Carpal Tunnel Syndrome - Research Paper Example

?Carpal Tunnel Syndrome Carpal tunnel syndrome refers to a painful condition that affects the hand wrist that results from the aggravation of the median nerve in the wrist owing to several factors. Due to the nature of the condition, it is crucial to analyze all the aspects that comprise the condition which include diagnosis, treatment and prevention among others. Symptoms and signs Carpal tunnel syndrome is characterized by a myriad of signs and symptoms; of which the most common is pain in the wrist. This is accompanied by numbness, tingling or a burning pain that occurs in the volar aspects of one or both hands, which is noted especially at night or after work (Washington State Department of Labor and Industries 4). The most common symptoms occur at night, and are thus referred to as nocturnal symptoms and occur to a majority of patients with the condition. As a result, patients suffering for the condition often have to wake up in the night to shake their hands in an attempt to relieve the symptoms they experience (Washington State Department of Labor and Industries 4). Usually, the pain involves the entire hand or is confined to the thumb and the first two or three fingers; in this regard, the symptoms are localized. In addition, patients suffering from the condition may experience weakness in their fingers and paresthesias. Furthermore, symptoms of carpal tunnel syndrome include the unusual trait of ascending the arm in a manner that imitates radiculitis syndromes (Taylor 1). In this light, patients tend to be clumsy in operations that involve manipulations using their hands in that they often drop things. Apart from these, they are insensitive to the pain associated with pinpricks in the index and middle fingers. In addition, slowed nerve conduction velocity is observed in the wrist translating to increased reaction time in manual manipulations. In severe cases, sensation in the hand and wrist are lost altogether; a permanent change while thumb muscles may lose functionality. Etiology The causes of carpal tunnel syndrome are widely known despite the association with pressure median nerve at the wrist, as well as performing tasks or activities requiring prolonged dorsiflexion and simultaneous finger flexion (gripping) (Taylor 3). In addition, carpal tunnel syndrome is associated with the repeated performance of stressful motions with one’s hand or holding the hand in one position for prolonged periods. This makes the condition to be classified as a cumulative trauma disorder; a condition that attacks the musculoskeletal system (American Physical Therapy Association 2). This is because, the musculoskeletal systems consist of muscles that pull on the tendons and move the bones found at the joints. With this information, it is evident that carpal tunnel syndrome impacts sensory nerves and blood vessels in the wrists and hands. As a result, it is likely to be caused by poor blood circulation in the hand and wrist. This is according to studies that show the populations of the society that are at risk. These include all men and women who participate in activities that require the same movements of the hand to be repeated over and over again. Such include meat packers and typists who spend a great deal of time making repetitive motions with their hands and wrists. At the same time, they rest their wrists and palms on the surfaces of the devices they use leading to the compression of the distal median nerve and an elevated pressure in the carpal tunnel. The injury, in turn, brings about the aforementioned symptoms mainly from the first to the fourth digits of the hand (Napadow et al. 159). Diagnosis In order to diagnose the condition, there exist a number of means to do so. These include physical examinations although they are not diagnostic means by themselves in any case. The one standard that is applied in the diagnosis of the condition is the nerve conduction studies (Aroori and Spence 6). However, the studies are usually not conclusive as they yield both positive and negative results for the condition. This makes the best option to be the use of the patient’s history, physical examination and analysis of electrophysiological studies. Diagnosis is based on the combination of symptoms, physical signs and nerve conduction studies to ascertain the presence of the condition and its severity. As for physical examination, it is based on the ability to discriminate two points in the median nerve distribution, as well as thenar atrophy. These two are in regard to the ability to perception of varied vibratory stimuli (Katz and Simmons 1808). On the other hand, electrodiagnostic testing involves examining nerve conduction velocity which examines the ability of the nerves to conduct impulses effectively. The test is conducted