Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a painful condition that affects the wrist, fingers and – in some instances – the forearm. The carpal canal or tunnel is a very small space in the wrist that connects the palm and the forearm. Several tendons and the median nerve pass through the carpal canal. The median nerve is one of the 5 main nerves that run from the shoulder to the fingers. If the canal swells or deteriorates, it can place pressure on the tendons and median nerve resulting in tingling, significant discomfort, and/or pain. Since the median nerve controls various finger and hand movement, much of that discomfort manifests in both the hand and wrist, though in some cases the symptoms may extend in the forearm.

What causes carpal tunnel syndrome?

• Aging and arthritis
• Repetitive movement, especially if it involves bending the wrist downward
• Wrist injuries
• Bone spurs
• Pregnancy
• Hypothyroidism
• Diabetes
• Obesity
• Smoking

Women have a higher proclivity to develop this syndrome as their carpal tunnels are significantly smaller than males.

What are the primary symptoms of carpal tunnel syndrome?

• Tingling
• Numbness
• Weakness
• Pain in the fingers, hand, and/or forearm

Symptoms most frequently manifest in the thumb, index finger, middle finger, and half of the ring finger. Symptoms never manifest in the “pinkie,” so if you experience pain in all fingers except the pinkie, it is likely that you are experiencing carpal tunnel syndrome. Symptoms are often most prevalent at night and you may be able to relief pain temporarily by shaking the hand vigorously.

What are the treatment options for carpal tunnel syndrome?

• If possible, limit or cease activities that trigger symptoms and aggravate the condition. At the very least, rest the wrist occasionally when performing said activities.
• Wear a carpal tunnel brace or wrist support when at the computer or participating in activities that involve repetitive wrist movement.
• Ice the wrist for 10 minutes 1 or 2 times an hour.
• Take anti-inflammatory drugs to reduce swelling.
• Wear a carpal tunnel wrist splint at night.

The sooner you start treating the syndrome, the more likely you will prevent permanent nerve damage, so as soon as you are diagnosed with carpal tunnel syndrome, you should begin strategizing a treatment plan. In some instances the pain is just too intense and persistent, making surgery the best option. Surgery can increase the circumference of the carpal tunnel, thus reducing pressure on the nerve.

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Exercises for Lower Back Pain

Approximately 65 million Americans suffer from back pain, with lower back pain being the most frequent area of concern. Lower back pain is typically the result of ageing, overuse, muscle strains, and injury. While some initial down time may be in order, in most cases, staying active is the key to relieving chronic lower back pain. Too little activity can lead to loss of flexibility, strength, endurance, and increases the likelihood of more back pain. The right exercises will strengthen and support the lower back, reducing pain, speeding recovery, and preventing re-injury. On the flip side, the wrong exercises may trigger back pain or even cause irreparable damage, so it is important to choose your exercises wisely.

Beneficial Exercises for Lower Back Pain

• As a rule of thumb, choose gentle strengthening and stretching exercises for your core, back, and legs. These areas have the greatest influence on your lower back's health.
• Swimming is perhaps the best aerobic exercise for lower back pain. Try the back stroke or using a kick board.
• Pilates provide an amazing low impact comprehensive workout that stretches, strengthens, and tightens the core.
• Lifting hand weights – just be sure not to over-do it! The weight should feel slightly challenging but not uncomfortable or painful. Keep movements slow and calculated.
• Wall sits (see image) - Sit at a near 90 degree angle with your back against the wall. This will strengthen your core and your legs, while bracing your lower back.
• Press up back extensions - lie stomach down, with your hands under your shoulders, pushing with your hands so your shoulders begin to lift off the floor. This is will increase flexibility and strengthen your back.
• Partial crunches (i.e. a slight crunch, but not a full “sit up”) provide back stability while strengthening the core.
• Individuals with tight hamstrings are more likely to experience back pain, so gentle hamstring stretches are a great addition to any exercise regimen.
• Lie on the floor, with knees bent at 45 degrees, feet on the floor. Slowly lift your knee to your chest or as far is comfortable for you.
• Pelvic tilts are a very gentle strengthening move that will support the lower back and strengthen the lower abdominals – a tough area to target.
• Consider pairing exercise with a supportive lumbar back brace at early stages of recovery.
• Utilize heat therapy to loosen up muscles prior to a strenuous workout and apply cold therapy to decrease swelling and reduce pain.

Exercises to Avoid
• It goes without saying but avoid exercises that strain the back. If you feel pain, just stop. Be sure to “check in” with your body regularly. Trust your internal narrator. If your inner voice says “this feels like it could go wrong”, just stop.
• Avoid toe touches and similar fast-paced, drastic bending movements.
• Full sit-ups put too much pressure on the spine and should be avoided.
• Leg lifts (i.e. laying on the floor and elevating legs) place too much strain on the lower back.

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Back Pain in Children and Teens

If your child or teenager is experiencing pain in their back, it is important that you see a medical professional to diagnose the root cause or condition behind the pain. Thankfully, most back pain issues in children are simply the result of overuse or strain. Such minor soft tissue damage, such as strains to muscles, ligaments and tendons, is easily treated with rest and careful monitoring. There are, however, more serious injuries and conditions that should be considered and ruled out, especially is back pain is acute or persists for longer periods of time.

What triggers back pain in children and/or teens?

Sports Injuries & Accidents
If you are a parent, chances are you are no stranger to accident and activity-related injuries. These are natural parts of childhood. That said; always ensure your child wear the appropriate safety gear for sports and their seat belt. Obviously, some injuries may be more serious than others. No injury should be dismissed as minor without careful observation, especially if the child expresses acute or lasting pain. The injury could be a stress fracture which can be very serious.

Heavy School Bags
A recent BBC report reported that each year in the UK alone more than 120,000 kids visit the doctor regarding back pain resulting from a heavy backpack, with the problem being the worst among 11 to12 year olds. Your child should use both straps of their backpack and the pack should fit snugly against the back, with heavier books towards the back of the backpack. Children should not carry more than 10% of their body weight on their back, which is typically between 7 and 13 pounds. Recent studies showed some children carry as much as 60 pounds on their backs!

Scoliosis
Scoliosis is a condition that results in the abnormal curvature of the spine. It can manifest in children as young as 3 or as old at 18, and often grows more pronounced with growth spurts. Scoliosis is most prominent in females, but all children and adolescents should be regularly screened for the condition. Treatment varies depending on the condition and the patient’s age, but for most children, a special spinal back brace can help prevent further curvature. In some instances, surgery may be a better option.

More Serious Conditions
There are few serious conditions that may also result in childhood back pain, including spinal infection, a spinal tumor, juvenile arthritis, and spondylolisthesis (a condition that can affect vertebra and the nervous system.) While none of these conditions are common, they should be ruled out by a medical professional if pain persists.

About MMAR Medical: MMAR Medical Group Inc. is a supplier of orthopedic medical products including top quality post-operative back braces to a wide selection of hinged, unloader and arthritis knee braces.