Vim & Vigor - Fall 2019 - CH - 39

TRUE OR FALSE:

If you're experiencing pain in
your wrist or hand, it's probably carpal tunnel syndrome.

FALSE. "That's one of the biggest
misconceptions about carpal tunnel
syndrome," Baxamusa says. Rather than
pain, "the hallmarks are numbness and
tingling-especially at night."
In fact, painful conditions that occur
in the hand, such as trigger thumb and
arthritis, are commonly confused with
CTS. So is de Quervain's tenosynovitis,
a type of tendinitis of the wrist that's
common in pregnant women and mothers of newborns, Baxamusa says.
An electromyogram (EMG) test with
a nerve conduction study can confirm
CTS. The EMG measures the electrical
activity in the muscles, and the nerve
study helps providers spot any damage
and assess its severity.

TRUE OR FALSE:

Working on a keyboard all
day causes carpal tunnel
syndrome.

FALSE. While CTS is commonly
linked with computer work, a combination of factors can cause it, including
heredity or an underlying medical condition like diabetes, rheumatoid arthritis
or thyroid imbalance. Awkward or
improper posture and activities on the
job can also play a role (hence the keyboard connection).
"But it's not that working on a computer all day causes it," Baxamusa says.
"Poor ergonomics is the cause."
According to the National Institutes of
Health, assembly-line workers are actually at greater risk for CTS: They're three
times more likely to develop it than
someone who performs data entry.

A HAND IN
SUPPORT

TRUE OR FALSE:

While surgery may not be preventable for all patients with carpal tunnel
syndrome, there are some things
that can help alleviate symptoms and
provide relief.
"It's best for patients to be evaluated first by an orthopedic hand
specialist to determine severity
of their symptoms," says Holly
Gutierrez, a certified hand therapist
at Community Healthcare System's
Neuroscience and Sports Medicine
Center in Schererville. "If symptoms
are mild to moderate, therapy can be
quite an effective treatment."
Patients may be fitted with a custom splint or brace to reduce compression of the nerve.
"Certified hand therapists are
uniquely qualified to make these
devices, which are more effective and
supportive than anything you can buy
over the counter," Gutierrez says.
Whatever treatment is right for
you, Community Healthcare System's
specially trained orthopedic hand
surgeons and therapists provide early
diagnosis, treatment and preventive education.

TRUE. Surgery typically involves
cutting a ligament that forms the "roof"
of the carpal tunnel to reduce pressure
on the median nerve. Known as carpal
tunnel release, it can have a high success rate-up to 90 percent-but
recovery takes time. The tingling usually
goes away within weeks after surgery.
In severe cases, where the nerve has
been under pressure for a long time, it
can take a while for the nerve to regenerate, and thus the numbness can take
much longer to go away. The rate of
nerve regeneration generally occurs at
a millimeter a day or an inch per month,
Baxamusa says.
"So, if you consider that the carpal
tunnel is compressed at the wrist and
you measure from there to the tip of
the middle finger, it's about 6 inches,
which means it's roughly six months for
that nerve to regenerate."

WEBSITE

Need Therapy?
Community Healthcare
System offers outpatient
hand, wrist and upper
extremity therapy. Visit
COMHS.org/services/
therapy-services/out
patient-therapy-services/
hand-therapy.

Recovery from CTS surgery can
take a while.

TRUE OR FALSE:

CTS can be reversible.

TRUE. With early diagnosis and
proper treatment, the damage can be
reversible-to a point. With severe CTS,
where the muscle around the base of the
thumb is starting to become disconnected from the nerve, it may be irreversible. But surgery can still make sense
to halt the progression, Baxamusa says.
"Beyond numbness and tingling,
there's also a muscular component. The
motor branch of the median nerve [the
CT nerve] controls the thumb, which
gives us opposable thumbs," he says.
"If left untreated, that could be lost in
severe cases, so it's important to seek a
diagnosis and treatment early." ■

FALL 2019

http://www.COMHS.org/services/therapy-services/outpatient-therapy-services/hand-therapy http://www.COMHS.org/services/therapy-services/outpatient-therapy-services/hand-therapy http://www.COMHS.org/services/therapy-services/outpatient-therapy-services/hand-therapy http://www.COMHS.org/services/therapy-services/outpatient-therapy-services/hand-therapy

Vim & Vigor - Fall 2019 - CH

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