Replies

1. 
   PatchoguePhil | Jul 12, 2001 06:27pm | #1

   *
   Avoid surgery until it is an absolute necessity!!

   The EMG test is more painful than the ailment.

   I deal with it by limiting the hand motions that aggravate. When my hand and fingers start cramping and numbing, I do something else. Hammering, using a screwgun, turning wrenches and spackling are the worst activities for me. (No wonder it takes so long for me to finish spackling these rooms!). Even a lot of mouse clicking & scrolling bothers me.

   Alleve, advil, celebrex all help some. Plain rest is the best medicine, and it doesn't have bad sideaffects like too many pills can have. Some people swear by Glucosamine & Condroitin (sp?) but it can raise your cholesterol level. I'm already borderline high, so I haven't tried it.

   There are some exercises/stretching motions that help sometimes.

   The splint helps some. Best "feel good" remedy is to get your wife/girlfriend to massage your forearm, wrist and hands with some lotion. Ice packs help too.

   JMHO
   Phil

1. 
   David_Thomas | Jul 12, 2001 06:33pm | #2

   *I have found it helpful to sleep with my wrists straight. Mostly through conscious thought for a month or two (and it felt a bit more comfortable during the night and far better in the morning). Now it is pretty unconscious. But wrist splints might have trained me faster. I haven't needed splints while working (yet?) - maybe that is the next step.I've been trying to keep my wrists straight when putting any significant force or torque through them. Episodes of lots of force at weird angles is what annoys my wrists the most.I know typists who find they get less carpal-tunnel irration when working in splints. -David

1. 
   PatchoguePhil | Jul 12, 2001 06:35pm | #3

   *Just found this....Exercise. Hand and wrist exercises may help reduce the risk of developing CTS. Isometric and stretching exercises can strengthen the muscles in the wrists and hands, as well as the neck and shoulders, improving blood flow to these areas. Performing the following simple exercises for four to five minutes every hour may be helpful. Wrists. Make a loose right fist, palm up, and use the left hand to press gently down against the clenched hand. Resist the force with the closed right hand for five seconds, but be sure to keep the wrist straight. Next, turn the right fist palm down and press against the knuckles with the left hand for five seconds. Finally, turn the right palm so the thumb-side of the fist is up and press down again for five seconds. Repeat with the left hand. Another easy wrist exercise requires first holding one hand straight up next to the shoulder with fingers together and palm facing outward. (The position looks like a shoulder-high salute); next, with the other hand, bend the hand being exercised backward with the fingers still held together and hold for five seconds; and third, spread the fingers and thumb open while the hand is still bent back and hold for five seconds. Repeat five times for each hand. A third simple exercise is called wrist circles. First hold the second and third fingers up and close the others. Draw five clockwise circles in the air with the two fingertips. Draw five more counterclockwise circles. Repeat with the other hand. Fingers and Hand. The first exercise is the finger bend and stretch. Clench the fingers of one hand into a fist tightly, and then release, fanning out the fingers. Do this five times. Repeat with the other hand. To exercise the thumb, bend it against the palm beneath the little finger and hold for five seconds. Spread the fingers apart, palm up, and hold for five seconds. This should be repeated five to 10 times with each hand. Then, gently pull the thumb out and back and holding for five seconds, repeating five to 10 times with each hand. Forearms. Excessive use of the hands can cause the forearm muscles to tighten, increasing pressure on tendons as they pass through the wrist. Stretching these muscles will reduce this tension. Place the hands together in front of the chest, fingers pointed upward in a prayer-like position. Keeping the palms flat together, raise the elbows to stretch the forearm muscles. Stretch for 10 seconds. Then gently shake the hands limp for a few seconds to loosen them. Repeat frequently when the hands or arms tire from activity. Neck and Shoulders. Sit upright and place the right hand on top of the left shoulder. Hold that shoulder down and slowly tip the head down toward the right. Keep the face pointed forward, or even turned slightly toward the right. Hold this stretch gently for five seconds. Repeat on the other side. A second exercise requires standing in a relaxed position with the arms at the side. Shrug the shoulders up, then squeeze the shoulders back, then stretch the shoulders down, and then press them forward. The entire exercise should take about seven seconds. General Exercise. A regular exercise regimen using a combination of aerobic and resistance training techniques strengthens the muscles in the shoulders, arms, and back, helps reduce weight, and improves overall health and well-being. Some experts have reported that people who are physically fit, including athletes, joggers, and swimmers, have a lower risk for cumulative trauma disorders. People with any chronic medical condition or with risk factors for heart disease should check with their physicians about an appropriate regimen.

