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Straight Talk About Injuries

Carpal Tunnel Syndrome

The carpal tunnel is an area on the wrist just below the palm of the hand. The tunnel is formed on one side by the bones of the wrist, and a structure called the transverse carpal ligament on the other. Running through the tunnel are the tendons that flex the fingers, blood vessels that supply the hand and the median nerve which, services much of the hand. The body is never one to waste space, so the tunnel is just large enough to allow for these structures. The blood vessels and nerve, which run through the tunnel, generally don't move, but the tendons that supply the fingers do. Fortunately, the body has certain structures and fluids to protect against the friction which could result from this movement, although these resources are limited. Repeated motions of the hand, such as typing, especially since we usually rest our wrists on the desktop while we type putting pressure on the carpal tunnel, can overwhelm these resources resulting in friction and inflammation which can cause pain. The inflammation caused by this friction causes the structures running through the tunnel to swell, and since the tunnel is already tight, the pressure on those structures increases and so does the pain. The condition can get so severe that the only way to prevent the pain is to immobilize the hand, and immobilization can cause problems of its own.

As with any medical condition, you should consult your physician to make sure this is what you are dealing with. The treatment is generally quite simple, and if you have read about other situations we have discusses here, is probably quite familiar. This is an inflammatory condition, and as such is generally treated according to three rules of thumb: rest, ice and anti-inflammatory medication. Rest, really should include rest. The activity causing the problem should be reduced to provide the structures involved the time necessary to heal. To assist in the resting process, a cock-up splint for the wrist is frequently recommended. This helps to keep the wrist in a neutral position, which allows the structures running through the tunnel the most room, reducing the aggravation they have to endure. The Sports Medicine Shop has a wide variety of splints to ease the discomfort and promote healing of carpal tunnel syndrome. Visit the shop's web site for pictures, descriptions, prices and comparisons.

Athletic trainer's go to school for four years to learn that if something swells, put ice on it. (I'm a certified athletic trainer, so I can say that. In good humor of course.) Ice is so simple a treatment, people forget that it is also a tremendously useful tool. While ice doesn't reduce the inflammation that's already there, it will prevent more from accumulating. While the inflammatory response is necessary for healing and the body is excellent at getting it geared up, it's not so good at stopping it or getting rid of it once it's there. Ice prevents the inflammation from getting too out of hand. Wrap the wrist in ice for twenty to thirty minutes every two hours, or as close to that as you can get. Even once or twice a day for twenty minutes is better than nothing, and will provide some excellent benefits. If ice is too inconvenient, get a gel cold pack, not the instant kind. There is a common misconception that the gel ice packs are not as cold as ice. The truth is just the opposite. Since gel doesn't freeze solid until extremely low temperatures, it is able to absorb more cold energy and get colder than ice, which is able to reach only 32 degrees. However, since the gel packs get so cold, you need to remember to put a small cloth between the pack and your skin, or you may find yourself with a nasty ice burn. A pillowcase is an excellent cover for the gel ice packs.

Anti-inflammatory medications may be helpful, but should be taken under the direction of a physician. Talk to your physician about the possible benefits these medications could provide.

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