Steemit Learning Challenge-S22W1; Carpal Tunnel Syndrome
AssalamuAlaikum & Greetings Everyone!
AssalamuAlaikum & Greetings Everyone!
It's me @amjadsharif
From #pakistan
From #pakistan
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Q.1 - What's carpal tunnel syndrome? Write in your own words after getting knowledge from the lesson post.
Carpal Tunnel Syndrome (CTS) is a give wrist and hand conditions that occur due to the compression of the median nerve. This nerve lies in the carpal tunnel of the wrist and is involved in sensation of part of the fingers and the thumb as well as fine manipulative movements of the fingers involving gripping. When this passage becomes constricted or swollen, leading to discomfort, pins and needles sensations and even paraesthesia.
Several types of job-related carpal tunnel syndrome include: 1) mill type and production line workers, 2) packagers and assemblers, 3) clerical and typists, 4) healthcare professionals and surgeons, and 5) musicians and artists.
Mild CTS:
Symptoms can be occasional pins and needles, sensations of cold or a feeling that something is just slightly uncomfortable.
They are more apparent during night or with fatigue arising from repetitive movements in the wrist.Moderate CTS:
They manifest more often and cause disability in writing, typing, or gripping, for instance.
It has more pain and weakness.Severe CTS:
Chronic pain, paraesthesia and muscle myasthenia.
Atrophies of the hypothenar muscles and thenar muscles may develop, particularly in the hypotenar eminence, which may suggest that damage to the nerve has reached an intermediate stage.Secondary CTS:
This type is attributed to other complications like diabetes, hypothyroidism or arthritis. Management of the conditions may help to resolve CTS symptoms.
Causes of Carpal Tunnel Syndrome
Several factors contribute to CTS, including:
- Repetitive Wrist Movements: Any occupation that requires typing, knitting or playing musical instruments may come in contact with the tendons thereby narrowing this canal.
- Health Conditions: Some of the conditions the place one on this group are diabetes, rheumatoid arthritis, pregnancy, and obesity.
- Wrist Injuries: The conditions which can cause problems include breaks, sprains or, if the tissue around it becomes inflamed; this places more pressure on the median nerve.
- Genetic Factors: Admittedly, when a person has superficial carpal tunnel then their chances of getting CTS are higher.
Based on the above explanation, principles of assessment for carpal tunnel syndrome includes Symptoms.
They include the following:
The symptoms of CTS typically start gradually and worsen over time:
- Tingling and Numbness: Sometimes it develop on the palm area with symptoms involving the thumb, index and middle fingers. The symptoms may develop at night, in the morning upon waking or during early morning.
- Pain: May be felt in the wrist itself, or extend upwards along the forearm and even the shoulder.
- Weakness: Like trying to pick up a glass or button a shirt, buckle a shoe or turn a key.
- Swelling Sensation: Swelling of the wrist though may not be apparent and have a sensation of stiffness of the joints.
Diagnosis of Carpal Tunnel Syndrome
To diagnose CTS, healthcare providers may perform:
- Physical Examination: Feeling for any lumps, a tendency toward bulge, hint of loss of muscle tone, or impingement upon nerves.
- Phalen’s Test: Sometimes the patient simply moves the wrist for a short period to see if after that he or she starts experiencing symptoms.
- Tinel’s Sign: Snapping the over median nerve to feel any of the tingly electric shocking nature of the signal.
- Nerve Conduction Studies: They are normally utilised to gauge the speed of signal conduction within the nerves as well as to try to find injury.
Treatment Options
The choice of treatment depends on the severity of symptoms:
Non-Surgical Treatments:
- Wrist Splints: It is forbidden to use the wrist and hold the wrist in a straight or no decoration when sleeping.
- Medications: Non steroidal anti inflammatory drugs that include ibuprofen help to minimize inflammation as well as pain.
- Physical Therapy: It has integrated some flexibility exercises of this wrist coupled with the muscles.
Surgical Treatment:
In most serious instances the dorsal nerve ligament may be surgically removed as this is pinching the nerve. The procedure, known as carpal tunnel release, takes pressure off the nerve and helps it work properly.
