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What is Carpal Tunnel
Vinnie Chiu discusses Carpal Tunnel Syndrome, symptoms and causes of Carpal Tunnel, and possible treatment options available.
Featured Speaker:
Vinnie Chiu
Hsien-Chih "Vincent" Chiu is the backbone of our Outpatient Occupational Therapy Clinic at Rehabilitation and Orthopedic Institute. As an Occupational Therapist, Vinnie helps our clients of all ages improve their abilities or adapt their environment to conquer all of life's challenges.Vincent joined our team in 2017 and has dedicated himself to improving his skills and has advanced his professional practice towards becoming a Certified Hand Therapist. Transcription:
What is Carpal Tunnel
Progressive, respectful, mentoring, compassionate. These are the values of Palmdale Regional Medical Center. And now, we proudly present Palmdale Regional Radio. Here's Melanie Cole.
Prakash: Welcome to Palmdale Regional Radio. I'm Prakash Chandran. And today, we're discussing carpal tunnel syndrome. Joining me today is Vincent Chiu, an occupational therapist and member of the medical staff at Palmdale Regional Medical Center.
First of all, Vincent, it's great to have you here today. Let's just start with the basics. What exactly is carpal tunnel syndrome?
Vinnie Chiu: Hello, everybody. I'm glad to be here. Carpal tunnel syndrome is caused by the compression to the median nerve in the wrist. Before we start to talk about carpal tunnel, we need to know where is your carpal tunnel. And there's an easy way to find it. Let's put our hand on the table and our palm facing up, and we draw the line from the fingertips of our thumb toward our wrist. And we draw another line from the fingertip of our small finger toward our wrist too. When those two lines cross each other on your wrist, that's about the carpal tunnel.
So in the carpal tunnel, there are nine tendons and the median nerve goes through this small passage. And the median nerve is the problem child here. If there's too much pressure to the nerve, then people start to have numbness in their fingers. And then because the medium nerve innervates the thumb, index, middle finger and half of the ring finger, so if you have the carpal tunnel syndrome, you will have the numbness, tingling, pain or even the burning sensation from the thumb to the ring finger.
Prakash: Yeah. So it's really about a compression of that nerve and that compression, maybe you can explain to us what causes this to happen?
Vinnie Chiu: For example, like right now, a lot of people are working from home, but they don't have proper setup at home. They use their laptop or the computer maybe like in the sofa or just not in an office chair, so they can cause the wrist pushing down against the table, so there's the pressure to the nerve. So if you're doing that every day, every day, then you will start to feel the symptom.
Prakash: Okay. Understood. So we'll get into the details of how you can position your wrist for when you're at a computer. But one of the next things that I wanted to ask is if someone is developing carpal tunnel syndrome, what are some of the symptoms that they're experiencing?
Vinnie Chiu: Some of my patients, they told me at the beginning, they feel the numbness in the fingers. A lot of them, let's start to feel it in the thumb or the index finger. And then when you're getting worse, then you will have the burning sensation. And the tingling or the numbness at the beginning is not that bad. So if you shake your hand, the burning sensation may go away. But when they get worse, you can feel it at night. So some people, they have a hard time to sleep at night because their hand is too painful.
Prakash: So Vincent, who is at risk for getting carpal tunnel syndrome? You mentioned that people that worked on their computer a lot or at a desk job, they were experiencing carpal tunnel, but are there any other professions that are potentially more predisposed to getting carpal tunnel over others?
Vinnie Chiu: For people who use their hand a lot, they have a higher risks to get the carpal tunnel syndrome. For example, like mechanics or you do the construction or you are the handyman, you need to use the tools a lot, you have the higher risks to get the carpal tunnel syndrome. Especially your tools, if your tools will cause a lot of vibration, you have the higher risk to get the carpal tunnel, too.
Prakash: So this is one thing that I struggled to understand. You mentioned that one of the things that causes carpal tunnel is that compression of that nerve. But if you're a mechanic, you may not necessarily have that compression you're just, for example, twisting your wrist a lot. So how do people like mechanics, for example, get carpal tunnel?
Vinnie Chiu: So when we talk about the compression, even twisting your wrist can cause the compression to the nerve, because your hand is not in a neutral position, because like when you use a tool, you probably need to twist your arm, you need to bend your wrist. And also, when you hold the tools, the tools can be the compression to the nerve, especially when there's a lot of vibration. They will be a continuous pressure to the nerve too.
Prakash: So let's talk a little bit about treatment itself. If someone is experiencing the symptoms of carpal tunnel that we talked about, what is available to them to get it fixed?
