Carpal tunnel syndrome is a common cause of wrist pain. You may feel aching, burning, numbness, or tingling in your palm, wrist, thumb, or fingers. The thumb muscle can become weak, making it difficult to grasp things. Pain may extend up to your elbow.
Carpal tunnel syndrome occurs when an important nerve (called the median nerve) gets compressed at the wrist because of swelling. Such swelling can occur if you:
Do a repetitive motion with your wrist like typing on a computer keyboard, using a computer mouse, playing racquetball or handball, sewing, painting, writing, or using a vibrating tool.
Are pregnant, menopausal, or overweight.
Have diabetes, premenstrual syndrome, an underactive thyroid, or rheumatoid arthritis.
Wrist pain with bruising and swelling is often a sign of an injury. The signs of a possible broken bone include misshapen joints and inability to move the wrist, hand, or a finger. Other common injuries include sprain, strain, tendinitis, and bursitis.
For carpal tunnel syndrome, you may need to make adjustments to your work habits and environment:
Make sure that your keyboard is low enough that your wrists aren't bending upwards while you type.
Take plenty of breaks from activities that aggravate the pain. When typing, stop often to rest the hands, if only for a moment. Rest your hands on their sides, not the wrists.
An occupational therapist can show you ways to ease pain and swelling and stop the syndrome from coming back.
Over-the-counter pain medications like ibuprofen or naproxen can relieve pain and swelling.
Various mousepads, typing pads, split keyboards, and wrist splints (braces) are designed to relieve wrist pain. Some people find these devices help their symptoms. You may wish to try a few different kinds to see if any help.
You may only need to wear a wrist splint at night while you sleep. This helps reduce the swelling. If that alone is not working, wear the splints during the day and apply hot or cold compresses periodically.
For a recent injury:
Rest your wrist. Keep it elevated.
Apply ice to the tender and swollen area.
Take over-the-counter pain medication, like ibuprofen or acetaminophen.
Wear a splint for several days. Wrist splints can be purchased at many drugstores and medical supply stores.
For non-infectious arthritis:
Do flexibility and strengthening exercises every day. Work with a physical therapist to learn the best and safest exercises for your wrist.
Try the exercises after a hot bath or shower so that your wrist is warmed up and less stiff.
DO NOT perform exercises when your wrist is actively inflamed.
Make sure that you also rest the joint adequately. Both rest and exercise are important when you have arthritis.
Are you involved in activities requiring repetitious hand and wrist movements, such as sewing, knitting, computer keyboard use?
Diagnostic tests that may be performed include an x-ray. If your doctor suspects that you have an infection, gout, or pseudogout, he or she may draw fluid from from the joint to examine under a microscope.
Anti-inflammatory drugs may be prescribed. Injection with a steroid medication may be performed. Surgery or medications may be needed to treat some conditions.
Viera AJ. Management of carpal tunnel syndrome. Am Fam Physician. 2003; 68(2): 265-272.
Padua L. Carpal tunnel syndrome in pregnancy: Multiperspective follow-up of untreated cases. Neurology. 2002; 59(10): 1643-1646.
American Academy of Orthopaedic Surgeons (AAOS). AAOS clinical guideline on wrist pain - phase I. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2002.
Update Date:
5/6/2007Updated by:
Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network.
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