to eliminate other likely factors that may lead to the development of carpal tunnel syndrome such as age polyneuropathy thus creating accurate results in combination with other tests (Washington State Department of Labor and Industries 5). Other diagnosis tests involve the use of Magnetic Resonance Imaging (MRI), neuropathy and ultrasound to map the nerves in the hand and wrist. However, these tests are yet to be proven, but bear promise. Treatment Treatment for carpal tunnel syndrome exists in different forms ranging from conservative to intrusive surgery to the affected part of the hand or wrist. One of the treatments that is non intrusive is low intensity laser therapy. The therapy seeks to eliminate pain and edema in the affected part as well as promote the regeneration of nerves. Studies suggest that laser therapy eliminates the symptoms with minimal effect on the productivity of the patients (“Carpal Tunnel Syndrome” 3). Conservative treatments aim at reducing symptoms and increasing the functionality of the affected hand or wrist. Such include the use of glucocorticoids in which local steroids are injected into the carpal tunnel (Washington State Department of Labor and Industries 7). Hence, the effect of this short term relief of the pain and numbness that accompany the condition. However, the glucocorticoid treatment requires that the patient undergoes surgery within a year of commencement to avoid the adverse effects of steroids; avascular necrosis. In addition, surgical carpal tunnel release can be done to relieve the symptoms by decompressing the median nerve at the wrist by releasing the transverse carpal ligament. This can be done through intrusive means, open surgery or endoscopic approach. However, the surgical approach bears a large risk to aggravating carpal tunnel syndrome by inflicting additional neurological trauma to the median nerve (Washington State Department of Labor and Industries 8). The affected wrist or hand can also be splinted to alleviate the symptoms; which reduces sensory latency by maintaining the wrist in a neutral posture rather than in extension. Apart from these anti-inflammatory drugs may be administered provided they contain nonsteroids. Such medication includes pyridoxine and diuretics (Katz and Simmons 1809). Prevention Carpal tunnel syndrome can be alleviated by the effected individual taking certain measures. In order for people who participate in high risk activities for carpal tunnel syndrome such as typists, there exists the need to consider ergonomics this refers to proper sitting in light of the height of one’s seat in relation to the backrest. In order for this to work one should sit comfortably on a chair with an adjustable backrest and a table configured to the appropriate height of the individual. In addition, the wrists should be placed at appropriate angles to work together with the position of the elbows. In addition, one should take regular breaks from repeated hand motions in order to allow the arms and wrists time to rest. Furthermore, one can take eat a healthy diet that include whole grains, seeds, nuts and vegetables while avoiding placement of wrists on hard surfaces for extended periods (“Carpal Tunnel Syndrome-Prevention, Symptoms, Treatment” 3). Other preventive measures involve exercising the wrists and arms to relieve them of strain while rotating the wrist. These exercises relieve the wrist and hand of any accumulated stress from repetitive motions. In conclusion carpal tunnel syndrome affects numerous people creating the need to find measure to treat, diagnose and prevent. As a result, it is crucial for one to understand aspects of the condition as discussed in the essay. Works Cited “Carpal Tunnel Syndrome- Prevention, Symptoms, Treatment” n.d. Web. 7 Aug. 2012. < http://www.remedies4.com/download/carpal-tunnel-sydrome-prevention-symptoms-treatment.pdf> “Carpal Tunnel Syndrome”. n.d., PDF file. 7 Aug. 2012. Washington State Department of Labor and Industries. Work-Related Carpal Tunnel Syndrome Diagnosis and Treatment Guideline. Medical Treatment Guidelines. 2009. Web. 7 Aug. 2012. < http://www.lni.wa.gov/ClaimsIns/Files/OMD/CTSGuidelineFINAL.pdf > Katz, Jeffrey. and Simmons, Barry. Carpal Tunnel Syndrome. Clinical Practice. Vol. 346, No. 23. 2002.Print. Aroori, Somaiah. and Spence, Roy. Carpal Tunnel syndrome. Ulster Med J Vol.77 (1) 6-17 . 2007.Print Napadow, Vitaly. et al. Somatosensory Cortical Plasticity in Carpal Tunnel Syndrome Treated by Acupuncture. Human Brain Mapping. Vol 28:159 –171. 2007. Print. American Physical Therapy Association. What You Need To Know About Carpal Tunnel Syndrome. 1996.Web. 7 Aug. 2012. < http://www.utmb.edu/rehab/Outpatient/Carpal.pdf > Taylor, Lyn. Carpal Tunnel Syndrome. n.d. Web. 8 Aug. 2012. < http://www.advtherapy.net/html/carpaltunnel.pdf > Read More