carpal tunnel

[lukeBW]

it sucks but I have carpal tunnel , doc will probably tell me to lay off the weights for several weeks and give me some kind of steroid medication .

I have had the symptoms for quite some time but this is the first time I get so inflamed and I am forced to wear a brace. I believe doing power cleans and wrist stretching might have worsen the situation

do you have any experience with this, related to weight lifting ?
anyway to treat it ?

Ironically the Carpal Tunnel Syndrome Exercises look like what i already do to stretch before I do cleans

http://www.eatonhand.com/hw/ctexercise.htm

[Mark Rippetoe]

I'm going to ask for Travis's input on this, if he can help.

[lukeBW]

I'm going to ask for Travis's input on this, if he can help.

thanks that would be super...

I did the ice massages as suggested by that web site above and the pain is almost gone but I would like to be able to try and avoid future problems if possible ..
thank you again

[TravisRussellDC]

First of all, we have to determine if you do, indeed have carpal tunnel syndrome. CTS is one of the most overly diagnosed conditions today. First of all, do you have numbness and tingling in your fingers, and if so which ones? Have you noticed any muscular weakness or atrophy in your hands and digits, and if so which ones? Are you experiencing this in one hand or both? What can you do to reproduce the symptoms? If you hold your hands in a prayer position with the wrists extended anad palms together or if you reverse this position and flex the wrists with the back of your hands together, do you get any numbness or tingling in your hands and digits? If so, which ones? Have you ever had any neck injuries that could impinge upon the nerves that travel down the arm and into the wrist and hand? There are tests that can determine between nerve root impingement and peripheral nerve entrapment. What tets were done for your doctor to arrive at the diagnosis?

If you do have true CTS, there are other options besides steroid injection or surgery. Great results have been achieved with a combination of chiropractic adjustments and ART or Graston on the tendons, muscles and retinaculum of the wrists. And there's no danger of connective tissue destuction as is seen with steroidal injections.

If it is a true CTS, and you have a great deal of inflammation in the wrist under the retinaculum then an anti-inflammatory would seem to make sense. But you have to ask yourself, what caused that inflammation? If you take the steroid injection and the inflammation goes away, but you don't fix the problem or change the habit that caused the inflammation in the first place, it will come back.

The problem is, that area of the wrist is a pretty avascular area, meaning it gets very little blood flow through there. Without a good flow of blood, the body can't remove any built up fluid from inflammation. Then the nerves get impinged upon and pain, numbness, tingling, and muscular atrophy will come about.

If you can answer the questions up top for me, I can get a much better idea of what we're dealing with.

[Rooney]

Hi there,

First, I am not a physician; I'm only studying to become a medical translator, and English is not my native language but German.

Just recently, I had to write a paper and hold a presentation on carpal tunnel syndrome (CTS), and maybe I might be of some help now.

Are you really sure that you have CTS or is it just wrist pain? I thought that I had CTS myself, but the research for my paper proved me wrong.

I just quote from the following website, to save me some work.
http://www.ninds.nih.gov/disorders/c....htm#115113049

Symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though little or no swelling is apparent. The symptoms often first appear in one or both hands during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to tell between hot and cold by touch.

Has your CTS been proven by diagnostic tests?

Physicians can use specific tests to try to produce the symptoms of carpal tunnel syndrome. In the Tinel test, the doctor taps on or presses on the median nerve in the patient's wrist. The test is positive when tingling in the fingers or a resultant shock-like sensation occurs. The Phalen, or wrist-flexion, test involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together. The presence of carpal tunnel syndrome is suggested if one or more symptoms, such as tingling or increasing numbness, is felt in the fingers within 1 minute.

Often it is necessary to confirm the diagnosis by use of electrodiagnostic tests. In a nerve conduction study, electrodes are placed on the hand and wrist. Small electric shocks are applied and the speed with which nerves transmit impulses is measured. In electromyography, a fine needle is inserted into a muscle; electrical activity viewed on a screen can determine the severity of damage to the median nerve.

If you really have CTS, I wouldn't use corticosteroid injections as they just suppress the inflammation but do not treat the underlying cause.

If your CTS is caused by inflammation of the flexor tendons sheaths, heat treatments by a physical therapist can aid in the removal of edema. I don't know the English names of these treatments, but in one, a hot towel is rolled in short intervals over your flexor muscles and tendons, and the other one has you dipping your hands and wrists in short intervals into hot wax (60? Celsius).

I don't know what actually caused my wrist pain, but strenghthening my wrist extensor muscles (wrist roller) and especially my finger extensor muscles (finger extension using small rubber bands) has greatly reduced my problems.
http://www.tennis-elbow-treatments.c...xtension_b.jpg
http://www.tennis-elbow-treatments.c...xtension_e.jpg

I recall reading somewhere that a strength imbalance between the flexor and extensor muscles can be a cause of CTS, but I have no references for that.

