Dr. Jeffrey Greenberg, an orthopedic hand surgeon at the Indiana Hand Center and a spokesman for the American Academy of Orthopaedic Surgeons, discusses carpal tunnel syndrome.
Question: What symptoms suggest you have carpal tunnel syndrome?
Answer: Carpal tunnel is a condition that causes numbness and tingling of the fingers of the hand. Classically, it involves the thumb, index finger, middle finger and the half of the ring finger that's closer to the thumb. It's caused by pressure on the median nerve, which runs in a relatively confined space at the wrist that also holds the nine tendons that bend your fingers.
One reason we think people get carpal tunnel is that the lining of the tendons becomes thicker, and that puts pressure on the nerve. There are many conditions that can cause that: age, diabetes, an underactive thyroid, pregnancy and inflammatory conditions like rheumatoid arthritis. The majority of people have idiopathic carpal tunnel in which we can't find an underlying cause.
Q: Is it more common today?
A: I think we're diagnosing it a lot more frequently, but I'm not sure that the frequency in the population is any greater.
There are some job activities that we do know can cause it, where vibration is generated and translated to the hand, like drillers, grinders, people who use power washers and weed eaters.
Q: How do you treat this?
A: The first thing we try to do is identify if a particular activity is causing the symptoms. With vibratory stimulation, we'll sometimes use a specially designed glove that has material in it to dampen vibration. We'll also use splints and injections of medicine, like steroids. The ultimate treatment, which is very effective, is surgery.
Q: Does technology play a role?
A: There's nothing scientific that shows that carpal tunnel is directly correlated to the usage we would typically associate with it, such as computer or keyboard. A recent study looked at computer programming and office work. We don't have any scientific evidence that shows those things cause carpal tunnel syndrome.
There is some evidence from epidemiological studies that shows other factors are more important, such as age, race and genetics. From an epidemiologic standpoint, these factors were twice as strong as repetitive hand use.
It's an interesting thing that we're learning. We have this entrenched in our society, if you work on a computer, you're going to get carpal tunnel, whereas there are other factors.
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