CARPAL TUNNEL SYNDROME
By Dr. Dionisio Celeste

CARPAL TUNNEL SYNDROME is an occupational hazard for anyone whose job involves making repetitive movements with the hands and / or fingers.  In the advent of computers, what used to be the assembly line workers’ hazard is now the bane of office workers.  CTS occur when the median nerve in the wrist is compressed or damaged.  The median nerve controls the thumb muscles and is also responsible fore sensation felt in the thumb, the palm, and the first three fingers of the hand.  It is vulnerable to compression or injury from – swelling due to pregnancy or water retention, pressure from bone spurs, inflammatory arthritis or even tendonitis.  The carpal tunnel is a very small opening about one-quarter inch below the surface of the wrist through which the median nerve passes.  CTS is associated with repetitive wrist motion injury which is linked to continuous rapid use of the fingers.  Other occupation affected by CTS includes, athletes, drivers, hair stylists, musicians, jackhammer and chainsaw operators, waiters, writers among others.  Illnesses that increase the risk of CTS include menopause, Reynaud’s disease, pregnancy, hypothyroidism and diabetes mellitus.  Symptoms of CTS can range from mild numbness and faint tingling to excruciating pain accompanied by a crippling atrophy of the muscles in the thumb.  The tingling is often referred to as feeling similar to the “pins and needles” associated with a limb “falling asleep”, and it also involves gradual weakening of the thumb.  Pain may spread to the forearm and in severe areas to the shoulder. 

A simple self-test called “Phalen’s test”, can help you determine whether you have CTS.  Place the back of your hands together, with the fingers pointing straight down and the wrists at a 90 degree angle, so that your elbows point straight out to the sides.  If holding this position for over a minute brings on symptoms, you probably have CTS.  This self-test is also known as “Reverse Prayer Test”.  However, this self-test is not foolproof.  The only truly conclusive tests for CTS is electromyography (EMG), which involves transmitting electrical impulse transmission occurs at 136 meters per second, hence if the neuro-transmission speed is 90 to 95 meters per second only, then nerve damage or compression is strongly suggested.  To prevent the risk of CTS, here are some recommendations:

1. Use you whole hand and all of your fingers when you lift an object.

2. Use a tool instead of flexing your wrist forcibly.

3. Shake your hands periodically throughout the day.

4. Slow your wrist and hand rhythm movements.

5. Take a break from handworks for a few minutes every hour.

6. Perform simple stretching exercises before your daily tasks to improve overall circulation and aid in warming up the muscles.  The American Physical Therapy Association recommends these exercises:

   1. Rest one forearm on a table, grasp the fingertips of that hand and pull back gently.  Hold this position for 5 seconds, then repeat the exercise with the other hand.

   2. Press the palms flat on a table, as if doing a push up.  Lean forward to stretch the forearm muscles and the wrists.

   3. Move your hands around in a circle for about 2 minutes, thoroughly stretching the muscles of the hand.

   4. Do strengthening exercises by placing a rubber band around the fingers to provide resistance and opening and closing the fingers.  3x a day, do as set of 10 repetitions with each hand.

Only a small percentage of CTS needs surgery.  A second opinion should always be obtained before surgery is agreed to.  A new treatment for CTS involves the use of magnetic field to penetrate tissues, stimulate nerves and increase microcirculation in the affected area.  With the use of Biomagnet pain relief Kit, follow the method of application in the diagram below:

The magnetic field will relieve the pain in the carpal tunnel area.  Avoid taking supplements that contain iron.  They are suspected of aggravating pain and swelling in joints.  Eat half of a fresh pineapple daily.  Fresh pineapple contains bromelain, which reduces pain and swelling.  Avoid salt and all foods containing sodium.  Use a splint to help prevent flare-ups.  Splints are cloth covered metal of plastic braces that attach to the forearm with an elastic bandage or hook and loop fasteners.  If symptoms persist, consult your family doctor.