Carpal Tunnel Syndrome Prevention
To reduce the risk of developing CTS:
- Use Proper Ergonomics: As it applies to keyboards, desks, and chairs and their positioning, write about keeping the wrist straight.
- Take Regular Breaks: If a person is occupied with repetitive activities, the latter should step aside, rest his hand and legs.
- Exercise: Perform extension and flexion of the wrist and hand muscles.
In order to keep CTS at a manageable level or try to avoid it where possible it helps to know what the causes are and what exactly the different types and symptoms are.
Q.2 - How would you diagnose a carpal tunnel syndrome? Any clinical investigation or assessment tests?
Diagnosis of Carpal Tunnel Syndrome:
Clinical Investigations and Assessment Tests
Carpal Tunnel Syndrome (CTS) may be defined as a condition which takes place when the median nerve, stretched within the carpal tunnel in the wrist get compressed. This leads to symptoms for example, numbness, tingling and weakness on the hand, especially on the first, second and third fingers. Symptoms of CTS can be important in diagnosing CTS, combined with the medical and family history, physical examination and, if necessary, other instrumental tests.
1. Patient Medical and Social History, and Comorbidities,” Symptoms and Complaints seen in the Hospital Stay
It starts with assessment of the patient’s complaint, but also includes identifying any past and current health problems. Key points include:
- Symptoms: This is mainly because tingling, numbness or pain is normally experienced at night by the patients. Atrophy in the thumb as well as difficulty with holding items and objects is not unusual.
- Onset and duration: Period of onset and frequency of the symptoms determines the level of the disease.
- Aggravating factors:: Repetitive wrist or hand actions, writing, car driving, or using tools aggravate the condition.
- Underlying conditions: Other risk factors include diabetes, hypothyroidism or rheumatoid arthritis.
2. Physical Examination
Many specific and nonspecific signs can be found during the physical examination of the hand and wrist in CTS. Key aspects include:
- Visual inspection: The doctor may pull the fingers and feel for thickening, redness or shrinkage of muscles (this is especially common in the thenar muscles near the thumb).
- Sensation testing: The doctor enquires whether the patient has reduced sensation or even feeling in the fingers that has been innervated by the median nerve.
- Strength testing: Measuring the firmness of thumb palmaris and examining thumb movements and grip strength will suggest weakness arising from nerve compression.
3. A list of clinical tests with which Carpal Tunnel Syndrome can be diagnosed:
Several specialized tests are performed to provoke symptoms and confirm the diagnosis:
a. Tinel’s Sign
The doctor puts pressure on median nerve at the wrist. If the current is rolled off slowly there should be a feeling of tingling or a little electric shock when touching the fingers.
b. Phalen’s Test
It is done by placing the palms of the two hands and folding the wrists till they come to the phase where the wrists cannot fold anymore and keep in that position, for one minute. Positive signs of symptoms related to this test include timngling, numbness and or pain, all of which confirm CTS.
c. Durkan’s Compression Test
They stimulate the area over the carpal tunnel in such a manner that they compress the median nerve. Tingling or numbness, for instance, will surely indicate that the person has CTS.
d. Hand Elevation Test
The patient raises their hands above the head for one to two minutes. If patient get symptoms or have sign during this time point, indicate CTS.
4. Advanced Diagnostic Tests
If the diagnosis remains uncertain, advanced tests may be recommended:
a. NCS stands for Nerve Conduction Studies in medical language meaning that nerve conductions are studied in order to check their proper functioning.
This test determines the conduction velocity of the median nerve. Prolongation of the conduction of the signal establishes the fact that there is nerve compression.
b. Electromyography (EMG)
EMG measures the electrical activity of muscles thus helping to aid in diagnosis of damaged nerves and exclusion of conditions such as cervical radiculopathy.
c. Ultrasound
Ultrasound imaging can also be ordered to examine the median nerve and-defined changes and enlargement in the wrist.
d. MRI
MRI is used sparingly in diagnosis of CTS but may reveal any structural abnormalities, tumor or injury, causing the syndrome.
