes of traffic merging into three. Something has to give, and in this case, the median nerve becomes inflamed and it starts sending messages of pain and discomfort. Attending to this syndrome immediately will prevent going under the knife. Some ways to treat carpal tunnel syndrome include:

• Avoid and/or limit repetitive wrist activities
• Wearing wrist splints to alleviate pain and discomfort
• Using NSAIDs (non-steroidal anti-inflammatory drugs) to reduce pain and inflammation

However, if conservative measures do not heed positive results, then surgery might be the only solution where the scar tissue will be removed from the carpal ligament to free up some space in the very narrow tunnel. The traditional invasive carpal tunnel release surgery requires the dissection of the layers of the palm and a lengthy incision, while the new advancement called Endoscopic Carpal Tunnel Release (ECTR) uses an endoscopy or an arthroscopic device resulting in a much smaller incision size. Other benefits to the patient include:

• Reduced pain after surgery
• Less scar tissue
• Quicker resumption of normal activities
• Better cosmetic result for patients.

Please visit SIRC for more information on carpal tunnel syndrome.