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Carpal tunnel syndrome

CTS) is a condition that affects the hand and the wrist. It can result from injury to the wrist - dislocated or broken wrist bones or sprains. Carpal Tunnel Syndrome can also be caused by diabetes, rheumatoid arthritis or thyroid disease. Those who are at increased risk are computer users, violinists, golfers, meat packers, assembly line workers, hair stylists and mechanics since they perform the same hand movements repeatedly.


The median nerve controls some of the muscles that move the thumb. It also provides sensations of temperature, pain and touch from the hand to the brain as well as sweating of the hand. CTS results when the tunnel walls are compressed, thereby putting pressure on the nerve. Carpal tunnel syndrome is particularly associated with tasks that involve:


Repeated wrist movement
Awkward hand positions
Strong gripping
Stress on the palm
Use of vibrating tools

Lubrication is essential for the normal and smooth functioning of the tendons. With excessive or repetitive activity on the carpal tunnel, the lubrication system may malfunction. It may not produce enough fluid or it may produce a fluid with poor lubricating qualities. This failure creates friction between the tendon and its sheath causing inflammation and swelling of the tendon area.


The swelling squeezes the median nerve in the wrist or carpal tunnel. Repeated episodes of inflammation cause fibrous tissue to form. The fibrous tissue thickens the tendon sheath and hinders tendon movement. This makes moving of the wrist or the hand painful.

Symptoms of this condition usually start gradually - frequent burning, tingling, pins and needles or itching and numbness in the palm of the hand and the fingers especially the thumb and the index and middle fingers. In time, these symptoms can spread to the arm and shoulder. They tend to worsen at night or first thing in the morning since many people sleep with flexed wrists.


Carpal tunnel syndrome can affect one or both hands and the severity of the symptoms can vary. The hand muscles may become weakened, making it difficult to grip objects. It can also result in permanent loss of feeling. Fine finger movements, such as writing, may become increasingly difficult. In extreme cases patients might feel tingling during the day and the muscles at the base of the thumb may waste away. In some chronic cases people are unable to tell between hot and cold by touch.

Carpal tunnel exercises should be done by individuals who perform hand-intensive jobs. These exercises should be performed at the start of each workday and during a break. It reduces the amount of pressure on the median nerve in the carpal tunnel and prevents injury. A few important exercises for avoiding the carpal tunnel syndrome are discussed below:


  • The most important thing to do is to get up from your desk and move around every 1/2 hour

  • Extend and stretch both wrists and fingers acutely as if they are in a handstand position

  • Straighten both wrists and relax fingers

  • Make a tight fist with both hands and bend both wrists down.

  • Take your arms out to the sides with the palms facing down. Extend your fingers and stretch through the elbows. On exhaling, rotate your shoulders back and bring the palms facing up.


Vitamin B2

This is essential for converting carbohydrates into energy and produce red blood cells. Significantly, this vitamin is important for vision. Vitamin B2 or Riboflavin is essential for fat and protein metabolization. Vitamin B2 boosts the immune system, maintains healthy hair and helps functioning of the nervous system. Deficiency of Vitamin B2 can lead to acne, muscle cramps, carpal tunnel syndrome and migraine headache. Best natural sources of Riboflavin are meat, eggs, legumes, nuts, dairy products, green leafy vegetables, broccoli, asparagus, and fortified cereals.

RDA - Recommended Daily Allowance:

Adults - Men: 1.3 mg
Adults - Women: 1.1 mg
Pregnant Women: 1.4 mg
Breastfeeding Women: 1.6 mg

Vitamin B2 is generally well tolerated and rarely produces adverse side effects like sensitivity to light with high doses. Supplements of Riboflavin can result in bright yellow urine.


Electromyography

Electromyography or EMG is a diagnostic test that understands the physiological of muscles thereby assessing their health. Electromyography involves inserting a needle electrode through the skin into the muscle. This electorde detects electrical activity in the muscles and nerves controlling the muscles. A patient is asked to flex or contract the muscles so that the response of the muscle to the nerve stimuli is observed. An electromyograph is used to detect and measure electric potential that is generated by the contracting muscles. Other indicators to the proper functioning of the muscles and their corresponding nerves are the size, duration and frequency of electric signals received from them. EMG is often conducted along with a nerve conduction velocity test.

The EMG test is used to diagnose any possible weakness or impaired muscle strength due to neurological problems. Some discorders that can lead to abnormal readings on EMG test are cervical spondylosis, myasthenia gravis, carpal tunnel syndrome, myopathy, Brachial plexopathy, Guillain Barre syndrome, sciatic nerve dysfunction and mononueritis multiplex. EMG test aids in differentiating between a muscle and nerve disorder. The muscle may feel tender after the EMG test with localised bruising.

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Collection of Pages - Last revised Date: October 16, 2017