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Keep hand and wrist pain at bay.

It's the bane of anyone who spends most of her time at a computer or doing intricate or repetitive work with her hands--a tingling or numbness in the hand and wrist, or a sharp shooting pain through the wrist and up the arm. Is it carpal tunnel syndrome?

"Possibly," says Robert Turner, PT, OCS, a Board-certified orthopedic clinical specialist and advanced clinician in the Sports Rehabilitation and Performance Center at the Weill-Cornell affiliated Hospital for Special Surgery. "Many people are familiar with the term 'carpal tunnel syndrome; so they think any discomfort or pain in the hand or wrist is a sign of the disorder. But pain from the neck or shoulder that radiates down the arm is equally common. That's why the right diagnosis is important."

Carpal tunnel syndrome. The carpal tunnel is a narrow passageway at the wrist on the palm side of the hand made up of small wrist bones and a ligament. Tendons, which help bend the fingers, and the median nerve pass through it. When the tendons or other soft tissues become irritated and swell, the tunnel narrows and the nerve becomes compressed, leading to carpal tunnel syndrome, Turner explains. "The main symptoms are numbness or tingling in the thumb and the next two or three fingers, as well as pain in the wrist and palm?

But entrapment of the ulnar nerve or the radial nerve, both of which run from the neck to the wrist and hand, also is very common. "When the ulnar nerve is compressed, you tend to have pain and tingling in the ring finger and the little finger--the third and fourth digits. When the radial nerve is compressed, you get wrist drop--an inability to extend the wrist upward when the hand is palm down--and numbness on the back of the hand and wrist?

What to do. Stretching the neck, forearm, and wrist will help relieve pain in all three conditions (see Moves of the Month), as will anti-inflammatories, such as ibuprofen (Advil) and naproxen (Aleve). However, these medications are not a good long-term solution, since they raise the risk of internal bleeding when taken frequently. In addition, Turner offers the following tips:

* Maintain good posture--don't slouch.

* Take frequent breaks: Get up and move around, turn your head from side to side, do neck stretches, and roll your shoulders back and down.

* Use a wrist pad when working at a computer.

* Get an ergonomic evaluation of your workspace, and make any necessary modifications.

* If you do a lot of cutting or chopping in the kitchen, "wrap a piece of foam around the handle of the kitchen knife to make it bigger and wider, so you don't have to clench your fist tightly," Turner suggests.

If symptoms persist or worsen, see your doctor.

"An assessment will determine whether the cause is coming from the neck, or directly at the carpal tunnel. If you have true carpal tunnel syndrome, your doctor may advise conservative treatments such as wearing a splint at night, reducing repetitive activities that stress the wrist, or a cortisone shot to relieve pain," Turner says. Surgery is an option if all else fails.


Two exercises to help relieve and prevent wrist and hand pain:

Forearm stretch: Stand in front of a table. Place the palms of your hands--fingers turned backwards toward your body--flat on the table, keeping your arms straight. Lean your upper body forward slightly and hold that position for 20 seconds, breathing normally; you will feel a stretch on the inside of your forearms and wrists. For a deeper stretch, move your upper body slowly back to an upright position. Repeat every hour.

Neck stretch: Sit in a chair. Reach your right hand toward the floor to stabilize your right shoulder. Place your left hand on the back of your head or neck and turn your head to the left. Gently pull as your chin moves to your left collarbone. Hold for three or four slow, deep breaths. Repeat on the other side. Do the exercise on both sides every hour or as needed.
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Title Annotation:BODYWORKS
Publication:Women's Nutrition Connection
Date:Dec 1, 2013
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