If you suffer from burning pain in half or full hand up to arm and shoulder and the pain is severe enough to impair normal work or sleep, seek medical attention. Such pain is likely to result from a condition known as the carpal tunnel syndrome. ‘Carpal tunnel, is the portion at the base of the hand, where the tendon of the flexor muscles of the hand along where small bones are located. The pain occurs due to compression of a nerve called ‘median nerve’ as a result of repetitive movements of hands while working on computers, cutting and writing for long hours. The problem could also develop after bending when making a bad particularly for heavy mattresses that have to be moved or lifted. Although this syndrome affects both genders, women suffer 3 times more than men especially those more in the middle age. This is because the carpal tunnel of women is small anatomically as compared to men, hence subjected to stress more readily, making them more prone to suffer. The problem usually starts after a person has been doing some work involving repetitive movements of hands a practice that mostly occurs in middle years of one’s life. With passage of time and continuation of the same work, symptoms increase in severity. Along with pain, an individual can feel abnormal sensations like tingling or shock especially in the affected part. Eventually, the affected part gets swollen and starts to feel numb. These symptoms may last for few minutes to an hour or so. But overall they are very disturbing in nature. As a result of this recurrent pain, normal work is hampered. Other musculo-skeletal conditions that can contribute to the carpal tunnel syndrome include rheumatoid arthritis, muscular-skeletal stress, osteoporosis, trauma, disease of the blood vessels supplying blood to the limbs among others. Typical features can be used to diagnose carpal tunnel syndrome easily. It can be differentiated from other conditions causing similar symptoms by tests like electrophysiological studies of the nerve and its conduction. Before entirely addressing this problem, giving rest to the hands after working for an hour or so is a good strategy to prevent occurrence of carpal tunnel or retarding its progress. While doing any work involving movements of the hands, a person should try to give pauses of few minutes to the hands. Also splinting of the affected hand provides more respite in the pain. While splinting, the hand should be placed in a position which is most comfortable especially after work.This gives rest to the affected hand and reduces pain and abnormal sensations. Local injection of corticosteroids are also used to provide relief. The relief may last from weeks to months depending on restart of the activity/activities causing carpal tunnel and its frequency. These conservative measures help if adopted within 10-12 months of commencement of problem. If symptoms are severe and persistent in spite of the measures, definitive treatment may require of surgery. In this, the carpal tunnel is opened up and enlarged which gives much relief to the patient. But this is a major surgery associated with its potential hazards like infection, accidental damage to nerves causing paralysis. Therefore once the features develop an individual should try to prevent aggravation of the condition. Good nutritious food abundant in vitamins B1, B6 and B12 will keep the nerves of the body strong and help in minimizing the damage caused to the nerve as in carpal tunnel syndrome. Whole grains, cereals, dried beans fortified bread, nuts, cereals, fish, eggs, white meat, are helpful in this regard. Regular exercises of the joints of hands will also be useful. Dr Rachna Pande, specialist internal medicine – Butaro HospitalE-mail-rachna212002@yahoo.co.uk
