For Sunaina Das (name changed), paintings were a mode of self-expression. So, when the 33-year-old artist started having severe pain and numbness in her hands, she was worried.
Sunaina found it difficult to hold the paintbrush and over the years the pain became unbearable, especially during the night and in cold weather. She also had a tingling sensation in her fingers.
When she consulted a specialist in July, a detailed examination and test results showed that the artist had carpal tunnel syndrome or CTS. The condition can have debilitating consequences if not treated on time. However, early detection and prompt treatment can relieve pain and help the person get back to their normal activities.
What is CTS?
The carpal tunnel is a passageway in the wrist and the median nerve runs through it, with many bones and muscles within. This nerve controls sensation in all the fingers except the little finger and send signals for movement of muscles in the base of the thumb. When there is too much pressure on the nerve from inside the tunnel, it causes pain in the hands and wrists, a tingling sensation and, sometimes, loss of grip. This is CTS in a nutshell.
Ways to reduce pain, numbness
The study ‘Current options for non-surgical treatment of carpal tunnel syndrome’ published in the International Journal of Clinical Rheumatology observed that non-surgical treatment options such as bracing/splinting, corticosteroid injections and hand exercises are found to be effective in reducing pain and numbness caused by CTS in many patients to a large extent.
The study also added that there is limited evidence to show that alternative therapies including yoga, laser therapy, acupuncture and magnetic field therapy may be helpful in reducing symptoms of CTS. However, more studies are needed to prove efficacy of alternative treatment methods.
A wrist splint is the most common and inexpensive way of treating CTS, especially in the early stages. It is a rigid garment worn around the wrist to keep it in a neutral position and to minimise repetitive motion.
Hand therapy involves exercises done under the supervision of a trained physiotherapist that help minimise pain, numbness and tingling sensation in the hands.
Diagnosis and treatment
“A clinical examination of the affected hand is done first, which is important for diagnosing CTS,” Dr Bharath Kadadi, consultant, hand, wrist and microvascular surgery, orthopaedics, Manipal Hospitals, Malleswaram, Bengaluru, told Happiest Health.
“Tests such as nerve conduction study (to check how much pressure is falling on the median nerve) and ultrasound may be required to get an accurate diagnosis. When detected early, the condition can be managed with medications and simple measures such as wearing a wrist splint at night to avoid bending; warm water soaks; giving adequate rest to and avoiding overuse of the hands and wrists. Physiotherapy can also help. In severe cases where medical management does not work, carpal tunnel release (CTR) surgery may be necessary.”
CTR surgery involves making a cut in the ligament passing over the carpel tunnel to release pressure on the median nerve. This gives the patient relief from pain and other symptoms. This procedure can be done as an open surgery or through the minimally invasive method. Recovery may take a few weeks to several months depending on the severity of the condition.
Path to recovery
Sunaina’s pain was alleviated with timely CTR surgery that removed pressure on her median nerve. She made a quick recovery and went back to work in less than a month.
“Often people ignore the symptoms, despite pain and numbness in the hand that may interfere with their day-to-day activities. After years of neglect, the muscles of the fingers, especially the thumb muscles, start getting weak and because of this the affected person starts dropping objects because of a loss of grip,” says Dr Kadadi.
Dr Kadadi, who performed an open CTR surgery on Sunaina, adds CTS usually affects people who do work that involves overuse of the hands and wrists. “It is often seen among homemakers, people who operate vibrating machinery and computer professionals, because of keyboard use for long hours and bad ergonomics while working. Diabetics and individuals with hypothyroidism are also at risk of CTS. In my practice, I have seen that almost 80 per cent of those diagnosed with CTS are women,” he says.
‘Computer Professionals and Carpal Tunnel Syndrome (CTS)’, a 2015 study by K Mohamed Ali and BWC Sathiyasekaran to identify CTS among computer professionals, found its prevalence to be 13 per cent among 648 subjects. The researchers suggested early diagnosis and ergonomic measures in the workplace to relieve pain and avoid disability. The study was published in the International Journal of Occupational Safety and Ergonomics.
Causes
In 50 per cent of people diagnosed with CTS, the causes may be unknown. In the rest, CTS may be caused due to presence of risk factors such as:
- Injury or fracture to the wrist
- A narrow carpel tunnel
- Hypothyroidism and pregnancy (since there may be fluid retention)
- Rheumatoid arthritis
- Occupations that require overuse of the hands and wrist
Symptoms
- Severe pain in the affected hand and fingers
- Numbness and tingling sensation, which may get worse when the wrist is in a bent position and at night
- Weakened grip, causing objects to slip from the hands
- In severe cases, loss of sensation caused by muscle wastage in the thumb
