Do I Have Carpal Tunnel?

July 30, 2008 8:29:08 AM PDT
According to the Neuropathy Association, more than 20 million Americans are affected with neuropathy -- more specifically, peripheral neuropathy. Peripheral neuropathy is a disorder of the nerves that connects the spinal cord to muscles, skin and internal organs. It often causes numbness, weakness, tingling and pain, especially in hands and feet. Among the many causes of this disorder are diabetes, injury, systemic diseases, infections, autoimmune disorders and inherited forms of peripheral neuropathy. One of the most well-known types of neuropathy is carpal tunnel syndrome (CTS). According to the American College of Rheumatology, CTS affects between four and 10 million Americans. The United States Department of Labor has cited CTS and other cumulative trauma disorders as accounting for 48 percent of all industrial workplace injuries. CTS is essentially compression of the median nerve, which runs from the forearm into the hand. Symptoms of CTS include numbness, burning, tingling and itching in the hand and fingers. In advanced cases, the muscles at the base of the thumb may waste away. Initial treatment of CTS involves resting and immobilizing the affected hand and wrist. Treatments in special cases include drugs like pain relievers and steroids, stretching and lengthening exercises, acupuncture, chiropractic care, yoga, and for advanced cases, surgery.PEOPLE AT RISK: Carpal tunnel syndrome, although usually caused by a combination of factors, often affects individuals who have a job that requires repetitive motion with the hand; however, contrary to popular belief, CTS is not the plague of those who work at a keyboard all day. In fact, carpal tunnel syndrome is three-times more common among assemblers than among data-entry personnel, according to the National Institute of Neurological Disorders and Stroke. In addition, women are three-times more likely than men to develop the syndrome. If you work at a job that involves manufacturing, sewing, cleaning, finishing, or fish packing, you may be at a high risk for developing CTS.

TRADITIONAL METHODS OF DIAGNOSIS: One way to diagnose CTS is through electromyography (EMG). This method involves inserting a needle electrode into muscles in the area of concern, reading electrical activity on a screen, and listening to the activity through a speaker. While electromyography is critical for the evaluation of muscle diseases, electromyography also helps in the assessment of nerve diseases since nerve problems will frequently affect the muscles in specific ways. EMG can be uncomfortable and even painful because of the needle insertion. Another way to screen for CTS is through nerve conduction velocity (NCV), which uses electrodes to test of the speed of signals through a nerve. Although the NCV test can be uncomfortable, it lacks the pain and soreness resulting from EMG.

ANOTHER KIND OF TEST: The NC-stat test is a portable electrodiagnostic test that screens for neuropathies like CTS. The test is manufactured by NEUROMetrix, Inc. and measures neuromuscular signals that are useful in the diagnosis and evaluation of nerve entrapment affecting functions of the hand. The test is painless and results are available in about five minutes.

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