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Carpal tunnel syndrome

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Carpal Tunnel Syndrome By student of Jakarta School of Prosthetic and Orthotics.
2016

Published in: Health & Medicine
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Carpal tunnel syndrome

  1. 1. Carpal Tunnel Syndrome Diah Rahmi
  2. 2. Carpal tunnel syndrome is a nerve compression syndrome where the median nerve gets compressed at the wrists
  3. 3. What is carpal tunnel?
  4. 4. Causes
  5. 5. Causes of carpal tunnel syndrome The most common causeof carpaltunnel syndrome is idiopathic(whichmeans that the exact aetiologyis unknown). • In general, anything thatcrowds, irritatesor compresses the median nerve in the carpaltunnel space can leadto carpal tunnel syndrome.
  6. 6. Anything that aggravates and inflames the tendons can cause carpal tunnel syndrome, including repetitive hand movements, pregnancy and arthritis.
  7. 7. Sign and Symptom
  8. 8. • Numbness Pins and needles Pain, particularly at night • Darting pains from the wrist • Radiated or referred pain into the arm and shoulder • Weakness of the hand and Decreased grip strength • The little finger and half of the ring finger are unaffected • Swollen fingers • Inability to differentiate between hot and cold by touch
  9. 9. atrophy of the thenar muscle
  10. 10. Test for Carpal Tunnel Syndrome
  11. 11. A common test for nerve entrapment is Tinel’s sign. Tapping or ‘percussing’ is performed on the surface of the skin along the nerve pathway over the suspected area of the lesion. If this produces a tingling sensation then the test is positive.
  12. 12. Treatment
  13. 13. Non-steroidal anti-inflammatory drugs, such as : • Aspirin and ibuprofen can manage carpal tunnel syndrome symptoms that have been present for a short time. • Corticosteroids can be injected directly into the wrist to provide relief to persons with mild symptoms
  14. 14. Exercise for Carpal Tunnel Syndrome • Straighten both wrists and relax fingers. • Make a tight fist with both hands. • Then bend both wrists down while keeping the fist. • Hold for a count of 5. • Straighten both wrists and relax fingers, for a count of 5. • Repeat 10 times.
  15. 15. Non Surgical Orthoses The following orthoses help manage the carpal tunnel syndrome pain: – Wrist hand orthosis – Thumb spica splint – Cock-up wrist splint
  16. 16. Orthotics goals – Decrease pain and swelling – Prevent deformity progression – Prevent Movement – By restrict flexion movement of wrist – Main objective is to position wrist in neutral but preferably slight extension to get pressure off of median nerve – Static low profile wrist supports often used to position wrist accordingly
  17. 17. Surgical Options Endoscopic surgery Carpal tunnel releasesurgery
  18. 18. Surgical Cut The Ligament (Flexor Retinaculum) Surgery is one treatment option for carpel tunnel syndrome. The surgeon makes an incision (cut) less than 5 cm long in your palm, and perhaps into the wrist as well, to expose the transverse carpal ligament. The surgeon then cuts the ligament to reduce pressure on the underlying median nerve. The incision in the palm is sutured (sewn) closed
  19. 19. • Surgery is usuallysuccessful.In some cases it does not completely relieve the numbness and pain in the fingers or hand. Thismay be the case if there has been permanent nerve damage caused by long-standingcarpal tunnelsyndrome or by other health problems such as diabetes.
  20. 20. Complications from surgery • Although complications are possible with any surgery, your doctor will take steps to minimize the risks. The most common complications of carpal tunnel release surgery include: • Bleeding • Infection • Nerve aggravation or injury
  21. 21. Risk factors of carpal tunnel syndrome* 1-Alterations inthe balanceof body fluids. Certain conditions such as pregnancy, obesity, thyroid hormone disorders and kidney failure, can affect thelevel of fluids inyour body. Fluid retentioncommon during pregnancy, for example may increase the pressure withinyour carpal tunnel,irritating the median nerve. Carpal tunnelsyndrome associated with pregnancy generally resolves on its own after the pregnancy is over.
  22. 22. 2-Nerve-damaging conditions. Some chronic illnesses, such as diabetes and alcoholism, increase your risk of nerve damage,including damage to your median nerve. 3-Inflammatory conditions. inflammation,such as rheumatoidarthritis or an infection,can affect thetendons in your wrist, exerting pressure on your median nerve. 4-Anatomic factors.A wrist fracture or dislocation thatalters the space withinthe carpal tunnelcan create extraneous pressure on themedian nerve.
  23. 23. Activity
  24. 24. Reference • http://www.repetitive- strain.com/ctsindex.html. • http://www.selfcare4rsi.com/carpal-tunnel- syndrome-anatomy.html. • http://www.carpal-tunnel- symptoms.com/anatomy-of-the-carpal- tunnel.html • https://www.ncbi.nlm.nih.gov/labs/articles/2 3798040/

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