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Carpal tunnel syndrome (CTS) is one of the most commonly reported work-related disorders in Dallas, Houston, throughout Texas, and across the United States. Although studies are still out, those most affected seem to be employees with jobs that require long-term repetitive movements, particularly those working with small hand tools or using computer keyboards on a regular basis.
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Women are more likely to be diagnosed with CTS than men, and though it is highly suspected many young people suffer from the condition, those between the ages of forty and sixty are the most commonly diagnosed. Those with health insurance are also more likely to be treated.
CTS is a painful syndrome caused by pressure on the median nerve of the wrist, which runs through a passageway called the carpal tunnel. This syndrome affects the musculoskeletal structures of the upper extremity, and often results in pain, tingling, numbness, and weakness in the hands and/or wrist. Further symptoms include increased tingling or pain at night, a feeling of uselessness or weakness in the fingers, decreased ability to squeeze objects, loss of strength in the muscles at the base of the hand, and shooting pain up the arm, sometimes as far as the shoulder. In severe cases, partial paralysis may occur.
It's been difficult to diagnose in the past, and therefore difficult for many in Texas and across the U.S. to get treatment covered by individual health insurance. Cities like Austin, Houston and Dallas, though, now have more easily accessible pain centers, which specialize in diagnosing the syndrome through physical examinations and specialized scans, like MRIs.
CTS is garnering more attention in the medical and business communities in Texas due to its ability to incapacitate valuable workers, not to mention the pain and suffering it causes.
"It's a tough call," sighed Mike* after a long day. "I hurt all the time now. I have to start considering surgery or…something. Otherwise, I'm not going to be able to work."
Mike was diagnosed with CTS several months ago, and is increasingly worried about his ability to maintain his income as a self-employed production artist. "I don't have health insurance, so if I can get out of doing the surgery, I will. It seems so drastic anyway."
The trouble with carpal tunnel syndrome is that the longer the condition goes untreated, the higher the chances of permanent damage. And like any disease, CTS is statistically less likely to be diagnosed and treated without health insurance coverage. Mike's story is not particularly rare. Over 25% of people in Texas went uninsured in 2005, far exceeding the national average of 15.9%. Rates are higher for the self-employed. What this translates into is 46.6 million Americans going without health insurance, 5.4 million more than in 2001—the recession year. Mike can't afford treatment, but he can't afford not to get treated, either.
Fortunately, there are less expensive options than surgery, and Texas offers a wide variety of choices, particularly in urban centers like Austin, Dallas and Houston. Pain centers specializing in carpal tunnel syndrome are excellent resources.
The first step, of course, is reducing the symptoms of the condition in hopes that, with time, those symptoms may be eliminated. These are free or low-cost measures that do not require individual health insurance policies. High caffeine, tobacco, and alcohol intake are contributing factors; those suspecting they have CTS should eliminate or reduce these as much as possible. Food allergies may exacerbate, or even cause, some of these symptoms as well, and common triggers include dairy, canola oil, and wheat/gluten products.
Some health practitioners believe dehydration also aggravates the problem. The earliest stages of dehydration don't exhibit immediately recognizable signs, and mild dehydration may only cause headaches or fatigue. Many practitioners in Texas predict Americans—with busy lifestyles, caffeine drinks, and high stress—go slightly dehydrated on a daily basis. Dehydration impairs body functions, including the ability to supply proper nourishment to the extremities, which, of course, only makes CTS worse. Upping healthy fluid intake alone may reduce the severity of the disease.
Other symptom-reducing measures include stretching or flexing the hands, wrists, and arms before and during repetitive movements, reducing such movements to a bare minimum, using a wrist splint for four to six weeks, modifying tasks to reduce pressure on the wrists, and, whenever possible, using CTS-friendly equipment, such as wrist rests, and adjustable keyboards, tables, and chairs. A study of library managers conducted at Texas A&M found promising results for preventing or reducing symptoms of the condition after modifying work surfaces.
Nutrition is also of utmost importance. In fact, some in the medical community believe carpal tunnel syndrome is actually caused by a deficiency of B-6, made worse by repetitive movement. Positive results have been achieved for those in Texas and across the United States by administering 100mg of B-6 daily. Other dietary recommendations include taking a high-quality multi-vitamin—which should include antioxidant vitamins A, C, E, and D, and the trace minerals magnesium, calcium, zinc, and selenium. Omega-3 fatty acids, found in fish oils, have been shown to reduce inflammation associated with CTS, as has Methylsulfonylmethane (MSM) and Resveratrol (from red wine).
Green tea, milk thistle, bromelain, turmeric, and cat's claw are excellent herbs for reducing symptoms associated with CTS. Applying a hot castor oil pack for one to five hours at a time may also reduce pain and inflammation.
One of the most promising, non-surgical treatments for CTS available today is acupuncture, an ancient form of Chinese medicine dating back thousands of years. The National Institutes of Health reported promising results for treating CTS with acupuncture as early as ten years ago, and the community of qualified Chinese medical practitioners—who undergo at least four years of extensive training in Chinese medicine—have long attested to its efficacy. Acupuncture is believed to help restore normal nerve function and provide long-term relief of pain associated with this, and other chronic inflammatory syndromes. Common forms of acupuncture treatment include low-beam laser acupuncture, often accompanied by electrical stimulation (a painless administration of low-intensity current).
Finally, an injection of corticosteroid in the wrist may provide temporary relief of pain without surgery for those with moderate symptoms. Dr. Shawn Marshall of the University of Ottawa (Canada) found twelve published studies that confirmed a single injection of the steroid was, on average, more affective than a placebo for relieving pain. Concerns in the medical community over use of the shot have surrounded long-term damage to the nerves. It's still controversial but, at the very least, practitioners recommend only short-term usage, and not to repeat the injection if it is ineffective the first time. Over the long-term, oral anti-inflammatory medications, such as ibuprofen, and using wrist splints, may be just as effective.
If you suspect that you may be afflicted with carpal tunnel syndrome, don't be afraid to check it out with a qualified practitioner. Texas abounds with pain centers, acupuncturists, and other qualified physicians with a growing knowledge of the condition and the ability to help. If it's caught early, the syndrome is reversible, and, with the proper precautions and dietary modifications, may never return.
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