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Bharat Savur

The hand-and-wrist movement, repeated in one direction, over-extend the tendons, thus causing the carpal tunnel syndrome.

As you pen a personal note to your beloved, does your wrist tingle? When you paint your windows, is there a sharp sensation in the brush-wielding hand? When tapping the keyboard, does your wrist throb? Do you wake up to a midnight numbness between your thumb and the forefinger and think fearfully that paralysis has struck? Check it out with a physiotherapist, it could be the carpal tunnel syndrome (CTS).

It affects do-it-yourself, hands-on people — bank tellers, keyboard-users, vehicle-drivers; homemakers who wring washed clothes, shell peas, slice with a knife; and factory personnel who use the staple gun, etc. The same hand-and-wrist movement, repeated day after day, year after year, brings on CTS. It's called the carpal tunnel because the wrist region is shaped like a tunnel, and instead of trains, tendons and a meridian nerve snake through it. When the wrist is repeatedly flexed in one direction, the tendons over-extend and swell up. In their swollen state, they press the nerve and... ouch!

Three on-the-spot first-aid measures:

To stem the swelling, wrap an ice-pack around your wrist immediately. Never use a heating pad — the wrist will balloon up even more.

Prop your elbows on a table, with your hands pointed upward. Hold for two minutes. Next, massage the fingers. Then, stretch fingers backward and hold — 5 times.

Tie a handkerchief snugly around your wrist to keep it straight. This splint helps take the pressure off the nerve.

These three measures should suffice. However, if the pain persists, consider taking an anti-inflammation painkiller like aspirin or ibuprofen. This medication will reduce pain and inner inflammation. A painkiller like acetaminophen won't help — it will reduce only the pain, not the inflammation.

Though first-aid measures are all right for the short term, it is important to think long-term too, because tendons play a vital role. They connect muscle to bone. The stronger the tendons, the greater the flexibility. If the tendon weakens through over-use, the muscle also loses power. It shortens because it is no longer held taut by the tendons. That's why physical therapist Susan Iserhagen of Duluth, Minnesota, urges, "Make exercise as routine as eating." She adds, "It's important to exercise and relax all the problem-muscles every day even when you're not in pain."

The exercises she recommends should be done at least four times a day:

Wrist rotations: Rotate your hands for two minutes. "This exercises all the muscles of the wrist, restores circulation, and gets your wrist out of the bent position that normally brings on the CTS symptoms."

Raised arms rotations: Raise your arms above your head and rotate arm and wrist simultaneously for two minutes. "This gets your shoulder, neck and upper back in a better position and relieves stress and tension."

Neck rotations: Rest your hands on the table. Rotate your head for two minutes. Bend neck backward and forward for two minutes. Tip head to either side for two minutes. Turn neck to look over left shoulder, then right shoulder for two minutes. These exercises stave off sympathetic headaches.

Therapeutic exercises like those given above are different from spot-shaping exercises. Their aim is broader — to align, stabilise and strengthen all the assisting muscles to work together as a cohesive team with the primary problem-muscles. Thus, the local wrist tendons get a helping hand from their fellow-muscles and tendons in the arms, shoulder and neck. And you build an entire support system for the afflicted region.

Dr Deepak Chopra, author, Ageless Body, Timeless Mind, describes the role of therapeutic exercises beautifully. The body is like a house full of rooms in which exercise works like a caretaker. The exercise-effect is like the caretaker walking from room to room, switching on the lights. As he enters, he lights up each room and its beam reaches the next room making it glow. He continues thus, until the entire house is ablaze with lights.

Dr John Ellis, surgeon, family practitioner, Titus County Memorial Hospital, Mount Pleasant, Texas, believes that "the carpal tunnel syndrome is caused by a deficiency in vitamin B6." His 26-year experience with CTS patients has been largely successful. "It doesn't bring about immediate relief," he informs. "It takes about six weeks until the enzyme-changes cause the symptoms to subside. From 6-12 weeks you will notice a decided difference in your hands and fingers," he assures.

However, take your daily dose of vitamin B6 under the physician's guidance. At high levels, it can be toxic. The recommended daily allowance as set by the US government is 2 mg. Alongside, Dr John Sebright, head, hand surgery section, St Mary's Hospital, Grand Rapids, Michigan, advises "not bending your wrists when typing or driving. Time and practice will rid the awkwardness," he asserts.

Adds Susan Iserhagen: "Make sure you don't dangle your hand over the side of the bed while sleeping." In sum, the welfare of your wrist lies in your hands!

The writer is co-author of the book `Fitness for Life'.

Picture by G.R.N. Somashekar

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