# Carpal Tunnel



## Lonelyguy (Nov 8, 2003)

Anyone ever had it? I've been experiencing weakness in my right hand for over a year, mainly with my thumb and index finger. Its especially bad if I've been using that hand for any amount of time. This past weekend I was using a chainsaw for about half an hour and when I finished my right hand was so weak I could hardly hold the saw or grip anything. I've read about the symptoms of carpal tunnel and most people also experience pain and tingling, which I have neither. There is pain if I twist it just right, like if I relax my hand and push the thumb back...but I don't experience any pain while using it, just weakness. Its especially difficult at times because I work with my hands and I'm unable to grip something because of it. 

Yeah, I know I should go to the doctor and I probably will soon...my experience the other day confirmed something isn't right. I just wanted to know if anyone here has ever had carpal tunnel, what your experience was like and how they treated it.


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## tommo1234 (Apr 20, 2011)

Lonelyguy said:


> Anyone ever had it? I've been experiencing weakness in my right hand for over a year, mainly with my thumb and index finger. Its especially bad if I've been using that hand for any amount of time. This past weekend I was using a chainsaw for about half an hour and when I finished my right hand was so weak I could hardly hold the saw or grip anything. I've read about the symptoms of carpal tunnel and most people also experience pain and tingling, which I have neither. There is pain if I twist it just right, like if I relax my hand and push the thumb back...but I don't experience any pain while using it, just weakness. Its especially difficult at times because I work with my hands and I'm unable to grip something because of it.
> 
> Yeah, I know I should go to the doctor and I probably will soon...my experience the other day confirmed something isn't right. I just wanted to know if anyone here has ever had carpal tunnel, what your experience was like and how they treated it.


I haven't had it myself but I know stuff about it 

Carpal Tunnel is caused by pressure on the nerve that supplies feeling and movement to the hand. Just because you don't get the symptoms that most people have doesn't mean you don't have it..you might not have it though..
Diagnosis...x-rays might be done, also pressing on the nerve will confirm if you have CT.
Erm, how it's treated....sometimes you have to wear a splint for several weeks at night time only though, unless that fails to do anything then you have to wear in in the day too...
Medication wise I think anti Inflammatory drugs are used like Ibuprofen...
If the splint and medication fail then it's time for surgery...the ligament pressing against the pressured nerve will be cut releasing pressure...and if surgery is successful then you can say goodbye to carpel tunnel..
If it's left untreated then you can get permanent tingling and pain..

Good luck!


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## humourless (Sep 27, 2011)

I got it a few years ago. Both hands. A specialist needs to test the amount of nerve damage you've done to your wrists/hands. My damage was high so I had to have surgery...under general aneasthetic .....took 6 weeks off work. 2 kinds of surgery. I got the open one, not the pin-hole.
100% recovery is elusive in my opinion. I still struggle to do push-ups.

See your GP toget a referral asap.


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## Lisa (Jul 8, 2006)

I have a diagnosed carpal tunnel syndrom. Thumb and index finger doesn't sound like it at all. Usually it is the ring finger and pinky. That is the typical thing. Get it checked out by a doctor it might be something else.

Also, I never experience weakness, it just tingles, goes numb and once I open and close my hand a few times it is gone again.


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## DeeperUnderstanding (May 19, 2007)

I have been struggling with this pain. It especially is frustrating, since I'm a musician and sometimes can't play the music I write.


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## Lasair (Jan 25, 2010)

Mmmm......I get pain in my right wrist at the thumb and other when I work long hours in the nursing home but when I rest it it goes away!


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## copper (Nov 10, 2003)

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## jonny neurotic (Jan 20, 2011)

> I have a diagnosed carpal tunnel syndrom. Thumb and index finger doesn't sound like it at all. Usually it is the ring finger and pinky. That is the typical thing. Get it checked out by a doctor it might be something else.


