The Doctor Is In

Q:After years of typing and holding a cell phone and everything else, I am noticing more frequent pain in my hand and am worried I have developed carpal tunnel. What are some of the warning signs and when do I need to see a doctor?

Ouch! Sometimes my hands hurt also as I type this column! There are many reasons to have hand pain, and carpal tunnel is just one of them.

If you have pain in the hands and wrists as well as joint stiffness and swelling, it may be arthritis. Or, even more likely, tendonitis in the wrist is often caused by repetitive motion or overuse, which is what you describe in your question.

Tendonitis can affect all the tendons in your hand and wrist, of which there are many. This condition can often be effectively treated with anti-inflammatory medications like ibuprofen and icing. It also helps to stop doing the activities that brought these symptoms on in the first place.

But, if you have tingling in the hand with numbness, pain and hand weakness, there is a good chance you have carpal tunnel syndrome.

Carpal tunnel syndrome symptoms usually start gradually. You may notice tingling and numbness in the thumb, index finger and half of the middle finger, along with an electric shock feeling in these areas.

The cause is pressure on the median nerve. Anything that squeezes or irritates the median nerve in the carpal tunnel space will lead to this syndrome, including wrist fractures and inflammation caused by rheumatoid arthritis. Because this nerve does not affect your ring or pinky, if those fingers are affected, there is a good chance that a condition other than carpal tunnel is afoot.

There are also other risk factors for developing carpal tunnel syndrome, including being female, being obese, and having a chronic medical condition like diabetes or an underactive thyroid.

Do not self-diagnose your hand and wrist pain. See a doctor if your symptoms last longer than a few weeks or do not respond to short courses of anti-inflammatory medications.

There are no proven strategies to prevent carpal tunnel syndrome, but I always tell my patients with any hand or wrist pain to reduce their force when striking the keypad, relax your grip, and take short and frequent breaks from typing or texting.

Make sure your computer mouse is comfortable, and that you are not straining your wrist when using it. Posture can always be improved when sitting, because the way you hold your neck and shoulders can compress the nerves in the hand and wrist as well.

It is important to treat carpal tunnel syndrome as early as possible, as non-invasive interventions may be the most beneficial at that stage. Wearing a wrist brace or splint while sleeping may be helpful. Anti-inflammatory medications might relieve the pain short term, and seeing an orthopedic hand specialist to get steroid injections into the carpal tunnel may also be necessary.

These options may decrease inflammation and swelling, which decreases pressure on the median nerve. If symptoms are still not improved, then surgery may be appropriate. The goal of surgery is to relieve the pressure by cutting the ligament pressing on the nerve.

The Beatles sang: “I want to hold your hand.” Do not let them if it hurts too much. It could make things worse.