Causes and Treatments: Diagnosis and Surgical Options for Carpal Syndrome

Causes and treatments

Not all cases of wrist syndrome are occupationally caused; guitarist May is a case in point. May, now forty, once took time off work to renovate his home. Two weeks later, one night, he was awakened by excruciating pain. He found both hands aching from head to toe, and his fingers numb. Nighttime hand pain and numbness are typical symptoms of wrist syndrome. This is because our bodies retain more water at night, increasing pressure on the median nerve. Other symptoms of wrist syndrome include burning or numbness in the middle three fingers, sometimes accompanied by curling; the pain can extend to the arm and even the neck. When symptoms reach the neck, it can easily confuse the diagnosis, causing various inconveniences.

When wrist syndrome progresses to a very severe stage, it can cause permanent damage to the median nerve, resulting in loss of sensation and weakness in the hand. At this point, even a very light object may be impossible to pick up due to the loss of control in the hand.

Physical rehabilitation experts say that the structure of the hand is extremely complex; it's almost an extension of the brain. When you can't see, your hands are essentially your eyes. In our lives, many aspects rely on our median nerve to transmit our sense of touch. Therefore, loss of the nervous system is akin to losing our eyes in the dark.

If you notice symptoms of arthritis, it's best to see a doctor immediately. If diagnosed with carpal tunnel syndrome, mild cases usually recover with a week or two of rest. If necessary, a splint can be placed in the wrist for stability. Hot compresses and anti-inflammatory medications (such as aspirin) can also be helpful. In severe cases, steroid injections into the carpal tunnel may be necessary to reduce swelling. Mild cases may be related to vitamin B deficiency, so his prescription requires patients to take 150 mg of vitamin B6 daily (75 times the normal intake), reducing the dosage to 25 mg after six months. However, it's important to warn against taking high doses of vitamin B6 without a doctor's approval, as excessive intake can lead to toxicity.

Surgery: A last resort

If the aforementioned treatments are ineffective, surgery may be necessary. This is a non-hospitalized procedure, and patients can recover at home afterward. Under local anesthesia, an incision is made in an appropriate area of ​​the palm to locate the ligaments above the carpal tunnel. The ligaments are then cut, allowing the carpal tunnel to loosen slightly. This loosened carpal tunnel provides more room for the nerves, blood vessels, and tendons passing through it to stretch, thus reducing nerve compression. As the ligaments heal on their own, the scar tissue naturally extends the length of the ligaments. The surgery cost approximately $1,500 to $2,000 per wrist. A splint is required for one week after surgery, but actual recovery takes longer than a week.

Mr. Shi, mentioned earlier, underwent surgery on both hands six months after the onset of his symptoms. He returned to work a week after the surgery. Full recovery took about a month. Now, his hand strength is practically the same as before, and he doesn't even feel any difference when lifting weights.

Besides performing the surgery on the palm, wrist joint syndrome surgery can also be performed by making an incision of about half an inch along the wrist creases. This surgery requires local anesthesia, but no splint or special physical rehabilitation is needed afterward. The cost of this surgery is around US$1,500.

Not all patients with carpal tunnel syndrome can have their problems resolved surgically. Some doctors estimate that only about a quarter of carpal tunnel syndrome patients have the opportunity to return to their original jobs. The others must change jobs.

Prevention

Prevention is better than cure. The key to prevention lies in understanding the body's structure. Here are some preventative measures you can do every day:

• When using the keyboard, keep your arms as parallel to the ground as possible. Let your wrists relax, as if they are floating above the keyboard. Adjust the height of your desk, chair, and keyboard as needed to avoid poor hand posture. Do not rest your wrists on the edge of the desk, as this will compress your wrists.

• If there is a long cable between your keyboard and the computer, and the keyboard is portable, you might as well take advantage of this feature to frequently change your working posture.

• When using power tools, choose models with larger handles. If the handles are too small, they can often cause direct damage to the tendons in the palm and the median nerve during use.

• Avoid working in excessively cold environments. Tendons are less elastic in cold environments, making them more prone to injury and swelling.

• Avoid repetitive, mechanical work. Take a short break every five to ten minutes. Take a five to ten minute break every hour. During breaks, try swinging your arms, shaking your head from side to side, etc.

Sports and wrists

Besides certain occupations that tend to cause wrist joint syndrome, experts have also found that certain exercises can worsen wrist joint syndrome. Below are introductions to these four types of exercise:

1. Weightlifting. To prevent wrist sprains, most people wear protective wrist bandages when lifting weights. However, it's important not to bandage the wrists too tightly, as this can cause swelling.

2. Running. Keep your hands relaxed while running. Clenching your hands will put too much pressure on your wrists.

3. Ball Games. When holding a racket, pay attention to the correct grip to avoid wrist injuries. If you have wrist syndrome, it's best to avoid sports that require the use of a racket or stick. However, don't be overly sensitive to hand pain, as pain is not always due to wrist syndrome. If you suspect wrist syndrome, it's best to consult a doctor.

IV. Exercise. When using a treadmill, avoid placing your hands on the handrails when accelerating. When using a stationary bike, the constant wrist movement can worsen wrist joint syndrome.