BENEATH THE SURFACE: UNDERSTANDING HOW CARPAL TUNNEL SYNDROME
QUIETLY ALTERS LIVES
Consultant Orthopaedic, Trauma and Paediatric Orthopaedic Surgeon at Sunway Medical Centre Velocity (SMCV), Dr Maria Shelynn Wong
14/06/2023 11:21 AM
KUALA LUMPUR, June 14 (Bernama) -- Going through daily routines without giving much thought to how repetitive motions such as using a computer keyboard and mouse, scrolling phone screens, occupational use of vibrating tools or even housework can actually contribute to hidden health risks and lead to conditions such as carpal tunnel syndrome that can affect anyone, regardless of their age.
Carpal tunnel syndrome occurs when the median nerve, located in the carpal tunnel (a narrow passageway running from the forearm to the palm of the hand)
becomes compressed, with common symptoms including weakness when gripping objects, along with pain, numbness, or tingling sensations, often triggered by repetitive movements regularly performed with the hands.
In a statement, Sunway Medical Centre Velocity (SMCV) Consultant Orthopaedic, Trauma and Sports Surgeon Dr Raymond Yeak Dieu Kiat shared that this epidemiological observation highlights the association between carpal tunnel syndrome and daily activities, but merely scratches the surface.
“Other factors such as joint or bone diseases, hormonal or metabolic changes and fluctuations in blood sugar levels can contribute to the development of carpal tunnel syndrome as well. Inflammatory arthritis can cause the protective sheath around multiple tendons in the wrist's carpal tunnel to thicken which then reduces the already limited space in the carpal tunnel, putting pressure on the median nerve.
“Moreover, diabetes itself can cause neuropathy, which means even a slight narrowing of the carpal tunnel can have a significant impact on diabetic patients, leading to symptomatic carpal tunnel syndrome,” he said.
Thus, Dr Raymond suggested reducing unnecessary repetitive hand motions, such as limiting leisurely use of a mobile phone and taking breaks to rest to prevent the occurrence of carpal tunnel syndrome and trigger finger, another prevalent non-traumatic disorder and he added that gentle stretching exercises during resting periods can decrease stiffness and improve the affected area’s range of motion.
Meanwhile, Dr Raymond said that treatment options are tailored to each individual case, the first of which is splinting and this involves using a neutral wrist splint with a metal bar that restricts wrist movement while allowing finger movement.
“By providing the median nerve with a break, splinting can help reduce swelling and facilitate the healing of mild to moderate nerve damage, in which the splint can be worn during sleep and as frequently as possible throughout the day,” he said, adding that another treatment approach is through physiotherapy which may involve exercises to improve wrist and finger range of motion and strengthen the affected area.
Lastly, medication can be considered. Pain relief injections containing a combination of steroids and a local anaesthetic injected around the median nerve may benefit some patients. However, Dr Raymond stresses that prescribing steroids during pregnancy is generally avoided to prevent potential side effects.
On the other hand, while individuals who have experienced previous wrist injuries, sprains, dislocations, or inflammation are more prone to developing carpal tunnel syndrome, SMCV Consultant Orthopaedic, Trauma and Paediatric Orthopaedic Surgeon Dr Maria Shelynn Wong noted that carpal tunnel syndrome tends to affect women more than men with pregnancy being a significant contributing factor.
She said that while approximately four per cent of adults in the general population are affected by carpal tunnel syndrome, the prevalence of symptoms among pregnant women is estimated between 31 to 62 per cent.
“During pregnancy, every expectant mother experiences a doubling of their blood volume. As a result, the additional fluid exerts increased pressure, leading to swelling in the blood vessels throughout their body. Consequently, in confined areas like the carpal tunnel region of the wrist, this swelling can compress the median nerve, potentially resulting in carpal tunnel syndrome.
“However, fortunately, after giving birth, symptoms of carpal tunnel syndrome typically subside, as the fluid levels return to normal and alleviate the extra pressure on the blood vessels. Nonetheless, it is advisable for pregnant mothers to consult a doctor if they experience carpal tunnel like symptoms in their hands,” she said.
She advised mothers to remain vigilant about their wrist health even after giving birth because the frequent lifting of the baby and engaging in repetitive motions can potentially contribute to tendinopathies caused by overuse.
Dr Maria also shared that those who experience carpal tunnel syndrome may be at risk to get trigger finger, scientifically referred to as stenosing tenosynovitis of the flexor tendons, which presents as a digit or digits becoming stuck, causing pain and tightness described as a clicking or catching sensation when opening and closing the fingers, which can be uncomfortable.
“One of the main causes of trigger finger is repetitive actions such as twisting, squeezing, grasping, or forceful hand activities, additionally with medical conditions such as diabetes and rheumatoid arthritis potentially contributing to its development as well.
“Similar to carpal tunnel syndrome, pregnant women are also vulnerable to trigger finger due to fluid retention and swelling during pregnancy. Lastly, trigger finger ismore commonly observed in older individuals and is rare in children, but there is a rare condition called congenital trigger thumb that can cause locked flexion of an infant's thumb,” she said.
Dr Maria also noted that apart from the elderly, housewives who perform repetitive gripping and grasping of kitchen utensils and cleaning tools, as well as sewing, knitting and hand-washing clothes, along with individuals with jobs or hobbies involving repetitive hand work, typing-intensive tasks, or prolonged gripping, are also at a high risk of developing trigger finger.
“Nevertheless, there are preventive measures and treatment options available as mentioned earlier,” she said.
In short, carpal tunnel syndrome affects people of all age groups and is often influenced by daily habits. By cultivating awareness of the potential risks linked to repetitive hand movements, proactive measures can be taken to prevent and effectively manage conditions such as carpal tunnel syndrome and trigger finger.
Sunway Medical Centre Velocity is located at Lingkaran SV, Sunway Velocity. For enquiries, please contact +603 9772 9191 or email smcv-enquiry@sunway.com.my.
For more information on SMCV, visit www.sunmedvelocity.com.my (Facebook: Sunway Medical Velocity).
-- BERNAMA
