Q: I’m an office secretary who is tied up with my computer during office hours. Last month, I started feeling pain on my right hand, especially around the thumb area. The pain became progressively worse so I consulted an orthopedic surgeon. After examining me, the doctor said I have carpal tunnel syndrome. What is carpal tunnel syndrome? Is this condition due to my computer use? Do I really need an operation? --cynthia_am@yahoo.com
A: The carpal tunnel is the canal-like passageway on the palm side of the wrist through which several tendons and a pencil-sized nerve, the median nerve, pass through on their way to the hand from the forearm. The passageway is circumscribed by some of the bones of the wrist and the strong ligament the binds the bones together.
When the carpal tunnel flattens or constricts, which happens under certain conditions, the median nerve gets compressed leading to the occurrence of signs and symptoms that are collectively referred to as carpal tunnel syndrome.
Carpal tunnel syndrome (CTS) is a relatively common painful ailment that affects women more than men. It usually involves the dominant hand but it is not unusual for it to affect the other hand, too. People with CTS usually complain of pain in the hand associated with numbness and tingling over the thumb, index finger, middle finger and part of the ring finger. The pain may radiate into the forearm and occasionally into the shoulder, neck and chest. It is aggravated by manual activity and often awakens the person at night. If nothing is done to relieve the nerve compression, the signs and symptoms progress and atrophy of the muscles at the ball of the thumb may ensue.
Carpal tunnel syndrome can be secondary to local conditions in the wrist such as inflammation of any of the tendons (tendinitis) that pass through the tunnel, fractures and tumors. Sometimes, it is one of the manifestations of a systemic disease like rheumatoid arthritis, diabetes mellitus and thyroid disease. It is also associated with pregnancy and menopause. Most CTS patients, however, do not have any specific local or systemic disease that can account for the condition. Instead, they have a history of holding jobs that require them to do repetitive motions with the hands and wrists for long periods of time. Hence, it is common in factory workers, seamstresses and housekeepers.
Theoretically, people like you who use computers extensively should be prone to CTS. However, scientific studies have not established a definite link between computer use and CTS; hence, it is difficult to say whether or not the computer has contributed to the development of your condition. But despite the fact that the evidence linking computers to CTS is weak, ergonomic experts claim that a split keyboard that is mounted on the arms of a typist’s chair or a “floating arms” keyboard can help prevent the development of CTS in heavy computer users.
The only definitive cure for CTS is surgical division of the ligament that forms part of the carpal tunnel. After the operation, the pain usually subsides within a few days and never recurs. Muscle strength also returns gradually except when the nerve has already been severely damaged. However, surgery should be the last recourse for CTS. You should try conservative treatment first, which should include elevating the hand whenever possible and splinting of the arm and hand at night. If the above measures do not work, you could ask your orthopedic surgeon to inject your wrist with a steroid solution. But if conservative treatment fails, surgery should be an option.
(Email inquiries on health matters to: medical_notes@yahoo.com)
source: mb.com.ph