5. Differential Diagnosis
CTS symptoms can overlap with other conditions, so it is essential to rule out alternatives like:
- Cervical radiculopathy: Compression of the nerves in the neck that produce similar signs and symptoms.
- Peripheral neuropathy: Closely associated with diabetes or vitamin lack.
- Arthritis: Inflammation of the wrist may lead to same symptoms as CTS.
To diagnose CTS there is use of clinical experience, from the patient, use of diagnostic tests. Amputation can be prevented by early definitive diagnosis so that right treatment is instituted to minimize long-term consequences on hand mobility.
Q.3 - Try to practice at least 3 exercises that you have learned from the lesson. Share images, gifs or videos while practicing preferably gifs or videos.
Wrist and Hand Care Exercise for Improved Health
It is important to look after our wrists and hand; especially if we spend many hours typing on keyboards or have medical conditions such as Carpal Tunnel Syndrome. Three exercises I performed today include Wrist Rotations, Arm Prayer Stretch, and Median Nerve Glides which I believe would help me build stronger wrists and relieve tension on the same. Described below is the exercise as well as the importance of each of them that I have personally gone through.
1. Wrist Rotations
The wrist rotations that are gentle anti-inflammatory exercises can be used to relax the wrist joint and enhance blood flow.
- How I Did It: I then sat up straight, placed my hands in front of me, and started to rotate my wrists in a clockwise and counter clockwise manner for at least full ten revolutions of each.
- What I Felt: At first or two, my wrists had slight rigidity but within a few more minutes, I felt the relaxing signal as rigidity decreased.
This is the perfect exercise for preparing the wrist joints for any other task that may require more flexing and extension as it helps in breaking the stiffness around the area.
2. Arm Prayer Stretch
The stretching exercise is called the Arm Prayer Stretch and is most effective when it comes to stretching the wrist and forearm muscles.
- How I Did It:
- I folded my hands over my chest as one might do when praying.
- Gradually, I placed both my hands back to the surface and made sure my fingers were interwined at the tips which built stretch to my wrists and forearms.
- I counted, saying it aloud and holding the position for 10 seconds and I did it three times.
- What I Felt: I was relieved of some tension especially in the forearm and wrists area at first then found it quite comfortable stretching.
One of the many signs that characterize CTS are wrist area stiffness and this exercise is quite useful in improving flexibility in that region.
3. Median Nerve Glides
It is for this reason that Median Nerve Glides are particularly encouraged for people with Carpal Tunnel Syndrome because they address the median nerve.
- How I Did It:
- Then making sure my wrist was in a natural position, I positioned my right arm southwards in a line parallel to my body, perpendicular to the table and my palm facing east.
- Using my other hand, I started to slowly move the bottom of the wrist into the up and down position and retained every position for about ten seconds.
- I slid and relaxed my fingers to open and close them again to create a nerve glide on my fingertips.
- What I Felt: This exercise brought a gentle stretch from the inner part of my wrist and the stiffness and tension on this area lessen.
A CTS rub for median nerve mobilization entails rubbing the median nerve gently while holding a position that gradually stretches the nerve to alleviate CTS symptoms.
Why These Exercises are Relevant
As far as these gentle exercises are beneficial for wrist stiff for painful or discomforting experiences for the wrist. They help:
- Improve blood circulation
Calm nerves and tight muscles
Strengthens the wrists and the forearms - Get rid of Carpal Tunnel Syndrome symptoms
My Experience:
I did these exercises slowly and without straining mostly because of the dragging motion I employed throughout the exercise. I also made short videos of me practicing to determine my posture and to share with other people.
Q.4 - Share your review after performing these exercises either on yourself, healthy individual or patient.
Three Exercises: Wrist Rotations, Arm Prayer Stretch, SThretches For CTS & 3 Nerve Glides
These exercises are made from wrist rotation, arm prayer stretch, stretches for Carpal Tunnel Syndrome (CTS), and median nerve glides, and they are typical exercises for reduction of discomfort and increasing the mobility of the wrist, forearm, and hand. I got a chance to try out these exercises and see how suitable they are especially in case on wrist pain or CTS syndrome.
