Carpal Tunnel Syndrome

Cure Carpal Tunnel Syndrome today. Effective treatment, Non Surgery. Call us +65 97731458 to schedule for an appointment.

Definition of Carpal Tunnel Syndrome:

There are several common causes of hand tingling. Carpal tunnel syndrome tends to be one of the most common causes of hand tingling. One of the nerves that supply the hand is called the Median nerve. This nerve travels across the wrist to supply the fingers. With repetitive bending and straightening of the wrist this nerve gets injured. This tends to occur in people that use the computer frequently, use the cash register, or are involved in activities that involve repetitive motion at the wrist.

Another nerve that supplies the hand is called the Ulnar nerve. This nerve passes behind the elbow and could get injured at that point. One of the common causes of injury is from leaning on the elbow which causes pressure on the nerve. Other common causes include pressure from surrounding tissue, arthritis, and injury to the elbow.

Since the nerves that supply the hands originate in the spine, injury to the nerves at this level could cause numbness, tingling, and weakness in the hands. Generally patients often have shooting pain down the arm with this kind of a problem. There could be multiple causes like disk disease, tumors, and arthritis.

Systemic disease like diabetes, kidney failure, infections, and others could cause injury to the nerves so that patients could develop weakness and numbness in their hands. These patients often also have numbness and tingling in their feet first. These patients most often have Neuropathy.

Carpal tunnel syndrome occurs when the median nerve which runs from the forearm into the hand becomes pressed or squeezed at the wrist. This results in pain, weakness, or numbness in the hand and wrist, radiating up the arm.

Hand and Wrist Pain

How is Carpal Tunnel Syndrome Diagnosed?
A physical examination help determine if the syndrome are related to daily activities or to an underlying disorder and can rule out other painful conditions that mimic carpal tunnel syndrome.

Electromyography is often used to confirm the diagnosis. This involves a fine needle being inserted into a muscle where electrical activities are viewed on a screen determining the severity of damage to the median nerve. Ultrasound imaging can also show impaired movement of the median nerve.

What are the causes of Carpal Tunnel Syndrome?
Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Most likely the disorder is due to a congenital predisposition. Other contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture. It can also be caused by medical conditions such as diabetes, arthritis, pregnancy and obesity.

What are the treatments of Carpal Tunnel Syndrome?
Treatments for carpal tunnel syndrome should begin as early as possible under a doctor’s direction. Initial treatment generally involves resting the affected hand and wrist for at least 2 weeks, avoiding activities that may worsen symptoms and immobilizing the wrist in a splint to avoid further damage from twisting or bending. If there is inflammation, applying cool packs can help reduce swelling. In early stage of Carpal Tunnel Syndrome, Injection will be one of the effective way in treating this condition. Surgery is recommended if symptoms last for more than 9-12 months. Surgery involves severing the band of tissue around the wrist to reduce pressure on the median nerve.

Cure Carpal Tunnel Syndrome today. Effective treatment, Non Surgery. Call us +65 97731458 to schedule for an appointment.

Hand and Wrist Pain

Dr Ambrose Yung Knee, Sports and Orthopaedic Centre Knee, Sports and Orthopaedic Clinic

Stop your Hand & Wrist Pain today. Effective Treatment, Non Surgery. Discuss with our Orthopaedic Specialist for the Diagnosis, Treatment and Prognosis of your Hand Pain. Call us +65 97731458 to schedule for an appointment.

Hand and Wrist pain can be caused by one or more of a number of different disorders. Lifestyle diseases will become more common as we live longer and lead more active lives. Hand and wrist pain are among these lifestyle diseases. They are usually amenable to simple treatment strategies, provided they are diagnosed early.

Hand and Wrist Pain

Why are the hand and wrist special?
The hand and wrist are our main point of physical contact with the world. They manipulate objects to aid us in our daily lives. As such, pain that disables our hand and wrist can lead to a marked decrease in our ability to functional at work and play.

Which parts of our hand and wrist are commonly affected by pain?

– Hand pain
A common cause of hand pain that many feel at the base of their fingers, in the palm of the hand, is trigger finger. Trigger finger is a condition where a patient feels pain or discomfort when trying to straighten or bend their finger/thumb. Sometimes the finger may become ‘locked’ or ‘stuck’ when swelling of the tendon sheath occurs. This swelling can be associated with diabetes, rheumatoid arthritis, or even golf.