Vinnie Chiu: If you start to have the symptoms, the most important thing for you is stop to do what you're doing right now, because your hand needs a rest. And then for the occupational therapist, what we do for the patient is we can make customized brace because the brace can support, immobilize and protect the wrist, so we can keep the pressure off your median nerve. So your hand has a chance to rest and to get better. Also, we will show people to do some exercise. For example, the nerve gliding exercise, they can help with the symptoms.
Prakash: Yeah. You know, one of the things that I was taught, because I work at a desk in front of a computer a lot, was to, for example, take my thumbs, put them in between my fingers and to push my wrist forward, right? So I'm getting a stretch on that nerve. Are those some of the things that you help your patients with?
Vinnie Chiu: Yeah. The exercise that I mentioned about, the nerve gliding exercise, it's like the stretching exercise. You put your hand to the side, just like you will reach to somebody sitting next to you and your palm facing up, and then you're bending your wrist and there will be the stretching exercise for the median nerve.
Prakash: Okay. Understood. So it sounds like carpal tunnel can be treated without surgery quite often. Can you talk a little bit about when surgery is needed?
Vinnie Chiu: I think it will depend on how severe are your symptoms. Because some people, they can get better with the therapy, but some people don't. I think it is because if you come to us and then you just start to have your symptom and then you listen us, you do what we told you, you use the brace and then you change the way you, then they will help the symptoms.
But for some people, they don't use the brace or they can not use a brace and then because of their job, they need to keep using their hand, so the therapies won't be able to help with the symptom. So, the doctor may just suggest them to get a surgery.
Prakash: Okay. And just moving back to what really causes carpal tunnel syndrome, we discussed earlier some of the professions that makes people more predisposed to getting carpal tunnel. Are there any other factors that just make it worse for people like genetics or anything like that?
Vinnie Chiu: Right now, according to research, there's no specific reason why some people get carpal tunnel. Because, for people who are the mechanics, some people get it, but some people don't. So it's really hard to tell how come some people have higher risk to get it. But what we see is some people, they will ignore the pain. Their hand starts to hurt, but they just kind of ignore it. They may take the pain medicine, but keep doing what they're doing, so they can make it worse.
Prakash: Yeah. And expanding on that a little bit. If people don't get this addressed, let's say they continually keep working on something where they're feeling numbness and they're feeling pain, what is the risk of not getting it addressed?
Vinnie Chiu: So if the symptom is really bad, eventually, let's look at our hand first. If you look at your thumb, there's like the fatty part over there. That's the muscle control of our thumb. And if you don't get treated of the carpal tunnel syndrome, the muscles here, they will get atrophy. When we say atrophy, the muscle is gone. Your strength will be really bad because you don't have the muscle over there. So you will lose the strength in your hand and then your hand will be really hurting a lot, really painful at night. You probably won't be able to sleep at night. And then your hand is tingling, have the burning sensations. Everything like you try to touch, you will have the burning sensation. That's really bad.
Prakash: You know, we always like to talk about prevention here and I'm sure you have seen so many cases of carpal tunnel syndrome. What is one thing that you wish more people knew before they came to see you?
Vinnie Chiu: The most important thing for us is we like for people to keep eyes on how they use their hands or how they use their wrists. Because we see a lot of people when they work, their wrists are bending a lot. There will be a lot of pressure to the carpal tunnel. So no matter what we do, if we can't keep our wrists in neutral position. When we say neutral, it's flat. You're not bending up or you're not bending down and then they can reduce a lot of pressure to the median nerve.
Prakash: That's really good advice. And for people that need to use their hands, for example, mechanics that are working with tools all day long, and that's just part of what they have to do, what advice or recommendations might you have for them to help prevent the onset of carpal tunnel syndrome?
Vinnie Chiu: For the people like that, I will suggest them to get-- because I know there are some tools that are defined to anti-vibration. So if they can get a tool like that, so the tools won't be shaking or vibrate that much, they will help a lot. And also really be careful how they're holding the tools. When you hold the tools, you don't bend the wrist too much. You try to keep it straight. And also, taking a break is really important to, too. If you feel like your hand is sore, it's numb, take a break, do some stretching, and then I think that will help a lot.
Prakash: Absolutely. So Vincent, just before we sign off today, is there anything else that you'd like to share with our audience about carpal tunnel syndrome?
Vinnie Chiu: I think for carpal tunnel syndrome, we see some people, they just ignore it. And then, they say, "All right. It will go away if I take a break, if I don't use that much." But I will say don't wait. If you have the symptom, go to your doctor or talk to the therapist and see what we can do to help you..
Prakash: Well, Vincent, I think that's the perfect place to end. Thank you so much for your time today. For more information, please call (661) 206-6250 or visit PalmdaleRegional.com/roi for more information and to get connected with one of our providers. That concludes another episode of Palmdale Regional Radio with Palmdale Regional Medical Center.