Wrist Rotations
Rotation of the wrist is one simple, yet suitable exercise for causing motion at the joint and easing stiff muscles. In this way, gentle movements in circles clockwise and counter clockwise makes the joint more flexible. I have found incidental of this type of exercise improved my wrist maneuverability as well as it decreased mild stiffness at the joint. This is a perfect exercise that should be recommended when it comes to prevention or even managing discomfort affecting the wrist in the future. This may be beneficial for a normal person or anyone experiencing mild wrist injury to keep the wrist joint active.
Arm Prayer Stretch
The arm prayer stretch is a good way to stretch both the forearms and the wrists while also elongating chest and shoulder muscles. This exercise involves placing both hands and then pushing the hands against the chest, an excellent stretch for the forearm flexors in addition to the muscles of the wrist. When done appropriately, this stretch is helpful in loosing tension in the wrists and forearms and in most cases benefits patients diagnosed with CTS. It also loosened any tension in the upper part of the body and, thus, is helpful for those who type at a computer for many hours a day or merely use their hands frequently.
Stretches for CTS
For those who have Carpal Tunnel Syndrome, it is very important to make exercises, which focus on wrist and forearm flexibility. To relieve CTS, I also did some stretching; wrist flexor stretch and wrist extensor stretch. These stretches assist that aid in stretching the muscles of the forearm and wrist hence minimizing the pressure of the median nerve which leads to CTS manifestation. These stretches, arrayed in their own controlled fashion, offered a notable amount of relief from pain and increased the available range of motion of the wrists. These exercises can be beneficial to anyone with CTS but they’re even more useful when used along with other treatment options such as splints or ergonomic adjustments.
Median Nerve Glides
Another simple technique known as median nerve glide involves using your hand to slide the wrist and fingers up and down to enable the nerve to slide onward. This exercise is important to patients with CTS because, through use, the symptoms are eased as the median nerve receives no pressure. The glide motion is beneficial in helping to relieve tingling, numbness and weakness of the hand and wrist. Demands on my wrist and fingers increased for some time, but I was glad to see that such exercise really helped me to diminish the tenseness and consequently, discomfort. In cases of CTS or any similar ailment, this kind of exercise is critical for healing, and can form part of the recommended training program.
Conclusion
To summarize, I identified that all wrist rotations, arm prayer stretch, CTS stretches and median nerve glides give significant outcome for maintaining proper wrist flexibility and to relieve tensions as well as for treating symptoms of CTS. What is more important is that the described exercises are non-pharmacological and can be helpful when discomfort occurs in a day to day life. Wrist sprain or CTS arthritis patients, for subsequently after following up for these exercises, their hand pain could significantly decrease as their hand functions increase.
I am inviting here some of my friends @max-pro, @josepha, @wilmer1988, and @sduttaskitchen to participate in this engagement challenge of teacher @ashkhan.
Thank You
Thank you for understanding the lesson and sharing your assignment; I hope that you will enjoy this week's lesson and try to implement it in your life if you see any such case.
Observations
Task 1 (2.8/3)
You have shared a great knowledge about carpal tunnel syndrome, its symptoms, cause, and it's types. There are 4 types that I explained in the lesson. Acute, chronic, primary and secondary. That's good you add new types but if you secondary CTS you should also add primary CTS. I have asked about diagnosis and special tests in second question so it would be better to avoid such things in first question. Instead of getting full grade, your marks will be deducted on extra writing. I appreciate your effort.
Task 2 (3/3)
In the second question, you tell us about how you have to assess a patient by doing physical examination, history taking, special tests and investigations. Excellent.
Task 3 (3.8/4)
You try the CTS stretches, wrist rotations , median nerve glides and arm prayer stretch exercises. You did the CTS stretch, median nerve glides and wrist rotations correctly. But in arm prayer stretch you have to keep your arms straight not to move them downward. Always remember to apply heat pack before performing exercises to relax the muscles and reduce stiffness. I appreciate your efforts.
Overall you made a great attempt to answer all the questions. I appreciate your efforts. But next time try to avoid the above written suggestions. Keep learning and try to implement your knowledge to the people suffering from carpal tunnel syndrome or any type of wrist. Thank you.
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