27/11/2018
So recently Ruth came to me this time grabbing her right wrist.
At first I thought she was adjusting her watch only to read something else on her face!!!!! Painful wrist
“Pain and numbness whenever I move my wrist” was her response. I took her through a thorough physical examination only to realize that she was suffering from median nerve compression (one of the nerves that run through the wrist).This is also called carpal tunnel syndrome.
When this happens your hand gets tingly, numb, weak, or painful. Carpal tunnel syndrome occurs when a combination of health factors and activities puts pressure on the median nerve as it passes through the carpal tunnel in your wrist.
These factors include:
• Conditions or illnesses that can cause arm pain or swelling in the joints and soft tissues in the arm, or to reduced blood flow to the hands. These include obesity, rheumatoid arthritis, gout, diabetes, lupus, and hypothyroidism.
• Repeated hand and wrist movements. They can cause the membranes surrounding the tendons to swell.
• Broken wrist bones, dislocated bones, new bone growth from healing bones, or bone spurs.
• Forceful or repetitive hand movements and arm vibration.
• Working for long periods in the same or awkward positions.
Symptoms
• Numbness or pain in your hand, forearm, or wrist that awakens you at night. (Shaking or moving your fingers may ease this numbness and pain.)
• Occasional tingling, numbness, “pins-and-needles” sensation, or pain. The feeling is similar to your hand “falling asleep.”
• Numbness or pain that gets worse while you are using your hand or wrist. You are most likely to feel it when you grip an object with your hand or bend (flex) your wrist.
• Occasional aching pain in your forearm between the elbow and wrist as well as stiffness in fingers in the morning.
Symptoms most often occur in the thumb, the index finger, the middle finger, and half of the ring finger. Symptoms are usually worse at night and your grip will weaken as the condition progresses.
Eventually you will notice muscle atrophy (wasting away) of the thenar (thumb) muscles and loss of hand function or clumsiness.
Risk factors
• Health problems or illnesses that can cause arm pain or swelling in the joints and soft tissues in the arm, or reduce the blood flow to the hands.
These include obesity, rheumatoid arthritis, diabetes, lupus, hypothyroidism, and multiple sclerosis.
• Women between the ages of 40 and 60 have the highest risk. Pregnant women near the end of their pregnancies often have short-term symptoms. Women taking birth control pills, going through menopause, or taking estrogen are also thought to be at risk.
• Hand and wrist movements and activities that require repeated motions, especially in awkward positions.
• Smoking. It may contribute to carpal tunnel syndrome by affecting the blood flow to the median nerve.
• Broken wrist bones, dislocated bones, new bone growth from healing bones, or bone spurs. These can take up space in the carpal tunnel and put more pressure on the median nerve.
• Normal wear and tear of the tissues in the hand and wrist caused by aging.
Treatment
1. Physical therapy, which includes, ultrasound, and carpal bone mobilisation and flexor retinaculum stretching to open the carpal tunnel.
2. Activity changes. Symptoms often occur when your hand and wrist are in the same position for too long — particularly when your wrist is flexed or extended.
3. If your job or recreational activities aggravate your symptoms, changing or modifying these activities can help slow or curb the disease. In some cases, this may involve making changes to your work site or work station.
4. Anti-inflammatory drugs relieve pain and reduce inflammation.
5. Home treatment, such as changing or avoiding activities that may cause symptoms and wearing a wrist splint.
NAOMI WAUSI
PHYSIOTHERAPIST IN-CHARGE
SPINE HEALTH AND SPORTS INJURY CLINIC
0728008832/0780406755
