Wrist pain prevented 35-year-old woman from even holding her mobile phone. What was the diagnosis?

The diagnosis was swift, thanks to a distinct electric-shock sensation triggered by a simple tap near the wrist, a hallmark of carpal tunnel syndrome.

Published Feb 03, 2024 | 11:00 AM ⚊ Updated Feb 03, 2024 | 11:00 AM

Representative pic of CTS

Kala, 35, was too busy with life to bother about a minor annoyance — a tingling sensation, and slight pain in her right hand, especially on the wrist.

The daily juggling of work and household chores seldom gave her time for such minor irritant, a mistake anyone like Kala could make, oblivious to what lies ahead.

Kala soon paid the price for ignoring the warning her body had given her. The condition — and the pain — aggravated into an ordeal, depriving her of a good night’s sleep, and making it difficult for her to even hold her mobile phone without discomfort.

The symptoms worsened by the day, and Kala decided to seek medical help. The decision took her to Dr Sudhir Kumar, a Consultant Neurologist at Apollo Hospital.

Also Read: New tool by IISc researchers redefines carpal tunnel syndrome diagnosis

More than symptoms

A routine clinical examination revealed more than symptoms — it exposed an underlying condition exacerbated by lifestyle factors and highlighted by a high body-mass index of 28.

The diagnosis was swift, thanks to a distinct electric-shock sensation triggered by a simple tap near the wrist, a hallmark of carpal tunnel syndrome, later re-confirmed through nerve conduction studies.

The revelation of hypothyroidism as a contributing risk factor added another layer to Kala’s health condition, prompting a multifaceted treatment approach.

Taking to X, Dr Kumar, who usually writes detailed descriptive diagnosis to create awareness in the general public, said he prescribed a tailored regimen for Kala.

She was prescribed medications, physical therapy, and advised to adopt a low-carbohydrate diet coupled with regular exercise. The integrated approach bore fruit, manifesting in significant clinical improvement in a month.

Also Read: Handwriting or typing? Researchers know what is better for your brain

What is carpal tunnel syndrome?

Carpal Tunnel Syndrome (CTS), characterised by the compression of the median nerve in the wrist, manifests through pain, tingling, and a burning sensation in the affected hand, sparing only the little finger.

This condition predominantly affects the dominant hand. It can, however, afflict both hands in about 40 percent of cases, with symptoms potentially radiating to the forearm and intensifying at night.

The CTS risk landscape is diverse, and triggered by hypothyroidism, diabetes, rheumatoid arthritis, gout, obesity, pregnancy, and certain occupational activities like prolonged computer use or playing musical instruments.

Diagnosing CTS

The doctor explained that diagnosing CTS involves a combination of clinical symptom assessment and nerve conduction velocity (NCV) studies, with ultrasound and MRI reserved for specific scenarios.

Also, treatment options vary from medications, steroid injections, and splint usage to physiotherapy and, in some cases, surgery, depending on the severity and underlying causes of the syndrome.

Also Read: Karnataka has a teen pregnancy problem: More than 28,500 underage girls reported pregnant

Exercises designed for CTS relief — but stop if it hurts

Wrist flexor stretch:

Extend your arm in front of you with the palm facing up.
Use the other hand to gently pull the fingers down toward the floor until you feel a stretch in your forearm.
Hold for 15-30 seconds, then switch hands.

Wrist extensor stretch:

Extend your arm in front of you with the palm facing down.
Gently pull the hand towards your body using the other hand until you feel a stretch on the top of your forearm.
Hold for 15-30 seconds, then switch hands.

Median nerve glide:

Extend your arm in front of you with the palm facing up.
Slowly bend the wrist and fingers upward, then extend them. Bend your elbow slightly if needed.
Repeat the motion smoothly, gliding the median nerve within the carpal tunnel.

Tendon glides:

Start with your fingers extended straight out.
Bend the top two joints of the fingers down into a hook fist, keeping the large knuckles at the base of your fingers straight.
Next, move into a full fist position.
Finally, open your hand with your fingers straight out.
Repeat the sequence 5-10 times.

Wrist lifts (using a light weight):

Sit or stand with your forearm supported on a table or your knee, palm facing up.
Hold a light weight (like a small dumbbell or a can of soup) in your hand.
Slowly, bend your wrist up and down, maintaining a smooth and controlled movement.
Repeat 10-15 times, then switch hands.

Thumb stretch:

Extend your arm in front of you with the palm facing upwards.
Gently pull your thumb back towards your body until you feel a stretch.
Hold for 15-30 seconds, then switch hands.

Grip strengthening:

Squeeze a soft ball or a stress ball in your hand as tightly as possible without causing pain.
Hold for 5 seconds, then release.
Repeat 10-15 times, then switch hands.