For more health tips and updates, follow us on your social channels and remember to subscribe, rate and review this podcast and all other Palmdale Regional Medical Center podcasts. Finally, please share this on your social media and be sure to check out all the other interesting podcasts in our library.
Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center, and the hospital shall not be liable for actions or treatments provided by physicians. My name is Prakash Chandran, and thank you so much again for listening.
What is Carpal Tunnel
Progressive, respectful, mentoring, compassionate. These are the values of Palmdale Regional Medical Center. And now, we proudly present Palmdale Regional Radio. Here's Melanie Cole.
Prakash: Welcome to Palmdale Regional Radio. I'm Prakash Chandran. And today, we're discussing carpal tunnel syndrome. Joining me today is Vincent Chiu, an occupational therapist and member of the medical staff at Palmdale Regional Medical Center.
First of all, Vincent, it's great to have you here today. Let's just start with the basics. What exactly is carpal tunnel syndrome?
Vinnie Chiu: Hello, everybody. I'm glad to be here. Carpal tunnel syndrome is caused by the compression to the median nerve in the wrist. Before we start to talk about carpal tunnel, we need to know where is your carpal tunnel. And there's an easy way to find it. Let's put our hand on the table and our palm facing up, and we draw the line from the fingertips of our thumb toward our wrist. And we draw another line from the fingertip of our small finger toward our wrist too. When those two lines cross each other on your wrist, that's about the carpal tunnel.
So in the carpal tunnel, there are nine tendons and the median nerve goes through this small passage. And the median nerve is the problem child here. If there's too much pressure to the nerve, then people start to have numbness in their fingers. And then because the medium nerve innervates the thumb, index, middle finger and half of the ring finger, so if you have the carpal tunnel syndrome, you will have the numbness, tingling, pain or even the burning sensation from the thumb to the ring finger.
Prakash: Yeah. So it's really about a compression of that nerve and that compression, maybe you can explain to us what causes this to happen?
Vinnie Chiu: For example, like right now, a lot of people are working from home, but they don't have proper setup at home. They use their laptop or the computer maybe like in the sofa or just not in an office chair, so they can cause the wrist pushing down against the table, so there's the pressure to the nerve. So if you're doing that every day, every day, then you will start to feel the symptom.
Prakash: Okay. Understood. So we'll get into the details of how you can position your wrist for when you're at a computer. But one of the next things that I wanted to ask is if someone is developing carpal tunnel syndrome, what are some of the symptoms that they're experiencing?
Vinnie Chiu: Some of my patients, they told me at the beginning, they feel the numbness in the fingers. A lot of them, let's start to feel it in the thumb or the index finger. And then when you're getting worse, then you will have the burning sensation. And the tingling or the numbness at the beginning is not that bad. So if you shake your hand, the burning sensation may go away. But when they get worse, you can feel it at night. So some people, they have a hard time to sleep at night because their hand is too painful.
Prakash: So Vincent, who is at risk for getting carpal tunnel syndrome? You mentioned that people that worked on their computer a lot or at a desk job, they were experiencing carpal tunnel, but are there any other professions that are potentially more predisposed to getting carpal tunnel over others?
Vinnie Chiu: For people who use their hand a lot, they have a higher risks to get the carpal tunnel syndrome. For example, like mechanics or you do the construction or you are the handyman, you need to use the tools a lot, you have the higher risks to get the carpal tunnel syndrome. Especially your tools, if your tools will cause a lot of vibration, you have the higher risk to get the carpal tunnel, too.
Prakash: So this is one thing that I struggled to understand. You mentioned that one of the things that causes carpal tunnel is that compression of that nerve. But if you're a mechanic, you may not necessarily have that compression you're just, for example, twisting your wrist a lot. So how do people like mechanics, for example, get carpal tunnel?
Vinnie Chiu: So when we talk about the compression, even twisting your wrist can cause the compression to the nerve, because your hand is not in a neutral position, because like when you use a tool, you probably need to twist your arm, you need to bend your wrist. And also, when you hold the tools, the tools can be the compression to the nerve, especially when there's a lot of vibration. They will be a continuous pressure to the nerve too.
Prakash: So let's talk a little bit about treatment itself. If someone is experiencing the symptoms of carpal tunnel that we talked about, what is available to them to get it fixed?
Vinnie Chiu: If you start to have the symptoms, the most important thing for you is stop to do what you're doing right now, because your hand needs a rest. And then for the occupational therapist, what we do for the patient is we can make customized brace because the brace can support, immobilize and protect the wrist, so we can keep the pressure off your median nerve. So your hand has a chance to rest and to get better. Also, we will show people to do some exercise. For example, the nerve gliding exercise, they can help with the symptoms.
