YOUR HEALTH
Splint often effective for carpal tunnel syndrome
DR. DONOHUE

DEAR DR. DONOHUE: Will you do a piece on carpal tunnel syndrome? Its causes, symptoms and how doctors cut you to fix it? -- J.S.

ANSWER: "Carpus" is "wrist." The tunnel spoken of is just that, a tunnel whose sides and bottom are wrist bones and whose roof is tough ligaments. Through that tunnel pass the tendons that bend the fingers and a large nerve that serves the thumb, index, middle and part of the ring finger. If things get crowded in that tunnel -- and they can -- then the nerve is compressed and you have carpal tunnel syndrome.

The compressed nerve sends out painful sensations, numbness or peculiar feelings felt in the thumb, the involved fingers and wrist. Sometimes the grip weakens, especially when the thumb comes into play.

Most of the time the diagnosis is self-evident. When there is a question, studies on how impulses are conducted in the involved nerve remove a doubtful diagnosis. One simple confirmatory test is to bend the wrist downward and hold the bent position for a minute. When people with carpal tunnel syndrome do that, the pain of carpal tunnel syndrome occurs.

Before thinking about cutting, how about trying a splint? It rests the wrist and can open the tunnel. Sometimes it needs to be worn only at night. Antiinflammatory medicines help -- Advil, Aleve and the rest. A doctor can inject one of the cortisone drugs into the tunnel to quiet swelling, another way to open the tunnel. Surgery is the last step. The surgeon makes an incision in the wrist and then surgically enlarges the tunnel. Today many surgeons are doing this operation with a scope, which lessens the damage to wrist tissues and accelerates healing. Not every carpal tunnel patient, however, is a candidate for scope surgery.

In a few instances, this syndrome comes on as a result of some other illness, like rheumatoid arthritis, diabetes or a malfunctioning thyroid gland.

DEAR DR. DONOHUE: I have a friend who plans to have a double knee replacement. Since he is 81, I am concerned that the healing process will be difficult to bear. Do you consider it advisable to have both knees replaced in one operation? Is healing more successful in the warmer months of the year? -- M.B.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853- 6475. Readers may also order health newsletters from www.rbmamall.com. 2006 North America Syndicate Inc. All Rights Reserved