Are you a computer gamer who plays 24/7? A secretary who uses the computer 8 hours daily? Do you surf the internet for long hours? Well, let me tell you about a health problem that is common among these types of people. The Carpal Tunnel Syndrome!

What is CTS or Carpal Tunnel Syndrome?

Carpal tunnel syndrome or CTS is an injury arising from impingement or compression of the median nerve within the carpal tunnel which results to various signs and symptoms.

What are the SxS of CTS?

Signs and symptoms that are common to carpal tunnel syndrome are the following:

* Paresthesia - this is one of the most common symptoms present in CTS. Paresthesia is defined as an abnormal sensation which is felt like the palms are being pricked by pins and needles or the "pins and needles" sensation in layman's terminology.

* Numbness - This is usually felt in the most distal aspect or at the tips of the palmar aspect of the fingers.

* Pain - pain are usually felt in the distal fingers but in severe cases, the pain may even be referred to the forearm.

* Muscle weakness - muscle weakness affects the muscles with median nerve distribution like the long flexors of the fingers ( flexor digitorum superficialis and profondus) and most of the thumb muscles.

- All of these symptoms are more pronounced at night and upon waking up since most people tend to bend their wrist in their sleep. Bending of the wrist causes more compression of the median nerve inside the carpal tunnel. The distribution of these symptoms commonly affects the lateral side of the palmar aspect of the hand and also includes the entire thumb, index and middle finger and the lateral one-half of the ring finger.

What causes Carpal tunnel syndrome?

Carpal tunnel syndrome is usually caused by compression in the hand due to trauma (example is Colle's fracture, lunate dislocation). This can also be caused by inflammation of any of the nine tendons inside the carpal tunnel. Arthritis can also lead to Carpal Tunnel syndrome. 20 percent of pregnant women experience this problem. Repetitive manual labor or activities which cause the heel of the palm in constant pressure can cause this problem also. That is why this problem is common on typists, computer gamers and other computer related job.

How can we prevent CTS?

Prevention is better than cure! If you are a gamer or a typist, a rest period every two hours is needed. During this rest period, you can shake your hand and do some mild stretching to improve blood circulation in the hand.

How is CTS diagnosed?

Orthopedic doctors or physiatrists usually diagnose this problem. Specialized tests like the Phalen's test are done during evaluation. During this test, the doctor will ask you to bend both of your wrists downward with fingers pointing to the floor. You will then be asked to push your wrist together with the back part of the hand in contact with each other. If the symptoms worsen after during this test, then you are positive for the test which indicates that you may be suffering from CTS.

Another diagnostic test is a test called nerve conduction velocity test or electromyography. In this test, the speed of conduction of the median nerve compared to the other nerves in the hand. In the presence of injury or impingement on the median nerve, the conduction velocity is slower compared to the other nerves of the hand.

How to treat CTS?

Medical management includes anti-inflammatory drugs to lessen inflammation and local steroid injections to provide local relief.

Physical therapy and occupational therapy are also beneficial for this problem. Physical therapy usually manages the symptoms like pain, paresthesia, weakness, numbness through application of modalities such as hot and cold packs, electrotherapeutic machines and exercises. Occupational therapy focuses on return to work exercises and help with work space adaptation to prevent recurrence of the injury. This includes proper ergonomics, adaptive keyboard designs and others.

If the treatments above did not work or were not successful in relieving the symptoms, then the patient can undergo surgery. The surgical procedure is called Carpal Tunnel Release. In this surgery, the transverse carpal ligament which forms the roof of the carpal tunnel is divided into two to provide compression relief to the median nerve. Success rate for this kind of surgery is very high and leads to long term recovery of the patient.