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The Doctors Book of Home Remedies II: Carpal Tunnel Syndrome

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Carpal Tunnel Syndrome

Yes, the computer has certainly expanded our horizons and given us the ability to perform lightninglike calculations. But along with every computer comes a keyboard-and human fingers that hit the keys with the speed of raindrops in a thunderstorm.

Unfortunately, the human wrist wasn't made for this kind of frantic activity. Hands that carry out repetitive tasks at the computer keyboard (or anywhere else, for that matter) may begin sending up protests of pain. This wrist pain is the screaming ouch of a disorder called carpal tunnel syndrome.

Carpal tunnel syndrome is like a traffic jam in the wrist, resulting from too much crowding in too little space. Nestled among the bones and tendons of the wrist area is a major median nerve that leads from the arm into the fingers. This is the nerve that "signals" some of the small muscles in the hand and also provides sensation to the thumb and first three fingers.

Crowded in next to that nerve, inside the "carpal tunnel," are several tendons. When the tendons are overworked, they become inflamed and swell, and the median nerve is literally crushed within the carpal tunnel.

As the tendons swell and the tunnel size shrinks, the median nerve gets crushed like a piece of soft spaghetti. No wonder it hurts!

Although often caused by the repetitive movements of keyboard operation or typing, hammering or other hand-intensive job chores, carpal tunnel syndrome can result from just about anything in which your hands are used frequently and for long periods. A good start toward stopping the pain is to eliminate the cause (if you know it). And here are some other approaches.

Stretch your hands. To keep pain at bay, start off each activity with a series of hand-stretching exercises. "Anything that extends the range of motion in your fingers and wrist will help," says Janna Jacobs, president of the American Physical Therapy Association's Section on Hand Rehabilitation. "Open and close your fingers, bend your wrists in both directions-do various things to exercise your hands for about 10 or 15 minutes before beginning the activity."

Watch out for bad vibes. Although electric tools do quick work, they're also a bad influence on your wrist. "True, there may be less force placed on your wrist, but the vibrations of an electric knife or other power tools could require a tighter grip to steady them and lead to another disorder called hand-arm vibration syndrome," says occupational medicine specialist Thomas Hales, M.D., of the National Institute for Occupational Safety and Health in Denver. When buying tools like a power painter or chain saw, look for those with special "vibration control" mechanisms.

When to See the Doctor

You need a doctor's examination to confirm that you have carpal tunnel syndrome. But how can you tell whether you should see the doctor?

"It may be normal to have your hand fall asleep sometimes or ache when you use it excessively," says Peter C. Amadio, M.D., associate professor of orthopedics at Mayo Medical School in Rochester, Minnesota. "And if the pain and numbness go away after you rest it, you're probably fine. But if you notice a constant problem or severe pain, numbness or tingling at night, and if it's not improving, then you might want to see your doctor."

Symptoms of carpal tunnel syndrome include:

Numbness, tingling or a "pins and needles" feeling in the thumb, index and middle fingers, particularly after you use your hands.
Trouble using your fingers or thumb, as demonstrated by dropping things or losing dexterity.

Fatten tool handles. Placing foam rubber over the handles of brooms, rakes and other tools-or simply wrapping handles in foam tape to fatten them-makes them easier to hold, decreasing or eliminating pain. "If handles are too small, they can press directly on the tendons and median nerve in the palm," says David Rempel, M.D., an ergonomist and expert in occupational medicine at the University of California, San Francisco. But don't make handles too big, either-that also hurts wrists.

Sharpen your knives. Simple household chores such as cutting meat or clipping hedges can cause big-time pain for those with carpal tunnel syndrome. "Keeping your tools sharp or well lubricated reduces the amount of pressure needed to use them," says Peter C. Amadio, M.D., associate professor of orthopedics at the Mayo Medical School in Rochester, Minnesota.

Write with a light touch. "Using pencils with soft lead or pens with easy-flow ink also helps a lot," says Dr. Amadio. "And the fatter and rounder the pen or pencil, the easier it is to use."

"B" aware of vitamin deficiencies. Why do some people who use their hands and fingers a great deal develop carpal tunnel syndrome while others don't? Some studies suggest that it may be partly the result of a borderline B-vitamin deficiency, specifically vitamin B₆. Although excessive doses of vitamin B₆ supplements may cause nerve damage, a low dose is safe. "Studies suggest that 100 milligrams a day of vitamin B₆ can significantly reduce the debilitating and crippling symptoms of carpal tunnel syndrome," says Hans Fisher, Ph.D., professor of nutrition at Rutgers University in New Brunswick, New Jersey.

Wear a wrist splint to bed. All of our experts recommend wearing a wrist splint whenever possible and especially at night. Splints are available at most drugstores without a prescription. "Carpal tunnel pain is usually worse at night, when body fluids collect in wrists and other body parts," according to Steven Barrer, Jr., M.D., a clinical assistant professor of neurosurgery at the Medical College of Pennsylvania in Philadelphia who has written numerous articles on carpal tunnel syndrome. "In fact, loss of sleep due to the pain of carpal tunnel syndrome is probably the most bothersome symptom of the disease."

Another problem: Many people inadvertently curl their wrists while sleeping, putting pressure on the median nerve and causing pain. "A wrist splint immobilizes your wrist," says Jacobs. In fact, you should wear a wrist splint whenever you're not doing a "hands-on" activity. (Wearing one during such activities may reduce range of motion too much.)

Take frequent breaks from "hands-on" activity. "If your carpal tunnel syndrome is related to your job, taking a five-minute break from the offending chore every hour or so will make a big difference in your condition," suggests Dr. Barrer. "Even a few minutes' rest can often relieve the pain you feel. Of course, if possible, try to completely avoid the activity causing the trouble."

Pack on an ice pack. You may find that the pain lessens when you put an ice pack on your wrist, according to Dr. Barrer. "If you use an ice pack (a bag of frozen vegetables works fine), wrap it in a dish towel and hold it between your wrists for 10 or 15 minutes, then remove it for about the same amount of time, and repeat. This will prevent a freeze burn."

Or warm your wrists with a heating pad. Others find relief by holding a heating pad or warm compress between their wrists to relax muscles, adds Dr. Barrer. "The best thing to do is try both and see what works for you," he says. "For some, it's heat; for others, it's cold."

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