How do you know if you have carpal tunnel syndrome?

Question

I have pain in my right wrist that comes and goes. some days are worse than others and some days it doesnt hurt at all. It is right at the pulse point on my wrist, and hurts when I try to lift or make a pinching motion with my thumb and 1st and 2nd finger. Any ideas? I saw a doctor today and she thought maybe arthritis or tendinitis, but made no mention of CTS. I was prescribed Naproxen and a wrist splint. Should I get a second opinion?

Answer 1

CTS can be confirmed with a nerve conduction study (EMG). Arthritis is typically the first thing that a physician will rule out but she should have taken x-rays of your hands which would easily confirm/disprove that diagnosis. Use of splints and NSAIDS (anti-infalmmartories) such as Naproxen can afford a patient some relief.

Typically, CTS starts with aching pain or numbness and tingling to the hand, wrists and fingers. It usually increases from there and can involve the entire arm, weakness and loss of grasp.

I would highly advise you to request an EMG to rule out CTS ASAP as the sooner you have an accurate diagnosis, the sooner you can take steps to avoid surgical intervention. If you do not have a primary care physician who can make a referral for you, you may wish to seek the assistance of a hand specialist, orthopedic physician or neurologist.

Good luck!

Answer 2

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RE:
How do you know if you have carpal tunnel syndrome?
I have pain in my right wrist that comes and goes. some days are worse than others and some days it doesnt hurt at all. It is right at the pulse point on my wrist, and hurts when I try to lift or make a pinching motion with my thumb and 1st and 2nd finger. Any ideas? I saw a doctor today and...

Answer 3

Yes, get a second opinion. If you do that sort of work that motions the same . Naproxen is good for some people but it didn't do me any good, so I had to have them change mine. Your hands may start to get worse. The only thing I can see, if see gave you a splint and that medicine it sounds like you have CTS. Was this a company doctor? If so, get checked by your own doctor. They don't like to say workers comp. Plus make sure you keep all your documents together.

Answer 4

Your symptoms indicate a neurologic problem involving the abduction of the thumb and fingers you mentioned.. Be aware, there are several carpal bones in the wrist (9). Any one can move out of position and create pressure on the nerves to the hand. The bones can be easily reduced and take the pressure off the nerve, as well as stop the pain. You will find tenderness on the most prominent of those bones.. If you are unable to reduce it yourself you may find a chiropractor, very adept at doing this for you.

Answer 5

The wrist splint should help. I had surgery on my right wrist/hand for carpal tunnel syndrome. When you have it your fingers and hands will start to go numb...sometimes from the elbow all the way down to the fingertips.Wearing the splint will help keeping it from getting worse.If it turns into CTS you will know because it will hurt all the time and you'll start getting alot of weakness in the hand and wrist.Of course, you don't want to wait for it to get as bad as I did before you get it taken care of.

Answer 6

Carpal Tunnel usually starts with numbness and tingling in the palm, thumb, pointer,middle and some times the ring finger. If not treated it begins to ache and feel like electric shocks in your wrist and hand. It is much worst at night to the point that you can't sleep because of the pain and burning. Your hands go numb and the palms burn like if you would hold your hand over fire, also your thumb and the muscle connecting it to your wrist cramps severely. You also have shooting pains from under your thumb to your elbow and into your shoulder. Your elbow and shoulder aches. You begin to loose strength in you hand also. I was diagnosed recently. Mine came on suddenly after painting a couple of rooms in my house. My doctor put me in splints and has me on Neurontin ( a seizure medication used for nerve pain) and Zanaflex 3 times a day (muscle relaxer) He said If it is not much better in 1 month I will need to go to a neurologist for a nerve conduction test. If your not having symptoms at night its most likely not CTS. Hope this helps.

Answer 7

It sounds to me like you have carpal tunnel...My fingers use to get numb, or tingle., alot of times there was pain, I finally got to the point where I was dropping things. I'd see another Doctor.. many
times you can get a cortisone shot and it will clear right up....
But if there has been to much damage to your hand, you will need
surgery..its all done with lazors now...recovery time is fast..
good luck to you...

Answer 8

Naproxen (store brand Aleve) is an excellent NSAID (nonsteriodial anti-inflammatory drug); I used it for many years. Make sure to take extra water because it is a dehydrating medication, this will affect your bowel movements over time and it could even damage your teeth unless you brush and floss. The reduced water level will dry out your feces and your mouth. If that happens then you can get constipation, or tooth decay since your saliva doesn’t wash off the tartar. These are two long-term effects of taking NSAIDs that no doctor every told me until it was too late.

The principle reason that Carpal Tunnel hurts is because there is a swelling of the connective tissue inside the wrist bones. Motrin and Naproxen are the two primary medications used to treat it. All the other medications are prescription only and less commonly used—so they are more expensive.

The wrist splint should angle your wrist to avoid the swelling in the connective tissue that causes Carpal Tunnel. If the splint works then it can confirm that you have the disease, it will also help with any tendonitis. Tendonitis is simple over strain or actual damage to the tendons, but the tendons heal faster than bones do. Arthritis will actually create damage in the bones and cartridge areas so x-rays taken over time will determine that. Closer exams like a CT or an MRI can confirm this. In the mean time the Naproxen will help all the possible conditions. So you are receiving the proper treatment, in an attempt to narrow down the condition that you are suffering from. It is very hard to diagnose Carpal Tunnel Syndrome since the damage is actually inside the 8 bones of the wrist. That makes it next to impossible to treat as well.

