Carpal Tunnel Syndrome
Abstract
The wrist is surrounded by a band of fibrous tissue, which normally
functions as a support for the joint. The tight space between this
fibrous band and the wrist bone is called the carpal tunnel (The Stay
Well Company, 1999). The median nerve passes through the carpal tunnel
to receive sensations from the thumb, index, and middle fingers of the
hand. Any condition that causes swelling or a change in position of
the tissue within the carpal tunnel can squeeze and irritate the
median nerve, which causes tingling and numbness of the thumb, index,
and the middle fingers, a condition known as "carpal tunnel syndrome"
(Nidus Information Systems, 2001). All people can be affected by CTS,
but it is most common among women between the ages of 29 and 62.
Though medical awareness of CTS as a widespread and treatable
condition is only a recent phenomenon, current treatments are mostly
effective in relieving symptoms (The Hand Center, 2004). In this
essay, one will find detail about the causes of CTS.
Carpal Tunnel Syndrome –4-
Problem Statement
Carpal Tunnel Syndrome is an inflammatory disease of the median nerve
in the carpal tunnel. If left untreated it can result in serious nerve
damage.
Carpal tunnel syndrome is related to many repetitive type movements
that cause a pinching in the median nerve of the wrist. Doctors have
introduced surgery that releases the tension on this nerve with an
endoscopic procedure that was introduced fifty years after carpal
tunnel was introduced. The basic anatomy of the wrist is analyzed to
help gain a better understanding of where this disease is taking
...
... middle of paper ...
...
Pain and Posture Clinic.(2002).Solve Your Carpal
Tunnel Syndrome.
Site: http://ppclinic.com/carpalsynd.html>
Sheeham,Mark.(1990).Avoiding carpal tunnel syndrome: A
guide for computer keyboard users.
Site: http://justtemplates.com/google.html>
The Hand Centre.(2004).Carpal Tunnel Syndrome.
Site: www.carpaltunnel.com
The Stay Well Company.(1999). Anatomy of the wrist.
Site: http://www.everybody.co.nz/docsa_c/carpaltunnel.htm
University of Maryland Medicine.(2001).What Causes
Carpal Tunnel.
Site:
http://www.umm.edu/patiented/articles/what_causes_carpal_tunnel_syndrome_000034_3.htm>
University of Pittsburg Medical Center. Carpal Tunnel
Site: http://www.uofpmc.com/carp
Hakim AJ, Cherkas L, El Zayat S, MacGregor AJ, Spector TD.Arthritis
Rheum. 2002 Jun 15;47(3):275-9.
The ability to flex the finger consists of a serial of flexor muscles in the forearm and their tendons are inserted to the bones of finger. The injury of flexor tendon might cause the loss of bending of the fingers or thumb. The flexor digitorum profundus tendon (FDP) attaching to the distal phalanx and the flexor digitorum superficialis tendon banding to middle phalanx well demonstrated the specific type of tendon-to-bone insertion site characterized by the four-zone enthesis.[1] The retinacula (sheath) structures serve as strong fibrous bands wrap around the flexor tendons in order to keep the flexor tendons in place while flexion.
Pain was significantly increased with flexion and extension. Sensation is decreased in the bilateral upper extremities. Strength is decreased in the bilateral upper extremities.
The carpal tunnel is a passageway that runs from the forearm through the wrist. Bones form three walls of the tunnel and a strong, broad ligament bridges over them. The median nerve, which supplies feeling to the thumb, index (4th digit), and ring fingers (3rd digit), and the nine tendons that flex the fingers, passes through this tunnel. This nerve, also, provides function for the muscles at the base of the thumb (the Thenar muscles). Usually, carpal tunnel syndrome (CTS) is considered an inflammatory disorder caused by repetitive stress, physical injury, or medical conditions that cause the tissues around the median nerve to become swollen. The protective lining of the tendons within the carpal tunnel can become inflamed and swell or the ligament that forms the roof over the median nerve becomes thicker and broader and presses on it. Dr. L, an orthopedic surgeon stated " It's like stepping on a hose. Slows the flow of water through a garden hose. The compression on the (median) nerve fibers by swollen tendons and thickened ligament slows down the transmission of nerve signals through the carpal tunnel." The result is pain, numbness, and tingling in the wrist, hand, and fingers. This does not concern the little finger (5th digit) because the median nerve does not affect it.
The shoulder is the most complex joint in the body. It is capable of moving in more than 16,000 positions. Many of its ailments, including the most common ones, involve biomechanical mechanisms that are unique to the shoulder. The most common shoulder problem for which professional help is sought out for is shoulder impingement (Haig 1996). Shoulder impingement is primarily an overuse injury that involves a mechanical compression of the supraspinatus tendon, subacromial bursa, and the long head of the biceps tendon, all of which are located under the coracoacromial arch (Prentice 2001). Impingement has been described as a continuum during which repetitive compression eventually leads to irritation and inflammation that progresses to fibrosis and eventually to rupture of the rotator cuff. Because impingement involves a spectrum of lesions of tissue in the shoulder, a working knowledge of its structural relationships will facilitate an understanding of the factors that result in abnormalities. This paper will provide knowledge of the anatomy, biomechanics, and correct rehabilitation involved with shoulder impingement.
