Loss of certain hand and finger movements

Dear Ask The Doctor: I have lost certain movements of the left wrist, thumb and first three fingers. My little finger works perfectly. I just can't stretch my thumb and fingers out. I can clench my fist all right and even open bottles. I have all my normal feeling and I don't have any pain or tingling etc. I just can't open my hand or lift my wrist very easily. I am a golf professional.

Dear Michael: possibly your description corresponds with a beginning of a Carpal Tunnel Syndrome (CTS) which is an entrapment of the median nerve within the carpal tunnel at the level of the wrist. You may have or not some of the usual symptoms (numbness, tingling, “pins and needles” and pain in the hand), or just a feeling of weakness especially in 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. If you have any pain, 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) seems to work well. A specific stretching/strengthening program for the hand and wrist may be useful in your case to improve strength and dexterity. 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).