Possible Median nerve injury

Dear Ask The Doctor: Around a year ago, I woke up with an excruciating pain in my arm. I slept on it wrong and could not raise my arm above my head for two weeks. After three trips to the Chiropractor and two trips to the doctor I was given muscle relaxers to help ease the pain and increase my range of motion. They said it was caused by a pinched nerve. I worked through the pain until regaining all of my strength and range of motion back in my arm. I have never regained the strength however in the tip of my thumb. I have a complete loss of strength making it very difficult to pick up a ball and impossible to flick a lighter. This is the best example of tendon affected I can think of. As a Physical Education teacher, I have realized how important it is to have use of my thumb. Please help me! Thank you

Dear Jeff: Carpal Tunnel Syndrome (CTS) is an entrapment of the median nerve within the carpal tunnel at the level of the wrist. Usual symptoms include numbness, tingling, “pins and needles” and pain in the wrist and hand, especially the thumb, index and middle fingers. The conservative treatment includes first of all a work-site ergonomic assessment may help to reduce potentially exacerbating factors, in your case you should modify all the postures or activities that reproduce the symptoms. The use of a wrist-hand brace that sets the wrist joint in neutral position (to be worn at nighttime for a minimum of 3-4 weeks) many off-the-shelf wrist splints seem to work well. A specific stretching/strengthening program for the hand and wrist may be useful in improving strength and dexterity. The use of anti-inflammatory medications (i.e.: “Aleve”) may be of benefit if you have any pain. Lack of aerobic exercise (along with increased Body Mass Index) is a risk factor for the development of CTS and should be addressed. Overuse of legal drugs (e.g., caffeine, nicotine, alcohol) can contribute to CTS and should therefore be reduced. Most individuals with mild-to-moderate carpal tunnel syndrome (CTS) respond to conservative treatment, the local corticosteroid injection may be considered in those cases that show poor improvement with the conservative treatment (although injection rarely is used in practice).