LYCOS RETRIEVER 
Carpal Tunnel Syndrome: Hands
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Carpal tunnel syndrome develops when a large nerve — the median nerve — is compressed inside your wrist. This nerve controls feeling in your thumb, index finger and thumb side of the ring finger. The median nerve ... controls the muscles at the base of your thumb. The condition gets its name from the eight carpal bones that surround the median nerve in your wrist, forming a tunnel to your hand.
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As you know, there are approximately 1 million new diagnosed patients with Carpal Tunnel Syndrome in the United States every year and about 300,000 carpal tunnel release surgeries done yearly. Unfortunately, patients and many physicians believe Carpal Tunnel Syndrome patients will inevitably end up having surgery since conservative therapy often fails. The number of Physical or Occupational Therapy sessions are often limtied by insurance companies. But, as reasearch has shown, there is no specific consensus as to when in the course of the condition a patient should have surgery. Carpal Tunnel Release Surgery has been performed since the 1930s and has been known to fail on a high percentage of patients. After having the surgery, the options are very limited and a high percentage of patients end up having to change their lifestyle in order to manage the hand pain, tingling and numbness even after surgery.
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Symptoms of carpal tunnel syndrome usually progress gradually over weeks and months and, in some cases, years. The first symptoms may be pain in the wrist and hand or numbness and tingling of the fingers (except the little finger). Patients may ... experience a sense of weakness and a tendency to drop things. They may lose the sense of heat and cold or feel that their hands are swollen even though there is no visible swelling. Symptoms may occur not only when the hand is being used but also when it is at rest. In fact, the disorder may be distinguished from similar conditions by pain occurring at night after going to bed.
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Lifestyle changes are often the first type of treatment prescribed for carpal tunnel syndrome. Avoiding activities that aggravate symptoms is one of the primary ways to manage CTS. These activities include weight-bearing repetitive hand movements and holding vibrating tools. Physical or occupational therapy is ... used to relieve symptoms of CTS. The therapist will usually train the patient to use exercises to reduce irritation in the carpal tunnel and instruct the patient on proper posture and wrist positions. Often a doctor or therapist will suggest that a patient wear a brace that holds the arm in a resting position, especially at night.
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Carpal tunnel syndrome is characterized by tingling or numbness in the hand or wrist progressing to sudden, piercing pain that shoots through the wrist and up the arm. It occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. The median nerve controls sensations to the palm side of the thumb and fingers (although not the little finger), as well as impulses to some small muscles in the hand that allow the fingers and thumb to move.
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One of the tests most frequently used to diagnose carpal tunnel syndrome was developed during the 1950’s by Dr. George S. Phalen, retired Section Head of Hand Surgery in the Department of Orthopaedic Surgery at Cleveland Clinic. Phalen’s test is performed with the wrists bent fully for 60 seconds. Individuals who develop tingling in the fingers have a positive Phalen’s test. A Tinel’s sign represents an irritated nerve. The doctor taps over the nerve at the level of the wrist to produce a tingling sensation in the fingers. X-rays may be ordered if there is trauma, arthritis or other disorders, or when motion of the wrist is restricted.
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