Page 53 - Newcom

Back behind the wheel
It’s in the wrist
How to identify, treat, and prevent carpal tunnel syndrome
Carpal tunnel syndrome is one of the most common conditions that affect the wrists and hands of pro- fessional truck drivers. I think it is safe to say most of us have heard the term carpal tunnel syndrome at some point in our lives. However, many people do not know exactly what it means.
Carpal tunnel syndrome occurs when the median nerve in the wrist is compressed as it passes through a narrow passageway called the car- pal tunnel on its way to the hand. The median nerve provides sensa- tion to the palm side of the thumb and first four fingers. It also pro- vides nerve motor function signals to muscles in the thumb.
Repetitive shifting,
as well as resting the wrist on the shifter, are the most common causes of carpal tunnel syndrome in drivers.
There are several potential causes of carpal tunnel syndrome. Any con- dition that causes pressure or irri- tates the median nerve in the tunnel may lead to symptoms.
Wrist fractures, as well as repet- itive strain injuries, are common causes of the carpal tunnel narrow- ing. In my practice, I commonly see this condition in the shifting hand of professional truck drivers.
Repetitive shifting, as well as rest- ing the wrist on the shifter, are the most common causes of carpal tun- nel syndrome in drivers. To add to this, flatbedders are at greater risk due to the fact they must secure their loads by repetitively tighten- ing chains and binders.
The symptoms of carpal tunnel vary from person to person. How- ever, in most cases, symptoms begin gradually.
Symptoms usually include occa- sional numbing and tingling in the thumb and first two fingers. This sensation may radiate from the wrist up into the arm. Some patients experience an ‘electric shock’ feel- ing in their fingers. It is common for individuals to find relief from the symptoms by shaking out their hands. Over time, as the condition progresses, weakness of the thumb muscles may occur.
If you suspect that you may have carpal tunnel syndrome, it is important to consult with a health professional, as permanent damage can occur without treatment.
Your doctor will usually be able to diagnose carpal tunnel syn- drome by taking a detailed med- ical history and performing a
physical examination. Orthope- dic testing, which includes bend- ing the wrist in different direc- tions and pressing on the nerves in the wrist, is usually included in the physical exam. If necessary, your doctor may recommend fur- ther testing such as x-rays to help diagnose the cause of the carpal tunnel syndrome.
A nerve conduction study, which measures how well the median nerve is conducting the signal, may also be performed.
Once a diagnosis of carpal tunnel syndrome has been reached, your doctor will be able to recommend the proper course of treatment.
Conservative treatments such as lifestyle and job modifications are usually the first course of treatment. Ice application and over-the-counter medications are often recommended to help reduce inflammation.
Braces and splints are sometimes suggested to help immobilize the affected wrist. To add to this, physical therapy is often successful in treating mild cases of carpal tunnel syndrome.
If conservative treatments are unsuccessful, your doctor may sug- gest a corticosteroid injection to decrease inflammation and swell- ing within the tunnel. Finally, if all conservative treatment options fail, surgery may be recommended.
Dr. Christopher H. Singh runs Trans Canada Chiropractic at the 230 Truck Stop in Woodstock, Ont. He can be reached at 519-421-2024.
The most common surgical pro- cedure is called a carpal tunnel release. During this surgery, the sur- geon cuts through the carpal tunnel ligament to relieve pressure on the median nerve. As the ligament heals, it will leave more room for the nerve to pass through the carpal tunnel. Recovery from surgery usually takes a few months.
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