Carpal Tunnel Syndrome can also cause hand pain. There is a tunnel in the wrist called the carpal tunnel. Nine tendons and the median nerve pass through it. When pressure builds up in the tunnel, the nerve gets compressed and is unable to function properly. This may result in numbness, discomfort and pain in the fingers. This condition usually associated with a tingling sensation over the thumb, index and middle fingers, especially at night. Risk factors for carpal tunnel syndrome include age, diabetes and rheumatoid arthritis.
Another common cause of finger pain is trauma. In this instance, the injured tissue could be the tendon, ligament, bone, or even a combination. It is thus imperative that all injured tissues are adequeately addressed and optimally treated.

– Wrist Pain
Wrist pain is more complex. It is usually divided into conditions that cause pain on the radial side of the wrist, i.e. nearer the thumb, and those that cause pain on the ulnar side of the wrist, i.e nearer the little finger.

Radial-sided wrist pain
Radial-sided wrist pain can be caused by an injury to an important ligament called the scapholunate ligament. This ligament helps two important bones of the wrist joint, namely the scaphoid and the lunate, move in unison. When this ligament is injured, these bones no longer move in tandem, thus leading to pain. This would be aggravated by motion and lead to accelerated arthritis in the wrist, which in turn, manifests as stiffness and poor grip strength.

In addition, woman who are in the perinatal period also belong to a unique population who can suffer from a tendon condition called Dequervain’s Tenosynovitis. It is a condition in which one feels pain over the wrist joint near the base of the thumb. It begins as an aching sensation initially, and progresses to a point when any movement of the wrist or thumb produces sharp pain in the affected area. That area of the wrist may become swollen at times. Often, nursing mothers affected for the period that they are caring for their newborns. This is due to poor ergonomics, or by the hormonal changes that affect their tissues.

Ulnar sided wrist pain
Ulnar sided wrist pain is common in a patient who has sustained a twisting injury or a fall on an outstretched hand. This is usually due to a tear of a ligamentous structure called the “triangular fibrocartiligeneous complex”, which stabilises the wrist joint. Patients with this problem can experience pain in their wrists associated with instability and diminished grip strength. Like the radial side of the wrist, tendons on the side of the wrist can also suffer from inflammation which causes pain, and is usually caused by overuse.

How do we diagnose such conditions?
Firstly, we take a history from our patients. This includes finding out the circumtance surrounding their complaint, as well as the nature of the complaint. This can help us ascertain the tissue that is the main “pain generator”.
Secondly, a thorough clinical examination of the hand and wrist helps us confirm or rule out the possible reasons for our patient’s pain.
X-ray, fluoroscopy (real time X-rays), computed tomograpgy (CT) scans and magnetic resonance imaging (MRI) scans are all important diagnostic tools to help Hand Surgeons confirm diagnoses.

Arthroscopy of the wrist is currently the gold standard diagnostic procedure of choice when the internal architecture of the joint, such as the cartilage, needs to be assessed. Therapeutic key-hole surgery can also be performed with the aid of this tool.

Most common causes of Hand and Wrist discomfort includes:

  • CARPAL TUNNEL SYNDROME – Carpal tunnel syndrome occurs when the median nerve which runs from the forearm into the hand becomes pressed or squeezed at the wrist.
  • DE QUERVAIN’S STENOSING TENOSYNOVITIS – is a condition brought by irritation or inflammation of the wrist tendons at the base of the thumb.
  • MALLET FINGER – Mallet finger occurs when the outermost joint of the finger is injured. With mallet finger, the tendon on the back of the finger is separated from the muscles it connects.
  • TRIGGER FINGER – Trigger finger is a common disorder of the hand which causes painful snapping or locking of the fingers or thumb.
  • ARTHRITIS – Osteoarthritis of the fingers and thumb is characterized as chronic and often disabling pain and stiffness of one or more joints.
  • HEBERDEN’S NODES – are hard or bony swellings that can develop in the distal interphalangeal joints (DIP) (the joints closest to the end of the fingers and toes).
  • WRIST GANGLION CYST – is a swelling that usually occurs over the back of the hand or wrist. These are benign, fluid-filled capsules.

Stop your Hand & Wrist Pain today. Effective Treatment, Non Surgery. Discuss with our Orthopaedic Specialist for the Diagnosis, Treatment and Prognosis of your Hand Pain. Call us +65 97731458 to schedule for an appointment.