[Mark Rippetoe]

Two different approaches to the problem, both recommending that you do not jump the gun. I'd pay attention.

[lukeBW]

Thanks Travis for taking the time..
I have to add that I am also a bass player and CTS is pretty common among guitar/bass players unfortunately

. First of all, do you have numbness and tingling in your fingers, and if so which ones?

it is in my right hand the tingling and numbness is generally on the 4 fingers
and the palm of my hand

Have you noticed any muscular weakness or atrophy in your hands and digits, and if so which ones

not that I can think of , when the pain was intense I could not move my hand much but
I don't recall any atrophy nor weakness

Are you experiencing this in one hand or both?

only in my right hand

What can you do to reproduce the symptoms? If you hold your hands in a prayer position with the wrists extended anad palms together or if you reverse this position and flex the wrists with the back of your hands together, do you get any numbness or tingling in your hands and digits? If so, which ones?

even now without pain I can feel mild numbness when I do it and it's stronger in my index and middle finger then in my ring or pinky..

Have you ever had any neck injuries that could impinge upon the nerves that travel down the arm and into the wrist and hand?

no neck injuries that I am aware of

There are tests that can determine between nerve root impingement and peripheral nerve entrapment. What tets were done for your doctor to arrive at the diagnosis?

I haven't seen a doctor yet I am thinking of seeing a CP instead

If you do have true CTS, there are other options besides steroid injection or surgery. Great results have been achieved with a combination of chiropractic adjustments and ART or Graston on the tendons, muscles and retinaculum of the wrists. And there's no danger of connective tissue destuction as is seen with steroidal injections.

If it is a true CTS, and you have a great deal of inflammation in the wrist under the retinaculum then an anti-inflammatory would seem to make sense. But you have to ask yourself, what caused that inflammation

?
Hard to tell.. I have been stretching my wrists to do hang cleans & front squats 2-3 days prior but I have done it many times before that day and I never had any problems, there is usually a little pain from the stretching and the exercises but normally it would be gone in a few hours..
I believe that the stretching and stress I put on my wrist might have inflamed the nerves
but I am not positive that is the main cause as the occasional tingling and numbness has been there for a long time..
I used to play 3-5 times a week, I would need frequent breaks between songs or my hand would get so numb . I attributed that to my life style.. I am sure drinking and smoking didn't help

If you take the steroid injection and the inflammation goes away, but you don't fix the problem or change the habit that caused the inflammation in the first place, it will come back.
The problem is, that area of the wrist is a pretty avascular area, meaning it gets very little blood flow through there. Without a good flow of blood, the body can't remove any built up fluid from inflammation. Then the nerves get impinged upon and pain, numbness, tingling, and muscular atrophy will come about.

are there any exercises I can do to help ?

If you can answer the questions up top for me, I can get a much better idea of what we're dealing with.

Thanks so much I truly appreciate the time you took to answer my Q..

Hi there,

First, I am not a physician; I'm only studying to become a medical translator, and English is not my native language but German.

Just recently, I had to write a paper and hold a presentation on carpal tunnel syndrome (CTS), and maybe I might be of some help now.

Are you really sure that you have CTS or is it just wrist pain? I thought that I had CTS myself, but the research for my paper proved me wrong.

I just quote from the following website, to save me some work.
http://www.ninds.nih.gov/disorders/c....htm#115113049



Has your CTS been proven by diagnostic tests?



If you really have CTS, I wouldn't use corticosteroid injections as they just suppress the inflammation but do not treat the underlying cause.

If your CTS is caused by inflammation of the flexor tendons sheaths, heat treatments by a physical therapist can aid in the removal of edema. I don't know the English names of these treatments, but in one, a hot towel is rolled in short intervals over your flexor muscles and tendons, and the other one has you dipping your hands and wrists in short intervals into hot wax (60? Celsius).

I don't know what actually caused my wrist pain, but strenghthening my wrist extensor muscles (wrist roller) and especially my finger extensor muscles (finger extension using small rubber bands) has greatly reduced my problems.
http://www.tennis-elbow-treatments.c...xtension_b.jpg
http://www.tennis-elbow-treatments.c...xtension_e.jpg

I recall reading somewhere that a strength imbalance between the flexor and extensor muscles can be a cause of CTS, but I have no references for that.

Great info as well.. thanks

Two different approaches to the problem, both recommending that you do not jump the gun. I'd pay attention.

And thank you as well ...

I don't know what actually caused my wrist pain, but strenghthening my wrist extensor muscles (wrist roller) and especially my finger extensor muscles (finger extension using small rubber bands) has greatly reduced my problems.
http://www.tennis-elbow-treatments.c...xtension_b.jpg
http://www.tennis-elbow-treatments.c...xtension_e.jpg

I have done those in the past to strengthen my hand, it's an exercise you do when playing both stringed instruments like a guitar or bass and piano
they work well .. time to do it again