Working in the kitchen takes its toll. Long hours standing, looking down, reaching up, bending and most of all, gripping utensils and bowls. Inevitably, something’s gotta give. Usually, it’s the smaller and weaker joints that collapse under the tremendous pressure. In the upper extremity, it’s the wrist and a very common diagnosis when you use your hands to grip is Carpal Tunnel Syndrome.
Carpal Tunnel Syndrome (CTS) is diagnosed when the median nerve in the wrist gets inflamed and irritated. It can present as numbness and tingling, weakness or a sharp, piercing pain in the hand, wrist and even up into the forearm. The median nerve is responsible for sensation to the first 3.5 fingers, the thumb to half of the 4th finger as well as motor control to the hand. The nerve sits in the carpal tunnel, which is a narrow passageway located in the base of the hand. The tunnel houses nerves and tendons and when there is irritation, poor positioning of the joint or other swelling, the median nerve can get compressed.
Catrine Roen, former pastry instructor at the International Culinary Center and founder of Real Treat Confections was diagnosed in June 2013. As a pastry chef, she understands the demands on the body. She woke with numbness in both hands and reports that this most recent episode came from increased caramel production in her new business.
CTS is the most common nerve entrapment of the body’s peripheral nerves. It is usually the result of pressure on the median nerve and tendons, rather than a problem with the nerve itself. In some people, the carpal tunnel is inherently smaller. Most common causes of injury are: typing, repetitive hand use, mechanical problems in the wrist joint, fluid retention during pregnancy, cyst or tumor in the tunnel or trauma or injury like sprains or fractures of the wrist. Differential diagnoses are bursitis and tendonitis which have been associated with repeated motions performed in the course of normal work or other activities.
Symptoms of CTS start gradually. Tingling, numbness, itching or burning can be felt in the hand and first 3.5 fingers. Swelling of the fingers and wrist is common but typically not apparent unless severe. Symptoms usually are one-sided but both hands can be involved, especially during sleep. A common complaint is the need to ‘shake out’ their hands to get the feeling back. Pain can progress as well as turn to weakness in the hand and wrist joints. There can be a loss of grip strength and fine motor task ability and if left untreated, wasting of the thumb muscles will occur. To treat CTS, reducing the inflammation comes first.
The use of cold therapy and rest is needed immediately. The wrist joint may also need to be protected with the use of a splint or other wrist guard that prevent the wrist from bending or extending. Anti-inflammatory drugs are beneficial at this time. They can be over the counter medicines, a prescription from your physician or local injection into the area. If the condition stabilizes, exercises for stretching and strengthening are incorporated. If there is no change to the above conservative therapies, surgery is an option.
Consult your local Physical Therapist who can diagnose you and prescribe a treatment plan. They will guide you in the appropriate exercises and modalities and refer you to any other practitioners as needed. We help you keep a good grip on life, and on your utensils!