1. 
   lonecat | Jul 12, 2001 08:54pm | #4

   *Like the others here, I have just had to modify my habits a little. Sheet rock finishing is about the worst, I just don't do it for as many days in a row as I used to. When finally driven to seek medical attention, don't consider surgery without a second opinion. Now that I am older and lazier I am kind of outgrowing the problem.

1. 
   piffin_ | Jul 12, 2001 10:24pm | #5

   *Vitamins-Broad spectrum B complex but high doses of B-6 and B-12. This helps nerve irritation.Add Salmon oil and/or Omega 3 or cod liver oil plus flax seed oil. This helps both cholesterol and the cartilage inflamationcayenne helps circulation which promotes healing.

2. 
   Mike_Willms | Jul 13, 2001 05:52am | #6

   *Best cure? Time off... Had it so bad once I couldn't sleep through the night. Had to get up and walk around for 1/2 hour before I'd get the feeling back in my hand. Doctor gave me meds and a splint. Didn't do didley for me. Took 2 weeks off at Christmas, completely went away. I don't think there's any evidence of this, but I believe stress can be an aggravating factor as well. Your body is basically telling you to slow down. For a while, anyways....

3. 
   RJT_ | Jul 13, 2001 06:01am | #7

   *Bananas. I think because of the potassium.

4. 
   splintergroupie_ | Jul 13, 2001 07:53am | #8

   *CTS is caused by a too-small carpal tunnel, the space between the tough ligament at the base of the palm and the bones of the wrist, for the enlarged tendons and the weaker, strangled nerve(s) to get through. The nerve most immediatey affected inmost people is the one feeding the tumb and first two fingers, though the one feeding the outside two fingers can be affected as well. If you don't treat it some way, you can suffer permament numbness and inability to hold things. I had both wrists done in 1985 with good results, though i had a bit of flare-up last year when i did a lot of nailing, so i bought a bunch of air nailers, which helped immensely. I don't know why i didn't think to just stop working...maybe the mortgage payment...anyway, leisure wasn't an option, so the splints (they made me some of form-fitting Plaster of Paris) got me through my busy season so i could sleep at night for three months until i could have the surgery in winter. The splints might not solve the problem entirely, but they take out the aggravation of the flexor muscles overcoming the extensor muscles while you sleep, causing the hand to curl over and the nerve to be crushed. If you want advice on the B-6 treatment, acupressure, exercise or icing therapy, go to a licensed or reputable naturopath (flee is he/she tries to get you to wear a crystal...) because the docs poo-poo low-tech/low-profit treatment. I have small wrists and a large workload so i decided to do the surgery after five years of near-constant pain, but i know several people who have avoided surgery by not doing repetitive tasks and using one or more of these therapies.Unless you have someone to help you, i strongly advise against getting both done at once! My surgeon got a bit overzealous and sliced the nerve sheath to release the nerve (no ne else i talked to ever heard of such a thing..), so it was three weeks before i could turn a doorknob, but most folks take about 5 days to get back to even. A normal scar is about 34" long at the base of the palm.

5. 
   chanle51 | Jul 13, 2001 07:40pm | #9

   *My, you must have big hands. Glad the surgery helped.

6. 
   splintergroupie_ | Jul 13, 2001 07:47pm | #10

   *I was wondering..what the...? OK, 3/4" long scar...

