Carpal Tunnel Syndrome

Alright. As a massage therapist, this is kind of a sore subject with me. Which is why I am going to address it on here. I will apologize ahead of time because I am totally going to break my rule of using internet sources at a minimum. Unfortunately, I am on a break at work and do not have access to my collection of medical books at home.

Carpal tunnel syndrome occurs when the pressure in the carpal tunnel increases enough to decrease nerve conduction in the median nerve. The symptoms usually come on gradually: burning, tingling, itching numbness in the palm and fingers. Grip strength may decrease, as well as, sensation.

The carpal tunnel is located in your wrist. It is created by three carpal bones and the flexor retinaculum. (Feel free to comment if you have questions). Nine flexor tendons and the median nerve go through the tunnel.

Causes can include:
*Congenitally smaller carpal tunnel
*Trauma or injury to the wrist
*Fluid retention
*Cyst/tumor in the canal
*Repetitive/consistent flexion of wrists such as typing or holding a large platter on a flexed wrist
*Inflammatory arthritis
*Hypothyroidism
*Tightness/swelling in forearm muscles

Okay, so this is where I jump on my soapbox. Carpal tunnel surgery should be a LAST resort. A lot of times tightness in the forearm muscles and swelling are causing the symptoms. Surgery may give temporary relief, but in MY EXPERIENCE, usually it is short lived. Scar tissue begins to form from the procedure which takes up the space just as well as the swelling. The symptoms then continue to get worse and scar tissue is much harder to break up than swelling and tightness. One type of surgery cuts through the flexor retinaculum (which helps hold your tendons down). This may reduce pressure off the canal, but IN MY OPINION, this increases the muscular instability and the chances that you could develop CTS again.

If you look above, I high-lighted what I have seen be the most common causes of carpal tunnel. In fact according to one website I found (althought it is a .com website), the most common cause of carpal tunnel syndrome is "muscle imbalance in the hand and forearm due to overuse."

It is best if CTS is caught early to keep the increased pressure from damaging the nerve permanently.

Massage is a great way to treat CTS. I would suggest going to a professional, but you can do it yourself at home, too. Your overall goal should be to reduce the swelling in the area and to loosen the muscles in the forearm and hand up. Other treatment options include drugs (NSAIDS, corticosteroids), increasing your vitamin B6 intake, acupuncture, chiropractic care,cold care and obviously surgery.

Sources
Katz and Simmons. The New England Journal of Medicine. Carpal Tunnel Syndrome.June 6, 2003. http://www.nejm.org/doi/full/10.1056/NEJMcp013018

National Institute of Neurological Disorders and Strokes. Carpal Tunnel Syndrome Fact Sheet.

Balance Systems, Inc. Causes of Carpal Tunnel Syndrome.http://www.repetitive-strain.com/causes.html

Body Blog 1: The bladder.

Hello. Welcome to my Body Talk blog. I think that the human body is one of the most fascinating subjects on the planet. How everything works together in sync. How it combats illnesses and abnormalities. I want to share my fascination with you. 

So, Topic #1: The Urinary Bladder. 

The bladder is such a fascinating structure. 

It expands (or distends) in size to allow you to hold more waste. The maximum capacity of the bladder is between 800-1000 mL. As the urine accumulates, rugae in the organ flatten out and the walls of the bladder thin. Rugae are fun structures. You can find them in the stomach, too. They are folds in the lining of the organ. 

Now, we get to the part I find most interesting. TRANSITIONAL CELLS. (A.K.A The reason your bladder walls can thin).  Transitional cells form the lining of the bladder and ureters and part of the urethra. 

As the bladder fills and the rugae flatten out, these cells do something amazing. They actually change shape. When the bladder is empty, these cells appear cube or dome like. Once the bladder is full, however, they become flat, irregular, and squamous. The cells also thin from 6 layers down to 3. All of this allows the bladder to store more urine without increasing the internal pressure significantly. 

Cool, huh? I'm keeping this one short and sweet. We'll talk about stuff I'm more versed in next post (like muscles).

Sources. 

Marieb, Mallatt. "23". Human Anatomy (5th ed.). Pearson International. p. 700

Marieb. Human Anatomy and Physiology (6th ed.). Pearson Education, Inc. p. 123-124, 1023-1024

SIU SOM Histology INTRO. Epithelial Study Guide. http://www.siumed.edu/~dking2/intro/epith.htm#trans