Prakash: Yeah. You know, one of the things that I was taught, because I work at a desk in front of a computer a lot, was to, for example, take my thumbs, put them in between my fingers and to push my wrist forward, right? So I'm getting a stretch on that nerve. Are those some of the things that you help your patients with?
Vinnie Chiu: Yeah. The exercise that I mentioned about, the nerve gliding exercise, it's like the stretching exercise. You put your hand to the side, just like you will reach to somebody sitting next to you and your palm facing up, and then you're bending your wrist and there will be the stretching exercise for the median nerve.
Prakash: Okay. Understood. So it sounds like carpal tunnel can be treated without surgery quite often. Can you talk a little bit about when surgery is needed?
Vinnie Chiu: I think it will depend on how severe are your symptoms. Because some people, they can get better with the therapy, but some people don't. I think it is because if you come to us and then you just start to have your symptom and then you listen us, you do what we told you, you use the brace and then you change the way you, then they will help the symptoms.
But for some people, they don't use the brace or they can not use a brace and then because of their job, they need to keep using their hand, so the therapies won't be able to help with the symptom. So, the doctor may just suggest them to get a surgery.
Prakash: Okay. And just moving back to what really causes carpal tunnel syndrome, we discussed earlier some of the professions that makes people more predisposed to getting carpal tunnel. Are there any other factors that just make it worse for people like genetics or anything like that?
Vinnie Chiu: Right now, according to research, there's no specific reason why some people get carpal tunnel. Because, for people who are the mechanics, some people get it, but some people don't. So it's really hard to tell how come some people have higher risk to get it. But what we see is some people, they will ignore the pain. Their hand starts to hurt, but they just kind of ignore it. They may take the pain medicine, but keep doing what they're doing, so they can make it worse.
Prakash: Yeah. And expanding on that a little bit. If people don't get this addressed, let's say they continually keep working on something where they're feeling numbness and they're feeling pain, what is the risk of not getting it addressed?
Vinnie Chiu: So if the symptom is really bad, eventually, let's look at our hand first. If you look at your thumb, there's like the fatty part over there. That's the muscle control of our thumb. And if you don't get treated of the carpal tunnel syndrome, the muscles here, they will get atrophy. When we say atrophy, the muscle is gone. Your strength will be really bad because you don't have the muscle over there. So you will lose the strength in your hand and then your hand will be really hurting a lot, really painful at night. You probably won't be able to sleep at night. And then your hand is tingling, have the burning sensations. Everything like you try to touch, you will have the burning sensation. That's really bad.
Prakash: You know, we always like to talk about prevention here and I'm sure you have seen so many cases of carpal tunnel syndrome. What is one thing that you wish more people knew before they came to see you?
Vinnie Chiu: The most important thing for us is we like for people to keep eyes on how they use their hands or how they use their wrists. Because we see a lot of people when they work, their wrists are bending a lot. There will be a lot of pressure to the carpal tunnel. So no matter what we do, if we can't keep our wrists in neutral position. When we say neutral, it's flat. You're not bending up or you're not bending down and then they can reduce a lot of pressure to the median nerve.
Prakash: That's really good advice. And for people that need to use their hands, for example, mechanics that are working with tools all day long, and that's just part of what they have to do, what advice or recommendations might you have for them to help prevent the onset of carpal tunnel syndrome?
Vinnie Chiu: For the people like that, I will suggest them to get-- because I know there are some tools that are defined to anti-vibration. So if they can get a tool like that, so the tools won't be shaking or vibrate that much, they will help a lot. And also really be careful how they're holding the tools. When you hold the tools, you don't bend the wrist too much. You try to keep it straight. And also, taking a break is really important to, too. If you feel like your hand is sore, it's numb, take a break, do some stretching, and then I think that will help a lot.
Prakash: Absolutely. So Vincent, just before we sign off today, is there anything else that you'd like to share with our audience about carpal tunnel syndrome?
Vinnie Chiu: I think for carpal tunnel syndrome, we see some people, they just ignore it. And then, they say, "All right. It will go away if I take a break, if I don't use that much." But I will say don't wait. If you have the symptom, go to your doctor or talk to the therapist and see what we can do to help you..
Prakash: Well, Vincent, I think that's the perfect place to end. Thank you so much for your time today. For more information, please call (661) 206-6250 or visit PalmdaleRegional.com/roi for more information and to get connected with one of our providers. That concludes another episode of Palmdale Regional Radio with Palmdale Regional Medical Center.
For more health tips and updates, follow us on your social channels and remember to subscribe, rate and review this podcast and all other Palmdale Regional Medical Center podcasts. Finally, please share this on your social media and be sure to check out all the other interesting podcasts in our library.
Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center, and the hospital shall not be liable for actions or treatments provided by physicians. My name is Prakash Chandran, and thank you so much again for listening.