 There is no reason that it should only effect certain fingers. There are three nerves running down the arm; radial, medial and ulna. Each serve different parts of the arm and hands. However I do agree that it may be something else regardless of which part of the hand is effected. A freind of my mum has had neck problems for years and pain around the shoulder blades. I can see that her posture is really bad an it is my feeling that this is the root of the pain she suffers, but this is not something the doctors pay attention to. She has been diagnosed with spondylosis in her neck and myofascial trigger points in her back. After years of this she started to get pain in her hand and was then diagnosed with carpel tunnel syndrome. The problem is that no scans were done and the diagnosis was based purely on the symptoms. She had the surgery in her wrist but the pain has not stopped. It is my belief that the pain in her hand was a result of a prolapsed disc in her neck puting pressure on one or more of the nerves of the arm. The term for this is brachial neuralgia. It is much the same as sciatica but it effects the arms rather than the legs. Make sure the diagnosis is the correct one because if it is brachial neuralgia the carpel tunel surgery is pointless. The cure for brachial neuralgia, if you are interested, is improved posture. Yoga or pilates will do the trick. I don't know anything about carpel tunnel syndrome so I can't say whether surgery is necessary but personaly, I would try to avoid being cut open as much as possible...


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## jonny neurotic (Jan 20, 2011)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888382/



> A 47-year-old right-handed man presented with acute onset left shoulder pain following physical activity related to his job in the construction field. He was evaluated locally and diagnosed with left rotator cuff disease. EMG/NCS were obtained and reportedly showed mild bilateral *carpal tunnel syndrome*. He underwent surgery for left rotator cuff and left carpal tunnel release... ...In the immediate postoperative period, the pain and weakness worsened, and he also developed numbness in the lateral aspect of the left forearm and hand. The pain was treated with non-steroidal antiinflammatory agents, and an MRI of the cervical spine was obtained which was unremarkable... ...he was found to have a flaccid, areflexic paresis involving all muscle groups of the left upper extremity, more pronounced in the supra- and infraspinatus, deltoid and biceps, with mild muscle atrophy... ...A clinical diagnosis of [idiopathic brachial neuritis] was established.


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## shyyguyy (Dec 23, 2010)

jonny neurotic said:


> There is no reason that it should only effect certain fingers. There are three nerves running down the arm; radial, medial and ulna. Each serve different parts of the arm and hands. However I do agree that it may be something else regardless of which part of the hand is effected. A freind of my mum has had neck problems for years and pain around the shoulder blades. I can see that her posture is really bad an it is my feeling that this is the root of the pain she suffers, but this is not something the doctors pay attention to. She has been diagnosed with spondylosis in her neck and myofascial trigger points in her back. After years of this she started to get pain in her hand and was then diagnosed with carpel tunnel syndrome. The problem is that no scans were done and the diagnosis was based purely on the symptoms. She had the surgery in her wrist but the pain has not stopped. It is my belief that the pain in her hand was a result of a prolapsed disc in her neck puting pressure on one or more of the nerves of the arm. The term for this is brachial neuralgia. It is much the same as sciatica but it effects the arms rather than the legs. Make sure the diagnosis is the correct one because if it is brachial neuralgia the carpel tunel surgery is pointless. The cure for brachial neuralgia, if you are interested, is improved posture. Yoga or pilates will do the trick. I don't know anything about carpel tunnel syndrome so I can't say whether surgery is necessary but personaly, I would try to avoid being cut open as much as possible...


Of course, there's a medical reason for carpal tunnel syndrome to only affect certain fingers. Out of the 3 nerves controlling the hands, only the median nerve actually travels through the carpal tunnel. The median nerve supplies the thumb, index finger, middle finger, and half of the ring finger. That's where the tingling should classically be in carpal tunnel syndrome. You wouldn't get weakness or muscle-wasting in those areas unless the carpal tunnel syndrome is severe or long-standing. Generally, tingling and numbness are the only signs. A quick way to diagnose carpal tunnel syndrome would be via the Phalen and/or Tinel Signs although there is a high rate of false positives and false negatives. The gold standard way to diagnose the disease is a nerve conduction study. However, if the presentation is classic, there's no reason for a doctor to get imaging or a nerve conduction study to diagnose carpal tunnel syndrome. It can be diagnosed purely on symptoms.