If you want a second opinion then you can get one, but your doctor seems to be giving you the proper treatment, right now. It is going to take a few weeks of wearing that splint to know for sure, and then it might take a few months to rule out arthritis. The diagnosis of Carpal Tunnel Syndrome is one of exclusion, so the other possibilities have to be ruled out first. My road to my own diagnoses was longer, and more painful. If the Naproxen doesn’t work, then you could try Motrin, but if that doesn’t work then it could be something else more complicated, like what I have. If the Naproxen or the Motrin don’t help then ask the doctor about Tramadol (brand name Ultram); this is a very safe non-narcotic medication that can be taken for years (I have been on it for almost a decade).

In my long history of illness I was suspected of having this disease. I was given a nerve conductivity test once; it is just like hooking up a car battery to two needles and putting one in your upper arm while the other needle is inserted somewhere on the lower arm, and the procedure is repeated several times. Then the neurologist measures the current flow to determine if your nerves are conducting the electricity well. If you have Carpal Tunnel or nerve damage then the test will show it. The test is painful, but compared to the pain I had at the time it was a minor problem (by the way the doctor said I had some very fast nerves).

I have also had a radiological exam of my hands, a few MRIs, a CAT Scan, and I have seen over 100 doctors. If you need advice in this area then I could help, contact me via my Avatar.

In the meantime I have some other advice:
Carpal Tunnel syndrome is caused by a narrowing of the space in the connective tissue in the wrist joint. This is caused by over use of the wrist, which creates a pressure on the nerves and tendons. This narrow gap is caused by a very minor gene abnormality or just plain over use and improper use of the hand. It is considered a form of Arthritis and handled by a Rheumatologist. The carpals are very small bones that form interlocking joints that make a wide range of motion possible.

According to Wikipedia: http://en.wikipedia.org/wiki/Carpal_tunnel
“In the human wrist there is a sheath of tough connective tissue which envelopes and protects one nerve (median nerve) and tendons, which attach muscles to the wrist and hand bones. The carpal tunnel is the space between this sheath (above) and the bones (below) making up the wrist and hand (carpal bones). The term 'carpal tunnel' is also used quite commonly to refer to 'carpal tunnel syndrome' which is a condition where the median nerve is pinched within the tunnel and causes pain and/or numbness of the wrist/hand, once thought to be a result of repetitive motion such as painting or typing.”

Check out Wikipedia: http://en.wikipedia.org/wiki/Carpals
Look at the gray and color image to see just what 8 bones are involved. The wrist needs these flexible joints so it can run the nerves and tendons through the bone. If a ball-and-socket joint were used, like it is in the shoulder, then the tendons would get resistance and not the mechanical advantage required to give us our flexibility.

The best way to treat it is to use surgery to relieve the stress, or to make the channel in the bone larger. This is also the most drastic way to treat it and the most expensive. More often than not the risks of surgery are not worth it. Since any damage to the nerves is can result in chronic pain, loss of sensation, or even paralysis. Microsurgery inside the carpel bones is possible, but very difficult to do, and still a little experimental.

The next best way is to use a splint to keep the joint from bending, or to find a way to reduce the stress on the joint. It can be painful to wear that splint though (I know from experience), and take anti-inflammatory medications like Motrin or Aleve. Aspirin will not help; it works by breaking apart the blood platelets. In the case of a headache this can increase the blood flow to the region. It doesn’t handle inflammation very well though. Vitamin B6 could help with the inflammation or the pain, but it is not a cure, only a treatment.

Make sure you have the proper diagnoses. I was diagnosed with Carpal Tunnel Syndrome for a while until the pain spread to other joints and became more serious.

Prednisone is a powerful pain-relieving steroid that can be useful for the short term. It causes drastic and violent mood swings and bone necropsy over a longer period so I don’t recommend it (I was on it several times, Once I developed a spontaneous nose bleed another time I developed such and angry temper that my friends couldn’t believe me. It also caused me boughts of fear and sheer unreasonable terror reactions—very dangerous stuff.) You never know just what prednisone will do so I would use it very sparingly and only occasionally, however it is the cheapest and best pain relief I have ever used.

Carpal Tunnel is a life long condition; it will always crop up again and again. You need to relieve the stress on the wrist. Get a keyboard wrist support and thing about buying an ergonomic keyboard. Now days keyboards are universal so you can use one on your work computer without any problems (still I would contact the computer pro, at work, to make sure the proper drivers are installed on your computer, not on the network, and that they know you are doing this. Take frequent breaks from typing and try to avoid putting stress on the wrist joint.

Check out
The National Institute of Neurological Disorders and Stroke: http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm
Medicine.net: http://www.medicinenet.com/carpal_tunnel_syndrome/article.htm
About.com: http://arthritis.about.com/od/carpal/
Familydoctor.org: http://familydoctor.org/023.xml
EMedicine Health: http://www.emedicinehealth.com/carpal_tunnel_syndrome/article_em.htm
American College of Rheumatology: http://www.rheumatology.org/press/2005/carpaltunnel0205.asp

Beware of the scams though. If it sounds too good to be true then it probably is. Nothing will cure Carpal Tunnel Syndrome unless it increases the size of the channel inside the bone itself. Any topical treatment will be just as good as using something like Ben Gay (which contains the same pepper in mace, it causes an increased blood flow that can take fatigue poisons out of the area). These will be a temporary solution at best; they don’t treat the root cause or cure the behavior that caused the condition in the first place.

The only CURE for Carpal Tunnel Syndrome is surgery. The only way to PREVENT it is to use a wrist support, or an ergonomic keyboard, or other such devices to relieve the stress. You can use a wrist splint to TRAIN your wrist not to move in the improper positions. There are many ways to RELIVE THE SYMPTOMS including drugs, acupuncture, and topical treatments, but they don’t cure the problem; they only provide a temporary solution.

Answer 9

I don't think either of those things can. It's caused by repitive physical movements and it usually affects the wrist.

Answer 10

only a doctor can tell for sure as it can also be the onset of arthritis good luck