Global Health Asia-Pacific Special Issue - Page 12

You Ask , They Answer

Q

: What ’ s carpal tunnel syndrome and what are its tell-tale signs ?

A

: Carpal tunnel syndrome is often caused by pressure on the median nerve . When the median nerve is compressed , symptoms may include numbness and tingling , and patients with the syndrome may also experience weakness in the hand and arm .
Repetitive hand motions may also contribute to carpal tunnel syndrome . Additionally , performing activities that involve extreme flexion or extension of the hand and wrist for a prolonged period of time can also contribute to increased pressure on the nerve .
Health conditions such as diabetes , rheumatoid arthritis , and thyroid gland imbalance may also play a role as conditions associated with carpal tunnel syndrome . Conditions such as rheumatoid arthritis have an inflammatory component that can affect the lining around tendons in the wrist and put pressure on the media nerve .
Certain conditions , such as menopause , thyroid disorders , kidney failure , and lymphedema may increase the chances of carpal tunnel syndrome .
Working with vibrating tools has also contributed to harmful pressure on the median nerve or worsened existing nerve damage .

Q

: What are the non-surgical treatments available and how effective are they ?

A

: It ’ s important for patients experiencing the syndrome to immediately consult an orthopaedic consultant to prevent effects to go on for a prolonged period . Non-surgical treatments include braces that are generally best when one is experiencing mild to moderate carpal tunnel syndrome .
Patients with the syndrome are also encouraged to tweak their activities by taking 10-15 minute breaks every hour and to stretch their hands . They should also try to alternate which hand they use for their tasks .
They should be sure to also watch their posture and try not to roll the shoulders forward .

Q

: When is surgery recommended and what are its benefits and risks ?

A

: There are two main types of carpal tunnel release surgery — open and endoscopic . In both cases , the doctor cuts ligament around the carpal tunnel to take pressure off the median nerve and relieve the symptoms .
An open surgery involves a larger cut , or incision , up to two inches from the wrist to the palm .
In an endoscopic surgery , the surgeon makes one opening in the wrist . These cuts are smaller , about a half-inch each , and they then place a tiny camera in one of the openings to guide them as they cut the ligament .

Q

: Can people prevent carpal tunnel syndrome ?

A

: There are no proven strategies to prevent carpal tunnel syndrome , but basic steps include minimising stress on the hands and wrists through reducing forces while gripping and adjusting their daily routine .
Patients should also be sure to alternate between activities or tasks to reduce strain on the hands and wrists .
Dato ’ Dr Badrul Shah Badaruddin
Dato ’ Dr Badrul Shah Badaruddin is a consultant orthopaedic , arthroplasty , and sports surgeon at ALTY Orthopaedic Hospital in Kuala Lumpur .
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