Carpal tunnel syndrome (CTS) is a common painful disorder involving the wrist and hand. The carpal tunnel is formed on three sides by the wrist carpal bones and covered by the flexor retinaculum a thick band of tissue. Within the carpal tunnel lies the median nerve surrounded by the flexor tendons of the hand.
Carpal tunnel syndrome develops when the median nerve is compressed within the wrist. Individuals such as drummers that repetitively use their wrists are at risk for developing CTS. Carpal tunnel syndrome may also develop from pressure on the median nerve from a wrist fracture, inflammation or swelling around the nerve as it passes within the carpal tunnel or pregnancy. Vibration may also predispose you to CTS. This occurs when the drumstick or hand hits a drumhead, cymbal or pad. Inflammatory diseases such as arthritis, diabetes and hypothyroidism may cause CTS.
CTS symptoms include:
- Pain, numbness and/or tingling in the wrist, thumb, index and middle fingers. Pain may radiate into forearm, arm and shoulder.
- Pain increases with increased use of the wrist or hand.
- Pain worsens at night and awakens you from sleep.
- Grip strength decreases and you can begin to drop objects.
- Muscle wasting in the thumb occurs in severe cases.
CTS is diagnosed by finding the following:
- A positive Tinel’s sign over the median nerve at the wrist with tapping causing an electrical shock sensation in the hand and fingers.
- A positive Phalen’s test causing numbness and tingling in the thumb, index and ring finger with wrist flexion.
- A positive nerve conduction/electromyography test (NCV/EMG), an electrical test to evaluate nerve and muscle function.
Treatment includes: Anti-inflammatory medication, wrist splinting at night and during periods of repetitive wrist motion, treating of underlying disease process, therapy, avoiding aggravating activities, oral steroid medications. Surgical treatment of severe cases includes: Open or arthroscopic carpal tunnel release.
Make sure your hands and wrists are comfortable while playing, take regular breaks from repetitive motion, avoid resting your hands and wrists on hard or ridged surfaces for prolonged periods, make sure your positioning is ergonomically correct, maintain adequate control of any disease process, practice daily wrist and hand stretches and exercises.