A Message from: Martin Avenue Pharmacy

Trying to ignore tingling or numbness in your hand and wrist?

Ever have a sharp pain shoot through your wrist and up your arm? It could be CARPAL TUNNEL SYNDROME

Carpal Tunnel Syndrome (CTS) is a painful progressive condition caused by pressure on the median nerve in the wrist. Some carpal tunnel sufferers say their fingers feel useless and swollen, even though swelling is not visible. The symptoms often first appear during the night, since many people sleep with flexed wrists. A person with carpal tunnel syndrome may wake up feeling the need to "shake out" the hand or wrist. As symptoms worsen, people might feel tingling during the day. Decreased grip strength may make it difficult to form a fist, grasp small objects, or perform other manual tasks. In chronic and/or untreated cases, the muscles at the base of the thumb may waste away. Some people are unable to distinguish hot and cold by touch.

Women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be smaller in women. The dominant hand is usually affected first and produces the most severe pain. Persons with diabetes or other metabolic disorders that directly affect the body's nerves are at high risk. Some cases of carpal tunnel syndrome may be due to repetitive strain and CTS is especially common in those performing assembly line work. There are also a variety of health conditions — including diabetes, arthritis and hypothyroidism – that can lead to CTS.

Carpal tunnel syndrome is typically diagnosed by a hands-on examination to rule out other conditions, as well as clinical signs of the condition, which can include swelling and discoloration. A practitioner may manipulate the hand to cause tingling or other symptoms. A nerve conduction velocity test can be done to measure the speed of electrical impulses as they pass through the carpal tunnel; a slowdown of the impulse can be a sign of CTS.

Early diagnosis and treatment are important to avoid permanent damage to the median nerve. Treatment of carpal tunnel syndrome may involve the following:

  • eliminating repetitive stress movement
  • night splints to immobilize the wrist
  • nonsteroidal anti-inflammatory drugs (NSAIDs such as ibuprofen)
  • corticosteroid injections to reduce inflammation
  • surgery

Some studies have also found Vitamin B6 (pyridoxine), prolotherapy, acupuncture, acupressure, exercise, physical therapy, and yoga to be beneficial for carpal tunnel syndrome.

Carpal tunnel syndrome can be a symptom of untreated — or inadequate treatment of — hypothyroidism. If you have carpal tunnel syndrome and have not had your thyroid evaluated, you may want to discuss this with your doctor before you consider an invasive treatment like surgery.

In the U.S., the primary cause of hypothyroidism is Hashimoto’s disease — an autoimmune disease in which antibodies attack the thyroid gland, and eventually slow it down. Symptoms can start long before the slowdown is reflected by the Thyroid Stimulating Hormone (TSH) test but can be detected when a Thyroid Peroxidase Antibodies (TPO) test is included as part of a thyroid workup. Studies show that treatment of patients with normal TSH levels who have Hashimoto’s disease may help lower antibodies, and prevent progression to overt hypothyroidism. Research has shown that restoration of hormone balance, immune system support and dietary changes (such as a gluten-free diet) may lower antibodies, reduce inflammation, and help resolve symptoms in some patients.

The thyroid produces the two key hormones, T4 and T3. T4 is a storage hormone, and its function is to be converted into T3, the active hormone that delivers oxygen and energy to cells, tissues, glands and organs. In a thyroid test panel, the prescriber can choose to include TSH, Free T4, Free T3, and TPO. Thyroid hormone therapy is complicated when the active thyroid hormone T3 is not measured and deficiencies are not addressed. A patient can have a TSH in the “normal reference range” and yet still have low-normal or below-normal Free T3 levels, indicating that she does not have enough active thyroid hormone in her bloodstream. Patients often prefer combination treatments that include both T4 and T3.

Ask your Martin Avenue Pharmacist for more information.

September 2014 Over-The-Counter Specials


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Phone: (630) 355-6400 | Fax: (630) 355-6522 | Email info@martinavenue.com