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Question:

Sudden thumb and pointer finger numbness

Dear Ask The Doctor:
Hi. I am a culinary student so I do a lot of knife skill practicals which involve a lot of intricate cutting. I had been doing it for about ten minutes and my right thumb and pointer finger went numb. I can still use them but it is the most bizarre feeling. They feel swollen almost but dont look it. While typing they tingle a little bit but thats all. I stopped using the knife almost two hours ago and nothing has changed. I tried stretching them, rubbing them, and nothing is helping. Please help. I dont have insurance so I dont want to make a doctors appointment if it isnt necessary.


Answer:

 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).


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