Although the wrist and hand is a small area, it consists of a complex system of muscles, nerves, tendons, and joints which work together to enable us to perform what are known as fine motor skills such as typing or buttoning a shirt. Nerve irritation can be a common cause of symptoms that affect those fine motor skills.
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The sciatic nerve is a large nerve that travels from the lower back through the hip and down the leg and into the foot. It supplies both skin and muscles. Symptoms can include pain, numbness and tingling, and in some cases weakness. Although some cases can be complicated, most are treated conservatively and never return.
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Carpal Tunnel Syndrome (CTS) is a common cause of median nerve entrapment. The tunnel itself lies between the transverse carpal ligament and the bones of the wrist. Along with several tendons, the median nerve must travel through this tunnel. When this space becomes compromised and the nerve is affected it is known as CTS.
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Carpal Tunnel Syndrome (CTS) belongs to a group of disorders referred to as “cumulative trauma disorders,” or CTDs. The word “cumulative” refers to the cause being repetitive motion, usually fast and prolonged. Over time, the wear and tear on the upper extremities accumulates and symptoms begin to occur and possibly worsen. This can result in changes in movement intended to avoid further injury that then overstress another part of the arm, which can lead to a second injury. Like dominos, injury after injury can eventually result in multiple conditions between the neck and hand. Let’s take a look at two common CTDs…
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The carpal tunnel is made up of eight small carpal bones that bridge the forearm to the hand. Without these eight little bones, the motion at the wrist would be very restricted and limited to bending a little bit up and a little bit down. Think of all the things you are able to do with a large range of motion at the wrist like tightening a small screw by hand, pulling on a wrench, using a hammer, working under the dash or inside the engine compartment of a car, threading a needle, sewing, knitting, crocheting, and even washing dishes. As you can see, we put our wrists in some pretty strange positions!
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Most patients will say that stretching seems to make them feel better and more mobile. Although stretching is important, it is not always recommended once pain starts. Stretching is designed to lengthen muscles and tendons, but back problems typically affect the ligaments. The problem here is that the ligaments are stretched out, allowing what is known as creep to happen. Creep is a progressive change or length which occurs when the joint and ligaments are under a constant load they were not designed to handle. So while stretching may help a tight muscle, in this case its effect on ligaments can be detrimental.
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