7. 
   Chris_Koehn | Jul 14, 2001 03:42am | #11

   *What a great spectrum of advice. I too have small wrists- which I suspect is part of my problem. Shoulda stayed in law school- on second thought..naw..Wonder how carpenters dealt with CTS 100 years ago- when everything was done by hand?

8. 
   L._Siders | Jul 14, 2001 08:18am | #12

   *I had the right wrist done in 1989 and the left wrist done in 1991. I haven't had any problems since. If it is left untreated you can have perminant nerve damage. I think they now scope the carpal tunnel to disect and remove excess tissue and recovery is not as painful. The problem also may come back. I really don't know how herbs and spices can cure carpal tunnel. I have also heard of that sore arms and hands can be caused by a pinched nerve (nerve to the arm and hand) under the arm pit at the rib cage.

9. 
   Courtney_Ostaff | Jul 15, 2001 03:29am | #13

   *My bf has carpal tunnel, and severe nerve damage in his right hand from an unrelated item - he sleeps with those cheap ($15 to $20) splints on both hands, on his stomach, with his forearms tucked underneath his chest. Weird, but it works for him. Also, he does hand exercises (like with those 'squishy' balls). About 100 per hand per day. The nerve is underneath the wrist, so when it's really bad, if you pull the top of your hand towards your chest, that will help alleviate the immediate pain. I massage his hands and wrists a lot too. He makes his living with his hands and he literally can't afford to take the time off to get the surgery - tip, make sure you get experienced board-certified orthopedic surgeons. He also takes cod-liver oil, calcium, Vitamin C, and zinc every day. Helps absorb potassium, which helps keep your nerves in good health. If it's painful to mouse click, you might buy a cheap touchpad, http://www.pagecomputer.com/cgi-bin/prodinfo?cd=04&pn=FEL00251 like laptops have....easier on your wrists. And get used to the splints. http://www.bluelight.com/store/ProductRedirect.jhtml?lt=nt&PRODID=3412628&ACAT=3282639

10. 
    Ralph_Wicklund | Jul 15, 2001 05:32am | #14

    *I've had the nerve conductivity tests and they show practically zero conductivity to both my thumbs, forefingers and middles. The other two are OK. I still don't understand, if that's the case, why I can still feel and have total use of my hands. The tests were done because of the numbness and pain that extended from the tips of my fingers and right up my forearms. So bad at times that I was up half the night. Had some deep neuromuscular massages and some visits to a chiropractor, recommended by someone who had similar symptoms, and my middle of the night pain episodes have ceased. It looks like CT is blamed for problems caused by other than repetitive hand/wrist/arm motion such as heavy lifting, especially over the head, and other activities that could cause trauma/pinching of the nerves as they exit the spine and make their way down to the fingertips.

11. 
    splintergroupie_ | Jul 15, 2001 05:54am | #15

    *I had referred pain in my biceps that felt like someone was stabbing them with an ice pick--i would wake in tears with the pain as soon as i went to sleep and my hands curled over like i described. I was told by the first doctor i went to that i shouldn't try to do "men's" work, so the condition went undiagnosed for five years. The splints took care of the referred pain, though i've heard of it occuring in shoulders, elbows, back of arm--maybe it depends on what action caused the problem in the first place, or how each person is constructed and wired. CTS is even more aggravated if you add vibration to the gripping operation, like running a chainsaw or, in my case, belt and orbital sanders.My employee last year had CTS before she got to me, didn't even know what it was, so i made some splints for her out of 1/8" Baltic birch ply and gave her some vet wrap to hold them on. Vet wrap is a type of material like an athletic bandage, but it sticks to itself and not to your skin, is reusable, and of lighter weight; you can get it in places like saddle shops and feed stores for a lot less than it sells for at a pharmacy.

