“I feel like I have to shake out my hand in the morning”

I’ve been seeing in the clinic an increased amount of clients diagnosed with Carpal Tunnel Syndrome (CTS). It’s a diagnosis that many of heard of, but few understand the etiology of it and most importantly, what can a person do about it? What is CTS?!

CTS is the most common nerve compression disorder of the upper extremity. It falls under the category of repetitive strain disorders, which are the nation’s most common and costly occupational health problem (repetitive-strain.com). With CTS, the median nerve and tendons become compressed in the carpal tunnel.

Image result for carpal tunnel

What may be causing the nerve to be compressed in the carpal tunnel?

  • Swelling in the wrist (due to trauma or injury)
  • Repetitive gripping or wrist flexion
  • Repeated use of vibration (such as when using vacuums, power drills, etc.)
  • Fluid retention during pregnancy or menopause
  • Development of cyst or tumor in the carpal tunnel
  • External compressive forces (tight bracelets, watches, wrist rests for mouse)

Symptoms include:

  • Burning, tingling, or itching numbness in the palm of the hand and fingers
  • Fingers feel useless or swollen
  • Swelling in the hand or fingers
  • Needing to shake out your hand in the morning
  • Difficulty grasping objects
  • Atrophy of thumb muscles

The Bureau of Labor Statistics listed these occupations as having a higher incidence of CTS:

  • Assemblers
  • Cashiers
  • Secretaries
  • General office clerks
  • Bookkeeping, accounting, auditing clerks
  • Data-entry employees
  • Welders, cutters
  • Truck drivers
  • Janitors and cleaners

If you think you may have CTS:

  • Think about activities which requires repetitive motions, then take more breaks in between the task!
  • Ask your manager for an ergonomic assessment for your work station
  • Wear an appropriate night splint to avoid sleeping with your wrists curled in
  • See a hand therapist who will teach you how to protect your hand from activities that may be causing the symptoms, as well as teach you stretches and use modalities to treat the pain

If caught early, CTS does not require surgery! In fact…

According to the National Center for Health Statistics, approximately 260,000 carpal tunnel release operations are performed each year (repetitive-strain). However, 57% of the patients had a return of pre-operative symptoms (is that statistic for real?!), such as pain, numbness, and tingling beginning an average of 2 years after surgery. In addition  to the possible residual symptoms after surgery, patients also reported poor to fair strength and long-term scar discomfort post-surgery (Nancollas, 1995).

So, instead of opting for the knife, try a less invasive approach and see your local hand therapist who will treat your symptoms and, most importantly, teach you how to prevent further damage to your hand!

If you’re in Eastern WA, check out our hand clinic at therapy-solutions.us, where we will treat your hand for the full hour

Thanks again for checking out this site!

Claire, OTR/L



Nancollas, MP, Peimer, CA, Wheeler, DR, Sherwin FS. Long-term results of carpal tunnel release. Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand. 1995 Aug, 20(4): 470-474.

Carpal Tunnel Syndrome Fact Sheet. National Institute of Neurological Disorders and Stroke. July 2012. Retrieved from http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm#3049_5

National & International Statistics for Carpal Tunnel Syndrome and Repetitive Strain Injuries of the Upper Extremity. Balance Systems, Inc. Retrieved from http://repetitive-strain.com/national.html.



That Touchy Subject…

Food has always been a very, VERY, important topic back at home. “What’s for ___” was a ubiquitous question. Particular family members were extremely picky eaters, and seemed to favor high saturated fat, high trans fat, and highly sugared foods, which led to health problems such as high blood pressure, high cholesterol, high triglycerides, diabetes, and high visceral fat, which in collection is called Metabolic Syndrome. Although this family member “knew” poor food choices were harming his body, he figured his 12+ pills, and shots of insulin, would reverse the effects of the unhealthy foods. Any attempt to suggest eating healthier would end with returned sarcasm and an awkwardly quiet and tense dinner table.

As part as a holistic occupational therapist, it is part of my job to educate clients on  nutrition and the damaging effects of poor food choices on our physical and mental selves.

Oh, and FYI, I am not supportive of diets. Growing up, I struggled with my weight and body image which led me to live a life of restrictive diets, binges, and eating disorders. But now that I’ve begun working at TherapySolutions, and can make my own food choices since I am only cooking for myself, my approach to food has changed. Rather than worrying about choosing only low calorie, low-fat foods–which ended up being high in sugar–I now focus on eating anti-inflammatory foods, even the ones high in fat…the good ones though! Think monosaturated or polysaturated fats.

It’s still uncomfortable to talk about food with clients, in fear that I’ll hit a vulnerable spot, or they’ll perceive me as judging them. But it would be a disservice to them, and failure on my part as an occupational therapist, if I didn’t educate clients on the role of food on our bodies, and the consequences of eating inflammatory foods.

In my last post, I discussed an article that came out by the NY times on the causes of arthritis. It was suggested that arthritis is more than a “wear and tear” condition. Rather, it’s a combination of “wear and tear” as well as exposure to chronic, low-grade inflammation from food sources such as sugar, trans fat, saturated fat, alcohol, and processed foods. In follow up, I want to discuss about what you can and should be eating to avoid conditions like arthritis, Alzheimer’s, and chronic swelling…the ANTI-INFLAMMATORY FOODS.

I am a strong supporter of Dr.  Weil’s Anti-Inflammatory Food Pyramid. Here he lists anti-inflammatory foods, as well as their nutrition description. You can check out his website at http://www.drweil.com/diet-nutrition/anti-inflammatory-diet-pyramid/dr-weils-anti-inflammatory-food-pyramid/


Rather than talk about each anti-inflammatory food listed, I just want you to take away the message that food does contribute to swelling, inflammation, pain, “foggy brain”, and the like! I’ve personally experienced it myself, but see it in the clinic all the time!

Dr. Weil’s site also has a list of recipes which look pretty quick and simple to make. I’ll be making this Bento Box Soup this week since the fall weather has been settling in! http://www.drweil.com/diet-nutrition/recipes/bento-box-soup/

Comment if you were able to try any of his recipes, or have ones to share yourselves. Eat well my friends!