"Am I having a stroke? What's going on here?" she
remembers thinking.
Her arms felt "asleep," like they might if you had fallen
asleep on top of them, but they wouldn't "wake up" as they
normally would. It took much longer than she expected for the feeling
to come back into her hands and arms.
"I wasn't even sure what was happening," she
says.
When the scary scenario repeated itself, she started telling friends
and co-workers at DynCorp about it. They told her it might be carpal
tunnel syndrome, and a visit to her doctor confirmed it.
A person develops carpal tunnel syndrome when the median nerve, which
runs from the forearm into the hand, gets compressed.
"The median nerve controls sensations to the palm side of the
thumb and fingers, as well as impulses to some small muscles in the
hand that allow the fingers and thumb to move," according to National
Institutes of Health. "The carpal tunnel -- a narrow, rigid
passageway of ligament and bones at the base of the hand, houses
the median nerve
and tendons. Sometimes, thickening from irritated tendons or other
swelling narrows the tunnel and causes the median nerve to be compressed."
Symptoms
The squeezed nerve causes pain, weakness, tingling or numbness in
the hand and wrist, which radiates up the arm.
"Splinting is the mainstay of first treatment," Dr.
Wade Huffman says.
People wear splints or braces that immobilize the wrist, reducing
pressure on the median nerve and, in some cases, allowing healing to
occur. Anti-inflammatory drugs and cortisone shots can also be used
to reduce swelling.
For many people, like LPN Dauna Sabin, the early indicators of carpal
tunnel syndrome are not bothersome enough to require any treatment
at all. Sabin didn't know she had a problem until her workplace, Premier's
Occupational Medicine center, introduced a new nerve transmission test
to detect nerve neuropathy.
"It shocks the nerve endings here," Sabin says, indicating
a spot about halfway between her wrist and elbow on her inner arm. "It
measures the length of time it takes for the stimulation to reach
that muscle (in the hand). The longer it takes to reach the muscle,
the
more interference you're getting."
In severe cases, people with carpal tunnel syndrome can't sleep, and
have trouble doing every routine task in life -- brushing their teeth,
turning a doorknob, using a fork or spoon, or writing. As the syndrome
progresses, muscles in the hand that are not getting nerve support
begin to atrophy. The resulting weakness in the hand makes people drop
even lightweight objects.
"Turning a key in a car or lifting a pot of hot water off the
stove" are some of the things patients complain they are unable
to do, Huffman says.
For some people, says Huffman, the nerve compression is not debilitating.
Even if they register nerve problems through testing, like Sabin, the
person does not have carpal tunnel syndrome until they begin to experience
pain, night waking, and other bothersome symptoms.
Relief
Some people get relief from carpal tunnel syndrome with minimal treatment
or none at all. Others, like Sabin, have precursors that may never
develop into the syndrome. Although she is a nurse, Sabin prefers to
limit medical intervention as much as possible.
"I'm one of those needle-phobia, surgery-phobia people," she
says. "I figure when it really starts interfering with my daily
activity, then I'll have to get aggressive. For now, I just shake
out the tingles."
For some people, surgery is the only option, Huffman says. Burnett
is one of those for whom surgery was a blessing. Because she had problems
in both hands, Dr. Cooper Beasley did surgery on first one hand, then
the other, to keep from disabling both hands at one time. Burnett says
the added strain on her left hand while her right hand healed -- she
had to write, type, carry groceries and do all other tasks with her
left hand -- caused the pain in that hand to worsen dramatically before
surgery.
Healing was slow, but the improvement is well worth it, she says.
Now, a few years after surgery, Burnett still has minor problems with
her hands.
"My left hand still has some numbness," she says. "Even
today, if I do extreme work in the yard, with my flowers, pulling
the hose around, you're constantly reminded, 'Hey, you don't have
a ligament
there.'"
"If you don't have anything done, the nerves support the muscles,
and you can lose the use of your hands," she says. "I think
they probably saved my hands."
Stacy Smith Segovia can be reached at 245-0237 or by e-mail at stacysegovia@theleafchronicle.com
Originally published Wednesday, July 28, 2004
