Carpal Tunnel Symptoms and How to Treat It
Ray Smith
/ Categories: WELLNESS, 2023

Carpal Tunnel Symptoms and How to Treat It

Whether you work on a computer all day, swing a hammer, operate heavy equipment, drive a truck, do your part on an assembly line, or do other work that requires repetitive use of your hand, you’re at risk of joining the four to 10 million Americans suffering from carpal tunnel syndrome (CTS).

Frequently experienced as numbness and tingling in the thumb, index, middle finger and the thumb-side of the ring finger, carpal tunnel syndrome is caused by compression, or a squeezing, of the median nerve located in the wrist. In addition to providing feeling to the thumb, index, middle and part of the ring finger, this nerve also sends signals to the muscles around the base of the thumb. Symptoms of CTS are typically worse at night or while doing activities that require bending your wrist or grasping an object for long stretches of time (think gripping a steering wheel or holding a book).

In addition to the numbness and tingling, other symptoms of CTS may include: weakness, especially when pinching and gripping; and dropping things.

An important aspect of CTS is this: Once a person has numbness that is there all day, it is unlikely to resolve on its own without taking any action.

Left untreated, it can progress to more persistent numbness and burning. In severe cases, loss of muscle mass occurs at the base of the thumb on the palm side of the hand and the loss of sensation in the hand can be present all of the time which can make daily activities, such as buttoning a shirt or eating, difficult.

If you’re experiencing any symptoms of CTS—no matter how infrequent—see your doctor.

Diagnosing CTS is not complicated. Based on your own account and description of symptoms, your doctor may be able to determine if you have CTS.  If the diagnosis is not clear, a non-invasive test can confirm whether you have CTS and how severe it is.

Early treatment for mild CTS involves wearing a wrist brace at night to keep you from bending your wrist while you sleep. In some cases, day use may also be recommended based on the type of activities you engage in.

For moderate or severe CTS, surgery is typically recommended. One effective option is often referred to as ‘mini-open carpal tunnel release.’ A 5-minute outpatient procedure, the surgery requires a small incision at the base of the palm through which the ligament is cut to relieve the pressure on the median nerve, resolving the pain and tingling of CTS. Thanks to the small incision, the amount of scarring and discomfort is minimal, and risk of infection is low.

If you're experiencing symptoms of CTS, see your primary care doctor and ask if a referral to an orthopedic hand surgeon is needed to improve your symptoms to keep you on the job and enjoying life to the fullest.

 

David Veltre, MD, is a hand and upper extremity specialist at SVMC Orthopedics, which has offices in Bennington, VT and Williamstown, MA.

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Introducing Dr. Amy Freeth

Amy E. Freeth, MD, resumed endocrinology services at SVMC in March 2020. The practice, known as SVMC Endocrinology, is a part of Southwestern Vermont Medical Center (SVMC) and Southwestern Vermont Health Care (SVHC). It replaces the Bennington Osteoporosis Center, where Dr. David Gorson had provided similar services to the community until his retirement in 2019.

How do you describe endocrinology to people who don’t know what it is? The endocrine system is made up of glands that make hormones. These hormones are chemical messengers that travel via the bloodstream to communicate with the cells and organs of the body. Hormones are important for growth, development, mood, metabolism, and reproduction. These glands include the pituitary, thyroid, parathyroid, pancreas, adrenal, testes, and ovaries.

Endocrinology is a practice of medicine that specializes in disorders of these systems. Disorders most commonly are related to underactive or overactive function of these glands and require replacement of the hormone or specific treatments such as medications, ablation, or surgery.

Since hormones function in feedback loops and are part of a larger complex functional system that exists in flow with the human body, replacement hormones or treatment of endocrine disorders can be challenging and involve changes to our lifestyles that support the optimal functioning of the body.

What diagnoses are most common among the patients you treat?  Pituitary tumors, hypothyroidism, hyperthyroidism, thyroid nodules, thyroid cancer, hyperparathyroidism, osteoporosis, diabetes, adrenal insufficiency, Cushing’s disease, primary hyperaldosteronism, pheochromocytoma, obesity, and polycystic ovarian syndrome.

What sorts of treatments do you offer? I offer comprehensive consultation and management of endocrine disorders. I also interpret testing and make treatment plans for endocrine disorders. I also provide interpretation of bone density reports and perform fine needle aspiration biopsies in collaboration with Radiology Associates of Bennington. Technology is increasingly becoming more important in the management of diabetes. Technology includes glucose meters, insulin pumps, and continuous glucose monitoring (sensors). I work with certified diabetes educators to create a team approach to diabetes management. As we develop this new department, we are looking for innovative ways to help people regain and optimize their health. I have training in nutrition counseling and health coaching to help people find their path to good health.

Why is it important for patients who need an endocrinologist see them regularly? Your endocrinologist is part of your health team and has experience and a deep understanding of what is happening within your body to help assess, guide, and co-manage your disorder. There is testing that may need to be done to make sure you are living with optimal hormonal balance. Allowing hormones to run too low or too high can have lasting adverse effects on the body leading to other disease or imbalances.

How do you help protect patients who need to come into the office from infections, like COVID-19? At this time, I am seeing patients via telemedicine and phone visits. This week we are starting to see a portion of our patients in the clinic. Patients can register on the phone and wait in their car until the room is ready. Patients will be screened for fever and should wear a mask. Staff will wear proper protective equipment and follow guidelines for handwashing and cleaning of the rooms.

Since many patients who will likely want to come to the endocrinology clinic will be members of high-risk populations (diabetes, hypertension, obesity, and the elderly), patients will have a choice of the type of visit they have.

Dr. Freeth sees patients 8 a.m. – 5 p.m. Tuesday - Thursday in Suite 307 of the Medical Office Building located at 140 Hospital Drive in Bennington. For an appointment, call 802-447-4555. The schedule will expand to additional days as needed.

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