The initial treatment for carpal tunnel syndrome should be wrist splints and ibuprofen. Only if that doesn't work would you need a carpal tunnel release (surgery). You don't really need to shop around for an orthopedic surgeon for that procedure. It's a pretty easy and a simple surgery to do. As an alternative, a plastic surgeon with training in hand surgery can also perform the surgery.


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## Lonelyguy (Nov 8, 2003)

Thanks for all the responses. I've been making a conscious effort to avoid using my right hand for anything strenuous or forceful at work all week. The strength has returned to my fingers finally, but there is some soreness in the hand and wrist muscles now. I'm going to start wearing a brace this weekend and see if that makes any difference. Working with that hand seems to aggravate the problem, giving it a chance to rest has helped considerably.


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## jonny neurotic (Jan 20, 2011)

shyyguyy said:


> Of course, there's a medical reason for carpal tunnel syndrome to only affect certain fingers. Out of the 3 nerves controlling the hands, only the median nerve actually travels through the carpal tunnel.


I see. As I said, I don't really know anything about carpal tunnel syndrome. All I know is that it is a strain injury like tennis elbow. Thanks for the info...



> The gold standard way to diagnose the disease is a nerve conduction study. However, if the presentation is classic, there's no reason for a doctor to get imaging or a nerve conduction study to diagnose carpal tunnel syndrome. It can be diagnosed purely on symptoms.


But if there could be another explanation for the neuralgia then surely a more robust diagnosis should be sought. The article I linked to demonstarted exactly this issue and is an almost identicle story to that of my mums friend. Performing surgery on the basis purely of symtoms, to my mind, is irresponsible.


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## shyyguyy (Dec 23, 2010)

jonny neurotic said:


> I see. As I said, I don't really know anything about carpal tunnel syndrome. All I know is that it is a strain injury like tennis elbow. Thanks for the info...
> 
> But if there could be another explanation for the neuralgia then surely a more robust diagnosis should be sought. The article I linked to demonstarted exactly this issue and is an almost identicle story to that of my mums friend. Performing surgery on the basis purely of symtoms, to my mind, is irresponsible.


I didn't say you should do surgery without further workup. I agree that if you are planning on sending a patient for carpal tunnel surgery, you need to do a nerve conduction study (you said in your original post that no scans were done; radiology is not the way to diagnose carpal tunnel syndrome). HOWEVER, it's fine to start someone on ibuprofen and wrist splints initially for carpal tunnel syndrome without doing a NCS, purely based on symptoms.

Note that even in the case report you cited, a NCS study was done and carpal tunnel syndrome was still misdiagnosed. You can find a case report to support whatever you want. In fact, if something is published as a case report it's because it's an UNUSUAL not a typical finding. If someone presents with "classic" carpal tunnel syndrome and only has those symptoms, then brachial neuritis is unlikely. End of story. You really need some sort of neck/shoulder pain + carpal tunnel symptoms to suggest that the lesion is in the neck and not in the wrist. If your family member did indeed have neck pain, then she didn't have classic carpal tunnel syndrome and the doctor's an idiot. If she only had hand tingling, then there's no possible way for the doctor to suspect that she had a neck problem. I would only advise making a clinical diagnosis of carpal tunnel syndrome if the symptoms are classic.


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## jonny neurotic (Jan 20, 2011)

shyyguyy said:


> You really need some sort of neck/shoulder pain + carpal tunnel symptoms to suggest that the lesion is in the neck and not in the wrist. If your family member did indeed have neck pain, then she didn't have classic carpal tunnel syndrome and the doctor's an idiot. If she only had hand tingling, then there's no possible way for the doctor to suspect that she had a neck problem. I would only advise making a clinical diagnosis of carpal tunnel syndrome if the symptoms are classic.


Yeah that is her symptoms. Pain and stiffness in her neck, burning/stabbing pain around her shoulder blades and sometimes her arm goes completely numb. All this for years before she got the pain in her hand. I tried to explain to her at the time but, alas, I have no qualifications to stand on.


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