Is it carpal tunnel or something else

[leatheroo]

There have been a few posts about sore hands so I thought i would give some information about whether this may be carpal tunnel syndrome or something else.

Carpal tunnel is just my field, i have been performing nerve conduction tests for 10 years with one of Australia's leading neurologists.

In your wrist there is a carpal tunnel structure. Lets think of it as a u shape boney thing with a stretchy thing over the top. The tendons to the fingers and one nerve past through this tunnel. The nerve is the median nerve and it supplies the messages to the muscles in the thumb and fingers with the exception of the little finger and half the ring finger. Carpal tunnel syndrome is when this nerve gets compressed in the tunnel. Sometimes it can be the tendons thickening and taking up more room or the stretchy thing at the top of the carpal bone gets tighter. What ever the reason the symptoms are usually pins and needles or numbness in the hands. It is usually worse at night or when the hands are elevated. There are lots of reasons people blame for their condition, but in my experience the biggest group are people are those that have a lot of vibration happening to their hands....power tools, jack hammers, motorbike riders, lots of HAMMERING..but of course there are lots of people who dont do these things. It tends to run in families, so your inherited wrist structure has a lot to do with it...some people have small tunnels to begin with.

Here is the tricky bit.....The symptoms of carpal tunnel are due to the irritation of the nerve, not so much the damage....you can irritate a nerve without damaging it and you can get severe symptoms which may include sharp pain in the wirst , pins and needles or numbness in the fingers.. It is only when the nerve has been damage that something needs to be done about it. This is the reason that a nerve conduction test is so important...you can have severe symptoms with little or no damage and very little in symptoms with severe damage. If the damage is severe it is VERY important to get it fixed. If the pressure on the nerve is not released the muscles that are supposed to be getting input will begin to waste away.. once this wasting gets really bad there is often no recovery, your hands will be disabled for life.

Swelling of the hands or pain without numbness are not typical symptoms of carpal tunnel. However if your hands are swollen this in turn will compress everything in the wrist and may give you temporary symptoms of carpal tunnel. If numb hands are waking you at night, its time to get a test.

Hope this helps, i have seen too many people leave it too late...imagine trying to lace when you cant feel the lacing needle!!!

[SCOUTER]

Hey Roo! Very informative! Thanks! I would like to also add one thing- Temperature plays a huge role in many pains that Leatherworkers experience. That is the Temperature of the damp Leather and cold marble or granet slab that we rest the heels of our hands on while tooling. I for one am VERY sensitive to this so what I do is have a small piece of thick cardboard that I rest my hand on... Never letting my heel come in contact with the tooling slab. Try it, you will feel much better after the project!

[Kani]

Very informative. Thanks Roo.

I am no doc by no means. But swelling does happen with arthiritis. I have it in my right wrist and it will swell and ache if I use it alot while working with leather. There for I have to let it rest in between times so it doesn't swell and get to sore. The elastic gloves does help some.

If your hands are swelling and sore you really need to go to the doc to see what is going on.

[Beaverslayer]

Roo, I had one of those nerve conduction tests a number of years back....it was the wierdest thing I've ever experienced. What it had determined was that my ulnar nerves had been damaged due to the type of work I was performing at the time. The numbness and tingling felt just like when your leg falls asleep, but only on my pinky and the next finger to it. For the longest time I just thought my hand was asleep like my leg would every now and again.

I had to go to physio 3 times a week, and have electroshock type thingies attached to me, and then ice cold water soak proceeded with hot water soaks. I was also fitted with these extremely obnoxious arm braces I had to wear at night while sleeping, that locked my whole arm and wrists into a very uncomfortable position. But I could sleep through the night without waking while wearing them. If I didn't wear them I would constantly wake up.

I did this for 9 months and the ulnar nerves only got a bit better, so they sujested surgery. I asked what this entailed, and was told that they would cut the damaged part of the nerve out and over time it would just grow back. Well I asked a guy that was in the same physio as me who had this proceedure done and he told me that if he had to do it over again he would not. He said that when the nerve was growing back, it was the most horrifying feeling he had ever felt. I declined the surgery and have learned to basically live with the numbness and asleep feeling in the fingers.

That's now 8 years, and since then I've even learned to pound leather and all that, even with the numbness.

But that nerve conduction test was about the neatest thing I've ever seen or experienced.

Ken

[leatheroo]

Hey beav, the way we treat ulnar nerve problems is to move the nerve away from the groove at the back of the elbow to the inside part of the elbow. We call it an Ulnar nerve transposition. You know if you hit your elbow and it hurts like hell and people say you hit your funny bone, well this is the ulnar nerve, never funny for the person getting the pain. I have never heard of anyone cutting a nerve, i wouldnt let them do it either. To see how bad ulnar nerve damage is, put a piece of paper between

your little finger and the ring finger..try to pull the paper out with the other hand...if you can pull it out easily the nerve is trapped, usually at the elbow groove. This type of damage is not as debilitating as the median nerve damage where the big thumb muscle is usually the first to go.

Edited April 25, 2008 by leatheroo

[Gremlin]

Excellent info on carpal tunnel, Roo. Will definitely be helpful to some of the folks here.

[David Genadek]

I'm no expert just a guy trying get my hands to work again. What my hand doctor at Mayo told me was that there is no evidence either way that if you don't get the operation that the carpal tunnel will get any worse or better. You do know if you get the operation you will loose strength. In my case the median nerve is about shot but I still have above normal hand strength. I guess in some cases the nerve that goes through the carpal tunnel snakes over and uses the other nerve to by pass the carpal tunnel which is what they figure has happened in my body. It is hard to know what to do but I will say my hands are doing a lot better since I have made some changes and I'm still hoping to avoid the surgery.

David Genadek

[St8LineGunsmith]

I had a test done about three months back and discovered I have carpul tunnel in both wrists and a nerve block at the elbow

my last two fingers on my right hand are numb .