A hypothesis that can be made from the patient’s report is that she is suffering from cervical radiculopathy, or a nerve root lesion. Symptoms that describe cervical radiculopathy include: arm pain in a dermatome distribution, pain increased by extension, rotation, and/or side flexion, possible relief of pain from arm positioned overhead, affected sensation, altered hand function, no spasticity, and no change to gait or bowel and bladder function (Magee, 2008, p. 142). These symptoms correlate to what the patient reported as a result of her injury. She stated that her pain is in the posterolateral upper and lower arm with aching and paresthesia in the thumb and index finger, which is in the dermatome pattern of cervical root 5 and 6 (C5, C6) (Magee, 2008, p. 25). She also reports lancinating pain with extension or rotation to the right of her head.
S: TM works in GA Trim 1. According to TM his both elbows and forearm area stared to have trouble gripping and picking up wires since late February. Also he was experiencing numbness and tingling sensation I his left hand. For the past several days his elbow pains were gradually getting worse that’s when he decided to come to the HMMA medical clinic; TM reports Tenderness at origin of wrist extensors, denies any difficulty with ROM.
Carpal tunnel syndrome occurs when the nerve that passes through the carpal tunnel becomes compressed. The American College of Rheumatology (https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Carpal-Tunnel-Syndrome) reports that between 4 and 10 million Americans experience carpal tunnel syndrome. Females are three times more likely to develop carpal tunnel syndrome than men. Carpal tunnel syndrome can typically be treated with non-surgical methods, including splinting, ultrasound, medications, modifications, rest, ice and chiropractic
Corticosteroid injections - injecting a steroid around the affected tendon, or even into the tendon sheath may help alleviate
DOI: 5/6/2016. Patient is a 53-year-old right hand dominant female welder who sustained injury due to welding for the last 8-9 years. Per OMNI, he was initially diagnosed with carpal tunnel syndrome.
S: TM completed 6 ESI visit. TM reports his wrist pain at 0, and at times 1-2/10 at rest; soreness at the right transverse carpal ligament area. TM reports intermittent soreness to right transverse carpal ligament area while working and rates his pain at 3-4/10. Reports sharp shooting pain going up to his mid-forearm at times; 5/10. TM reports some tingling sensation at times in in right pinky and ring finger. Denies his right arm pain interrupts his sleep. TM denies any numbness or loss of movements of right arm, wrist or hand.
Peripheral neuropathy is a term which describes damage to one or more of your peripheral nerves. The damage means that the messages that travel between your central and peripheral nervous system are disrupted. There are many different conditions that can lead to peripheral neuropathy. Diabetes is known as the major cause of persistent peripheral neuropathy. The symptoms and the cause of peripheral neuropathy depend on which types of peripheral nerves are damaged. Neuropathy can affect any one, both the young and the old. However, people suffering from diabetes and other infections have a high possibility of being affected with this disease. The aims of treatment for peripheral neuropathy are to treat any underlying cause, to control your symptoms and to help you to achieve maximum independence.
The first classification is considered mild. This is when digits two and three have that flexion contracture and they do not have a loss of sensation yet but they are beginning to develop that. This is due to the deep intrinsic muscles being affected by the anterior interosseous branch of the median nerve. The mild category can be further classified into three subcategories. These include twenty-one, three, and two. In the subcategory twenty-one, is in the middle one-third of the forearm is affected and this is the most common classification in the mild subcategory. The
The patient is a 53-year-old individual who was injured on 06/12/2016. During that time, he was stacking rims together and putting them inside the box. The patient states that each box would weigh up to 80 pounds. Suddenly one of the rims fell in-between the 2 separate stacks of rims. He reached down with his right hand to grab the falling rim. As he was pulling his arm up, he straightened his right index finger that got caught on one side of the stacked rims causing a cut.
Any pressure in this region will disrupt circulation into the hand and this will increase the risks of injury. Avoid Restricting Arm Movement - with a softly padded wrist rest, especially one that is rounded, or a soft chair arm rest the forearm becomes locked into position and this encourages people to make mouse movements by flicking the wrist, which also increases pressure. Choose a mouse design that fits your hand but is as flat as possible to reduce wrist extension. Don't use a curved mouse. Use a symmetrically shaped mouse. Consider a larger mouse, such as the Whale mouse, that encourage arm rather than wrist movements.
Throughout this paper, I hope to discover ways to minimize or prevent Carpal Tunnel Syndrome and the negative effects of monitor radiation on ones health.