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It’s in the wrist


Carpal tunnel syndrome is one of the most common conditions that affect the wrists and hands of professional 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 carpal tunnel on its way to the hand. The median nerve provides sensation to the palm side of the thumb and first four fingers. It also provides nerve motor function signals to muscles in the thumb.

There are several potential causes of carpal tunnel syndrome. Any condition that causes pressure or irritates the median nerve in the tunnel may lead to symptoms.

Wrist fractures, as well as repetitive strain injuries, are common causes of the carpal tunnel narrowing. In my practice, I commonly see this condition in the shifting hand of professional truck drivers.

Repetitive shifting, as well as resting the wrist on the shifter, are the most common causes of carpal tunnel syndrome in drivers. To add to this, flatbedders are at greater risk due to the fact they must secure their loads by repetitively tightening chains and binders.

The symptoms of carpal tunnel vary from person to person. However, in most cases, symptoms begin gradually.

Symptoms usually include occasional 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’ feeling 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 syndrome by taking a detailed medical history and performing a physical examination. Orthopedic testing, which includes bending the wrist in different directions and pressing on the nerves in the wrist, is usually included in the physical exam. If necessary, your doctor may recommend further 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 suggest a corticosteroid injection to decrease inflammation and swelling within the tunnel. Finally, if all conservative treatment options fail, surgery may be recommended.

The most common surgical procedure is called a carpal tunnel release. During this surgery, the surgeon 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.

Until next month, drive safely.

***

Dr. Christopher H. Singh runs Trans Canada Chiropractic at the 230 Truck Stop in Woodstock, Ont. He can be reached at 519-421-2024.


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