Does it Hurt When You go Like This?

Carpal tunnel syndrome behaves, according to Dr. Michael Redler, "Very much like a finger that's been slammed into a door, with the nerve being the finger. The problem is that if you have carpal tunnel, that door is still closed on your finger."

If the descriptive image is cringe-worthy, it's helpful in illuminating the chronic pain that drives so many patients to his office. Dr. Redler, who grew up and lives in Fairfield, is a founding partner of the Orthopaedic Sports and Medicine Center (OSM) in Fairfield (with offices in Trumbull, Shelton and Stratford) and is board certified and fellowship-trained in sports medicine and hand surgery. He is also the orthopedic consultant to Major League Lacrosse and associate clinical professor for the department of physical therapy and athletic trainers at Sacred Heart University.

"Typically, carpal tunnel syndrome starts gradually with a vague aching in the wrist that can extend to the hand or forearm," says Dr. Redler. Symptoms, he said, include weakness, numbness and tingling in the fingers, often during and after actions such as holding a telephone, using a computer mouse or gripping a steering wheel for prolonged periods of time.

Dr. Redler, who has treated hundreds and hundreds of patients for carpal tunnel, explains that the syndrome develops when the median nerve -- which runs from the forearm into the hand -- becomes pressed or squeezed at the wrist. The disorder can be due to a congenital predisposition, such as when the carpal tunnel itself is simply too small. But repetitive flexing and extending of tendons in the hands and wrists, particularly when done forcefully (as in operating power tools, for example) and for prolonged periods without rest, also can increase pressure within the carpal tunnel.

Carpal tunnel creeps in as you peck away at your computer all day, or swing a hammer or maybe enjoy a ferocious serve and volley game on the tennis court, when you notice weakness in your wrist. Or maybe even a little numbness and clumsiness. And your wrist begins to ache more and more. So, is all lost?

You needn't tender your resignation from work, nor must you give up that tennis game. Carpal tunnel, in its early stages at least, can be treated with the "simple things first" plan, according to Dr. Redler.

"I suggest seeing a doctor for treatment when you feel pain or have associated symptoms. Initially I'll suggest resting the afflicted area, along with a wrist splint at night and perhaps large doses of Vitamin B6," he says. "They can help."

And if they don't, the next step is an EMG nerve conduction test to determine the extent of tendon damage. From there, localized physical therapy or a round of cortisone injections will often alleviate symptoms.

Dr. Redler urges patients to "never skip the steps" before considering surgery for carpal tunnel syndrome. Many patients report relief from their symptoms before they need to take that step. But if you do need surgery, Dr. Redler's expertise will put your hands in fine hands.

For more information about Dr. Redler, go to the OSM website, or call (203) 254-1055.

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