12. 
    JIm_R | Jul 15, 2001 05:56am | #16

    *As a physician who treats CTS (Carple Tunnel Syndrome) frequently, I would recommend the following. See your doctor. I think it is reasonable to start out with a good Internal Medicine Physician (they have no vested interest in recomending surgery). The first step is to perform a good neurologic exam to make sure that there is no sign of loss of muscle strength. Severe CTS can eventually cause irreversible nerve damage and permanent muscle weakness. If there is no evidence of more severe disease, I usually start out with wrist splints, worn at night primarily. In many cases, mild to moderate symptoms can be controlled with these simple devices. Anti-inflammatory agents can occasionally be of benefit (over the counter and perscription). Occasionally, cortisone injection can be of benefit. Forget the vitamins, supplements, etc..If someone has symptoms that are progressing despite these simple measures or if they have any evidence of neurologic damage, I order an EMG. An EMG is a nerve test that tells if in fact the problem is CTS - (other neurologic problems can cause similiar symptoms) and also will measure the severity of the CTS. If the test shows severe CTS, I refer the patient to a qualified orthopedic or neurosurgeon. The current surgical technique is usually a laparoscopic nerve release (made with very small incisions and a small fiberoptic tube). Most patients have excellent results and the recovery time is usually short. From my experience, if the patient has CTS in both hands the surgery is usually done one side at a time.I have seen many cases where patients waited too long to seek treatment and ended up with permanent nerve damage. On the other hand, the majority of patients can be controlled with non-surgical measures. Again, I think it is prudent to discuss this with your doctor.

13. 
    splintergroupie_ | Jul 15, 2001 06:00am | #17

    *JIm R:Maybe you could answer a question for me. I've had some tingling the last couple years, not bad, but i was thinking i might someday have to have the treatment done over. I've heard tell that the release can't be done again, however. Can you tell me if it can, and if there are any complications of doing it twice?

14. 
    Thooks | Jul 15, 2001 06:03pm | #18

    *I had both hands done last Friday- 7/6/01 and we stopped at Chili's on the way home and I ate lunch. I am getting some strength back now and expect to be back about 90% by next week. Two small one-stitch incisions, splints for 24 hours and ice pack for about 4 days. I am a CAD operator, have been for 11 years. I went back to work monday. Have the surgery done and get over it.

15. 
    JIm_R | Jul 15, 2001 07:07pm | #19

    *I can't recall having seen anyone have to have surgery a second time but I certainly think that it could happen (ie. recurrent compression of the nerve from scar tissue, inflammation, etc.). Once again, an EMG should be able to document if it fact the cause of the numbness is recurrent CTS and the degree of the problem. If it were me, it would have to be causing quite severe symptoms (or loss of muscle strength) before I would consider a second surgery. I bet a second surgery would be more challenging due to the scar tissue from the first surgery (but I am sure it is possible).As a side note, one clue as to whether or not it really is CTS is whether the little finger goes numb. The median nerve (the nerve compressed in CTS) does not supply the little finger. If the little is involved it often is a different problem.

16. 
    splintergroupie_ | Jul 15, 2001 07:30pm | #20

    *Thanks, JIm R. I do pretty well with it just woodworking, but it flares up when i do heavier work, e.g. remodeling. Muscle strength no problem, just the incipient tingling for now. Also, one can use vibration-dampening gloves. I have a pair with jelly-like stuff in the palms i can use for activities like splitting wood that are very jarring. Other times i use the yellow, rubber-covered, knit gloves so i get the same effective grip on a tool handle without as much effort.There is a good article with a great drawing of a hand and its parts in Fine Woodworking #105, page 76.

2. 
   Chris_Koehn | Jul 15, 2001 07:30pm | #21

   *
   I've been deconstructing a barn (read: lots of nail pulling and assorted banging motions) which has caused a 12 year case of re-occurring carpal tunnel to flare up in a way it never has before. Last night I hardly slept from the discomfort of my hands going numb. After 12 years of nursing it and hoping it will go away, I'm now ready to admit I need to be more proactive about treating this curse. Looking for real world experiences in treatment- splints, vitamins, acupuncture (highly recommended in some circles), and last- surgery. Thanks!