When It’s not Carpal Tunnel
A number of other conditions can cause symptoms that you may mistake for carpal tunnel syndrome or another repetitive strain injury. Here’s a rundown on three of these conditions.
Until something goes wrong, you probably won’t know you have a bursa. There are about 150 of these tiny liquid-filled sacs in your body, which serve as little pillows to cushion your muscles and tendons. When they’re injured—from a blow, a fall, or too much constant pressure—they swell painfully. Kneeling or leaning on your elbow too long can cause bursitis, as can badly fitting or poorly designed shoes. Occasionally, bursitis is caused by an infection or by a nearby swollen tendon. It can cause dull pain that gets worse when you move your joint, and it may wake you up at night.
The conventional treatment for bursitis is rest and ice. Many physicians recommend that you stop the activity that causes pain, apply ice packs for twenty minutes every hour or two, and after forty-eight hours switch to heat, such as a warm bath or a hot compress for pain relief. I recommend gentle massage to the muscles around the joint to increase circulation and to decrease inflammation. Physicians will warn you, however, that directly massaging the inflamed bursae will only make them worse, as pressure is what caused the problem in the first place.
Tendons are bands of tissue that connect your muscles to your bones. Tendinitis—or inflamed tendons—is caused by stress on a tendon, such as misalignments or microtears. Tendinitis can be felt in the joints of the ankle, shoulder, elbow, wrist, hand, or hip. Because tendons and bursae are so close together, when tendons swell they can put pressure on the bursae, so you may often have both conditions at the same time, particularly in the shoulder. Treatment consists of alignment and muscle therapy. You shouldn’t exercise until you’re recovered, but you need to run the affected joint gently through its range of motion to retain flexibility. Massage lightly to increase circulation and to decrease swelling.
This is also known as tennis elbow or golfer’s elbow. The small knobs at the end of your humerus, the main upper arm bone, are known as epicondyles, and overworking the wrist and fingers can stress or tear the muscle and tendon at this spot. Symptoms of epicondylitis can include pain in the forearm and hand numbness, and pain on the inside or outside of the elbow joint (typically worse when you bend your wrist.) When your elbow is out of alignment, this problem can surface because of the constant repetitive stress on the elbow joint from using it in a specific motion. Generally, with this condition you will feel pain if you try to straighten your arms, and the elbow area may hurt when you touch it.
Raynaud’s has symptoms like those of carpal tunnel syndrome, but it is not a repetitive strain injury. It involves a constriction of the blood vessels and has been linked to arthritis, lupus, and other problems, such as using hand tools that vibrate. Raynaud’s causes cold fingers and sometimes tingling and numbness.
Other Repetitive Strain Injuries
As I’ve mentioned, carpal tunnel syndrome, while the best-known repetitive strain injury, is certainly not the only one. There are other conditions, some with similar symptoms, and you can have more than one at a time.
While the method and the other techniques presented in this website will likely give relief for most repetitive strain injuries, you may need professional medical counsel for diagnosis or to determine the seriousness of the muscle strength loss or to see if you have any other injuries.
Here’s a look at other repetitive strain problems.
This compression is caused by holding a phone with an upraised shoulder. It affects discs in your neck and makes moving your head painful. Symptoms include weakness in the upper arm and shoulder and, possibly, numb fingers. Preventing this is simple: If you need your hands free while you are talking on the phone, use a bluetooth, phone headset, or speaker phone.
When a tendon rubs against the lining of a joint, called the synovia, the resulting inflammation is called tenosynovitis. DeQuervain’s, a type of tenosynovitis, is an inflammation of the tendon and the tendon sheath at the base of the thumb. It can be caused by using a track ball on a keyboard, banging too hard with your thumbs while you type, or by jamming the joint accidentally. The result is sharp pain when your thumb is moved or twisted.
This condition, like carpal tunnel syndrome, involves compression of the median nerve, but in this case it’s at the pronator teres muscle—a muscle that twists the forearm and helps the elbow bend. It involves pain in the wrist and forearm, and Phalen’s and Tinel’s tests are negative. It can happen at work when your elbows are regularly raised too high—such as reaching up to use a computer mouse—or held at an awkward angle.
Ulnar nerve problems:
Cubital tunnel syndrome. This affects anyone who works with a bent elbow and makes small movements while holding a tool or device. It may result in numbness, tingling, and eventual weakness in the affected muscles, caused by entrapment of the ulnar nerve in the underarm. People who get this commonly include dentists, musicians, chefs, jewelers, or anyone who writes a lot.
Distal ulnar neuropathy. Also called Guyon’s canal syndrome or ulnar tunnel syndrome. What happens here is that the wrist’s ulnar nerve, which is in a tunnel near the carpal tunnel, becomes compressed. This can cause numbness in the ring and little fingers, and problems grasping.
Sulcus ulnar syndrome. You may know your ulnar bone as your funny bone, and this condition can develop in people who frequently lean on their elbows. It can cause numbness, tingling, or even a contraction in the ring and little fingers.
Thoracic outlet syndrome. These symptoms are caused by compression of the nerves that pass into the arms from the neck. This situation occurs when there is a misalignment of the lower cervical and upper thoracic vertebrae. It can be caused by an extra rib, a broken collarbone, or rounded shoulders from poor posture. Thoracic outlet syndrome causes pain, weakness, numbness, and tingling in the shoulder, arm, hand, or all three. Hand pain is often the worst in the ring finger and little finger, and pain gets worse as you use the arm. Musicians such as guitar players who sit with rounded shoulders, hunched over and looking down for long periods of time, tend to get this condition, as do students who hunch over their books, knitters, or quilters.
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