Lymphedema and Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition in which pressure on the median nerve results in:

• pain,
• numbness,
• tingling,
• weakness, or
• muscle damage in the hand and fingers.

Lymphedema of the arm may increase the risk of developing carpal tunnel syndrome. It also complicates the treatment of this condition.

If you have arm lymphedema, or at risk of developing it, you should:

• Be aware of how you use your hands and arms. This is particularly  true during extended periods of texting or keyboarding.
• Making changes as suggested below (see Modified Activities) will aid in reducing your risk of overuse injury.
• Act promptly if you have any symptoms of carpal tunnel (as explained below) to rest your hands and change the way you work. If symptoms perist, obtain treatment as quickly as possible, prompt treatment will minimize nerve damage to make recovery faster and more complete.
• Minimize lymphedema related arm swelling through lymphedema treatment, self care, and wearing properly fitted compression garments, as directed by your therapist.
• Try other treatment options before choosing surgery, since lymphedema can slow healing and complicate recovery from surgery on an affected limb.
• Eat foods that help fight inflammation. These include colorful vegetables and fruits, as well as fish or other sources of omega-3 fatty acids. Avoid foods that promote inflammation and overload the lymphatic system such as animal fats, dairy products, and fried foods.

CAUSES AND RISK FACTORS

The median nerve runs down the arm. along the palm side of the wrist, through a narrow passage in the heel of the hand (known as the carpal tunnel) and then it branches out into the palm and the fingers.

The carpal tunnel is so narrow that any swelling can pinch the nerve and cause the symptome of this disorder.

Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel.

SYMPTOMS

• Pain in the wrist or hand and sometimes when extending to
  the elbow.
• Numbness, or tingling in the thumb, fingers or the palm of the hand.
• Weakness, weak grip, difficulty carrying bags, or clumsiness gripping objects.
• Problems with fine finger movements (coordination) in one or both hands.

TREATMENT

Treatment options include:

• Make changes in how you use your hands.
• Wear a splint at night for several weeks to rest the wrist.
• If this does not help, you may need to try wearing the splint during the day.
• Do not apply ice or very hot compresses to skin affected by lymphedema. Hot and cold compresses may also provide relief.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen.
• Corticosteroid injections into the carpal tunnel area.
• Physical therapy or occupational therapy.
• Carpal tunnel release is a surgical procedure that cuts into the ligament that is pressing on the nerve.

MODIFY ACTIVITIES

Reduce the stress on your wrists by modifying your activities.

• Make sure the keyboard is at the right height so that your wrists are straight while typing.
• Try to minimize the time spent texting.
• Use gel pads or padded gloves to reduce pressure on the hands and wrist.
• Take regular rest breaks and avoid working in one position for long periods.

EXERCISES

Stretching exercises to help release tension include:

• Spreading your fingers as far as you can and gently flex your wrist back and forth.
• Using your thumb and forefinger to squeeze and gently massage the center of the palm, in the web of the thumb, and in the wrist.
• Starting from the center of the palm, slide your thumb along and gently stretch the thumb and each finger of the opposite hand.
• Exercises to improve upper body strength and flexibility can help prevent carpal tunnel. Look for a gentle exercise program such as yoga, qi gong, or Pilates. Ideally the instructor should knows about lymphedema.
• Increase your exercise program gradually within comfortable limits,

@ Lymph Notes 2015. This information does not replace the advice of a qualified physician.

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Category: Living With Lymphedema Updated: 2015-10-21