Sunday, December 30, 2007

Carpal Tunnel Syndrome


Carpal Tunnel Syndrome is a well know term for pain at the wrist. Did you know that the pain may only be a symptom and may actually have little to do with the wrist? As the name implies, Carpal Tunnel Syndrome is a symptom of many issues from the wrist to the neck. In depth testing and diagnosis is urgent to identify the true cause in order to treat the source effectively. Then the treatment can be focused on the cause rather than the symptom.

Diagnostically, CTS is a disease of nerve compression. Specifically, the big nerve running down the inside of your forearm gets squished as it goes through a canal made by the wrist bones, just above your palm.

This canal is designed for your nerve to pass through easily along with several muscle tendons and blood vessels. When you have carpal tunnel syndrome, space in the canal is crowded out by swelling and inflammation in any of the tendons traveling through the canal or in the sheath covering the canal. It would be similar to your truck transforming into a monster truck while in your garage, the same tendons that were fine last year are now bigger. There is only a limited amount of space and now nothing can move.

How does this happen? When you do repeatedly twist your wrist or hand in jobs like check outs, construction working, dry walling, typing, cleaning and accounting, the forearm muscles are overworked and become tired. A tired muscle will encourage you to compensate and will eventually swell from muscle break-down and tendonitis.

If compensating changes your posture, the problem may go into your neck, if the swelling goes down your arm, carpal tunnel pain may start. In this case where the carpal tunnel syndrome is a symptom of a problem somewhere else in the arm, then the traditional surgical treatment is not a cure. Treatment may include exercises to strengthen the muscle, stretches to elongate the muscle and massage therapy to release adhesions and realign the muscle.

You may first notice tightness in your wrist and then some or all of the following symptoms: pain and/or tingling in the hand, numbness, weakness of the thumb, sensitivity to cold. It can feel like gripping a coffee cup takes all the strength you have.

Although potentially crippling, there is a lot you can do to prevent and treat Carpal Tunnel Syndrome. If it’s painful, see your doctor about medical treatment. Meanwhile you can do the following yourself to minimize and potentially heal the problem:

Daily wrist stretches are very effective:
Arm straight out in front of you, palm up, pull fingers down so palm gradually faces away from you.
Arm straight out in front of you, palm down, pull fingers up so that palm gradually faces away from you.
Arm straight out in front of you, palm down, let fingers drop so that palm gradually faces you.
Alternating heat and cold over the forearm muscles, (those muscles just below the elbow).
Massage therapy, 30 minutes twice a week for 4 – 8 weeks

The wrist is designed to bend 90 degrees to your arm bone, forwards or backwards (not side to side). Stretches will benefit everybody by maintaining health in the forearm muscles.

Often this problem sneaks up on us when we start a new job or activity, but whenever possible prevention and staying healthy is the best treatment. Be aware of your body and treat sore muscles early to avoid larger problems.

Thursday, December 27, 2007

Tennis Elbow

Did you know that you could be diagnosed with Tennis elbow even if you don’t play tennis?

Characterized by pain near the outside of the elbow, tennis elbow is common in the spring when warm weather entices us outside to play tennis, golf, paint, etc. Tendinitis (epicondylitis) is defined as inflammation of a tendon, is caused by repetitive actions particularly while gripping something.

The tendon attaches muscle to bone. Repetitive actions strain the junction between the tendon & the muscle causing fatigue, then micro-tears.

If the muscle is not rested, it then becomes weak & painful especially when you grip something. You may first notice it as a general arm soreness and then a feeling of weakness as if you’re not as strong as you used to be. You may not notice it all day and then feel it throbbing at night as the muscle relaxes. To repair muscle tears, collagen fibres (scar tissue) grow in & around the musculo-tendinous junction. This scar tissue & has no contractile power & will hinder your range of motion.

Although most common near the elbow with the wrist flexors & extensors, tendinitis also occurs in other area such as the rotator cuff tendons and the achillies tendon in runners.

Tendinitis can be treated with massage therapy, but requires a commitment by the client. The more active a person is in their own recovery, the less you need therapists. Treatments can be painful & should be 3 days apart for 6 – 10 sessions depending on the extent of the injury. Recovery is faster is clients stretch & rest the muscle between sessions.