Steemit Learning Challenge-S22W1; Carpal Tunnel Syndrome"

What's carpal tunnel syndrome? Write in your own words after getting knowledge from the lesson post

Carpal tunnel syndrome is a pathologic condition in which median nerve that supplies your wrist becomes impinged or compressed. This excessive pressure or compression results in lack of blood supply at affected wrist muscles which results in loss of sensations which cause numbness ,tingling and weakness sensations in your hand or wrist and most of the symptoms patient feel in his thumb and fingers.

Types of CTS

• Carpal tunnel syndrome can be of acute type in which patient will feel a sudden onset of pain, tingling ,numbers sensations and it is most commonly caused by any sudden injury or trauma.
• There can be another type of carpal tunnel syndrome which is chronic in which patient suffers from symptoms including pain, numbness ,tingling and weakness from long time period so here onset of symptoms is gradual and it is most commonly caused by repetitive motions or adopting a fixed posture for long time.

Causes

• It can be caused by those activities that cause continuous vibration at wrist area for long time because it can irritate and cause compression or swelling in median nerve.
• It can be caused because of anatomical factors like due to presence of narrow carpal tunnel.
• It can be caused due to problems like arthritis that occurs in small joints
• It can be caused to those patients mostly who suffered from diabetes or thyroid disorders.
• It can be caused due to fluid retention or swelling in wrist for different underlying medical reasons.

Symptoms

• Patient suffering from this condition will complain about pain, numbness tingling sensations in thumb and fingers mostly.
• patient suffering from this condition will complain for visible weakness in hand and wrist muscles day by day.
• Patient suffering from this condition will complain that his pain and burning sensation increase at bed time.

Treatment

• First of all it would be good to recommend patient to wear wrist splint because it will keep the wrist in neutral position which will reduce pressure at median nerve and ultimately it will reduce pain.
• In case of presence of swelling at risk icing can be done for 10 minutes twice in a day and in case of presents of redness and pain and absence of swelling hot pack can be applied to wrist for 15 minutes twice in a day.
• Different exercises can be performed at wrist joint for improving mobility and stretches can be performed for increasing flexibility of muscles and for strengthening of muscles.
• For pain relief NSAID can be used and corticosteroid injections can be used at recommendation of doctors for reducing swelling.
• Open release surgery and endoscopic release surgery are some of the surgical procedures that can be done in most critical cases.

Prognosis

• Paying attention to this condition after occurrence of at least 3 months later can be important for full recovery of patient suffering from CTS within 1 month most probably but when it is left untreated after 6 months of occurrence then it can lead to permanent damage of nerve gradually so once the nerve will damage then it can't be recovered.

Reoccurrence

• Carpal tunnel syndrome can reoccur in case you are not eliminating root cause of its previous occurrence so it's really important to modify your lifestyle according to its cause for it's prevention to reocccur in future.

How would you diagnose a carpal tunnel syndrome? Any clinical investigation or assessment tests?

You have to pass through combination of clinical evaluation physical examination and different diagnostic tests for making a diagnosis for CTS.

Clinical evaluation

• In clinical evaluation you need to evaluate medical history of your patient by asking symptoms that he feels and by knowing duration of symptoms, pattern of pain that is it burning or throbbing.
• You also need to ask about patient occupation,his hobbies and occurrence of any previous injury for trauma at affected area which is wrist.

Physical examination

• In physical examination through your visual inspection you have to check for redness ,swelling or any sign of deformities if it is present.
• You also have to gently palpate or press affected area for check-in presence of tenderness.
• You have to evaluate range of motion of wrist and fingers.
• You have to check sensory and motor control of patient by pin prick and by assessing strength and mobility of wrist and fingers muscles respectively.

Diagnostic tests

• Tinel's sign is one of the most important diagnostic test in which you have to tap median nerve gently at wrist for assessing that are pain,tingling and numbers sensations are increasing or relieving. So if symptoms are increasing then it means test is positive.
• Phalen's test is another one of the most important diagnostic test in which doctor will command to his patient to flex his wrist and then Dr will ask that his symptoms are increasing or not so if symptoms are increasing then it means this test is also positive.
• Carpal compression test is another one of the most important diagnostic test in which doctor will apply pressure to carpet tunnel area and patient will give his feedback that his pain is increasing or not so if patient feedback is positive than it means it is indicating carpal tunnel syndrome.

Imaging tests

• Electromyography can be performed for measurement of muscles electrical activity for assessing extent to which nerve is damaged.
• Nerve conduction studies are useful for knowing speed and strength of electrical signal which median nerve is conveying.
• Ultrasound,X-ray or MRI can only tell about any secondary cause that is compressing this nerve due to arthritis, tumor or any fracture.

Assessment tools

• Boston carpal tunnel questionnaire is useful for assessing symptoms and functional status of patient.
• Carpal tunnel syndrome assesment questionnaire is also used by clinician for knowing severity, duration and type of symptoms from patient.

My diagnostic criteria

Methodology	Weightage
Clinical evaluation	15%
Physical evaluation	15%
Diagnostic test	30%
Imaging studies	25%
Assessment tools	15%

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Arm prayer stretch