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About wrist injuries and conditions | What is Carpal Tunnel Syndrome? | How is Carpal Tunnel Syndrome treated? | How do you treat a broken wrist?
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Wrist

About wrist injuries and conditions

Frequently treated wrist conditions and injuries may include:

• Arthritis

  

• Carpal Tunnel Syndrome

• Congenital Abnormalities 

• Dislocations

• Fractures

• Ganglion Cysts

• Joint Contractures

• Nerve Compression Problems

• Occupational Trauma

• Sports-Related Injuries

• Tendonitis

• Tendon Repair

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What is Carpal Tunnel Syndrome?

The median nerve runs from the forearm and into the hand. When pressure is put on this nerve at the wrist this is known as carpal tunnel syndrome. This nerve controls the senses to the palm side of the thumb and fingers (but not to the little finger). The median nerve also controls impulses to some smaller muscles in the hand that allow movement in the fingers and thumbs. The narrow, stiff passageway of ligament and bones at the base of the hand (also known as the carpal tunnel) maintains the median nerve and tendons. In some cases, the irritated tendons or other swelling narrows the tunnel and results in a compressed median nerve.

Symptoms of carpal tunnel syndrome include pain, weakness, or numbness in the hand and wrist, that may radiate up the arm. This condition is the most common and neuropathic condition in which the body's peripheral nerves are compressed or traumatized.

While work conditions contribute to this syndrome, the National Institute of Neurological Disorders and Stroke has listed that the most common reason for carpal tunnel syndrome is a hereditary predisposition, meaning that the carpal tunnel is simply smaller in some individuals than others.

Women are three times more likely to develop the condition than are men. The dominant hand typically develops the syndrome first and the most serious symptoms occur in the dominant hand.

How is Carpal Tunnel Treated?

Nonsurgical treatments

In some instances, nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen, and other nonprescription pain relievers, may help relieve symptoms of carpal tunnel syndrome. Oral diuretics ("water pills") may help allieviate swelling. In order to relieve pressure on the median nerve and provide quick but temporary relief to sufferers with mild or intermittent symptoms, corticosteroids drugs such as lidocaine may be injected directly into the wrist or taken by mouth. These drugs are available by prescription only and should be used at guidance of a medical professional.

Vitamin supplements, such as B6, may ease the symptoms of carpal tunnel syndrome. Stretching and strengthening exercises can be helpful to may the area stronger and more resistant to strain. These exercises should be supervised by a physical or occupational therapist with training in exercises to treat physical impairments. Alternative therapies such as acupuncture and chiropractic care may offer benefit to some patients but the effectiveness has not been measured. Yoga has been shown to reduce pain and improve grip strength among patients with carpal tunnel syndrome.

Surgerical Options

According to The National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health, carpal tunnel release is one of the most common surgical procedures in the United States. This surgery is recommended if symptoms last for six months or longer and the surgery involves separating the tissue band around the wrist to in order to relieve pressure on the median nerve. This procedure is done under local anesthesia as an outpatient basis. In many cases, surgery may be required on both hands.

Carpel tunnel syndrome may be performed through the traditional procedure in which an incision of up to 2 inches is made in the wrist and then carpal ligament is cut in order to enlarge the carpal tunnel. Usually, this procedure is completed under local anesthesia on an outpatient basis.

A minimally invasive procedure known as endoscopic surgery may offer faster recovery and less discomfort after surgery. During endoscopic surgery the surgeon makes two incisions (about ½" each) in the wrist and palm, next a camera attached to a tube, is inserted into the incision. Now the surgeon can observe the tissue on a screen and the carpal ligament. This procedure is effective and minimizes scarring and tenderness. Patients may experience immediate relief from symptoms after surgery, however full recovery from carpal tunnel surgery may take months. In some cases, infection, nerve damage, stiffness, and pain at the scar may occur. The wrist may lose strength because the carpal ligament is severed. Physical therapy is suggested after surgery to help improve and restore wrist strength. Recurrence following treatment is uncommon. Most patients recover completely following treatment of carpal tunnel syndrome

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How do you treat a broken wrist?

A fracture of the bone nearest the wrist (the radius) is one of the most common types of fractures. This fracture usually results due to direct trauma to the wrist, such as falling on the wrist, a vehicle accident or sports related blow to the wrist.

Symptoms include pain, tenderness and swelling at the wrist. Bruising may also occur and it may be difficult to move the wrist.

Illustration Swarm Interactive ©2006

Wrist fractures will vary in severity, the break may be clean and simple while other fractures may be severe and involve multiple bone fragments. Treatment will vary based on the severity of the injury. The overall goal for all fractures is to hold the broken bone in place until it heals. In cases where the fractured ends are misaligned, the provider may need to perform a closed reduction procedure. Bone stabilization may be provided by cast, splint, or brace and may cover only the wrist or extend to above the elbow. If the bones are not aligned by this method, surgery may be necessary.

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NO PHYSICIAN REFERRAL IS NEEDED UNLESS REQUIRED BY YOUR INSURANCE

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