Famous for the role of Penny in the American series The Big Bang Theory, Kaley Cuoco has announced that she suffers from carpal tunnel syndrome, which she attributes to carrying her little girl regularly in her arms. How does this disorder arise? What are the possible treatments ? Update with Dr Laurent Grange, rheumatologist at the Grenoble Alpes University Hospital Center.
Through a video posted on her sports coach’s Instagram account, actress Kaley Cuoco shows herself in the middle of a sports session with a splint around each wrist. Since the birth of her daughter – currently 4 months old – she has suffered from carpal tunnel syndrome. Carrying your baby very regularly in your arms would be the cause.
Postpartum carpal tunnel syndrome: rare cases
For Dr. Laurent Grange, suffering from carpal tunnel syndrome during post-pastum is not trivial. Overuse of the wrists to carry a child is not a classic cause. “I don’t know the case of this actress but she can probably suffer from a naturally narrowed carpal tunnel. The overstrain of the wrists which are constantly in flexion when carrying her child and the hormonal changes linked to pregnancy … are associated factors that can lead to compression of the nerve and thus, cause carpal tunnel syndrome”, explains Dr. Laurent Grange.
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Carpal tunnel syndrome: what is it?
Carpal tunnel syndrome is a common disorder that is part of musculoskeletal disorders. The latter usually occurs in women and men between the ages of 40 and 50, and between the ages of 60 and 70. According to Dr Grange, “3 out of 10 women suffer from carpal tunnel syndrome after the age of 50”.
This pathology results in compression of the median nerve at the wrist. The carpal tunnel corresponds to a “little extensible fibrous canal”, located on the anterior face of the wrist. The latter contains the tendons of the flexor muscles of the fingers and the median nerve. “The median nerve is a nerve which is both motor and sensory and which will innervate the first three fingers, as well as a small end of the fourth”underlines the expert.
According to Dr. Laurent Grange, carpal tunnel syndrome is often “multifactorial”. There are many causes that favor its appearance:
- Diabetes ;
- The pregnancy ;
- Thyroid disorders;
- Tobacco consumption;
- Rheumatoid arthritis;
- Drop ;
- Occupational overstrain.
As the expert points out, in certain professions (agrifood, hotels, secretarial services, etc.), certain repetitive gestures can promote the appearance of this disorder:
- The cuts;
- Movements that require significant strength in the hand;
- Prolonged static effort;
- Twisting movements of the wrist;
- Repeated use of the thumb-index clamp (for example by cashiers);
- Prolonged exposure to vibration (eg a worker with a jackhammer).
“Carpal tunnel syndrome can also occur during repetitive gestures linked to intense practice of video games, gardening or even DIY”adds the expert.
Often, a clinical examination to study the sensitivity and movements of the fingers and hand is enough to diagnose this disorder. “The clinical diagnosis of carpal tunnel syndrome is fairly quick. We will come and hit the carpal tunnel with a reflex hammer. If this triggers electric shocks, there is irritation of the nerve at this level. We can also put the wrist in hyperflexion, which will cause these electric shocks”adds the rheumatologist.
Following the clinical examination, an electromyogram can confirm the diagnosis. “This consists of placing small electrodes along the path of the nerve and thus stimulating it in order to see if there is any slowing down or electromyographic abnormalities. This examination is also important before surgery for a canal syndrome. carpal to check that there is no paralysis”says Dr. Laurent Grange.
Painful symptoms to treat immediately
Symptoms of carpal tunnel syndrome very often occur at night in the first three fingers. These are numerous:
- Tingling sensations;
- Electric shocks in the first 3 fingers;
- Tingling (paraesthesia);
- Pain in the first 3 fingers (may radiate to the arm);
- Decreased sensitivity inside the hands at the level of the first 3 fingers.
As stated by Health Insurance, the symptoms of carpal tunnel syndrome “disappear spontaneously in about a third of cases”. However, they can reoffend. In this case, the establishment of a treatment should be considered.
“It is important not to wait to consult a doctor as soon as symptoms appear. The risk is that the pathology worsens and leads to motor impairment (paralysis)”warns the rheumatologist.
What are the possible treatments ?
According to Dr. Grange, it is above all necessary “stop performing the movement that triggers the pain”. The doctor will then ask for a “rest”, that is to say the prescription of an orthosis for “immobilize the wrist in a position that will free the channel as much as possible”.
In some cases, one or two cortisone infiltrations can help treat this disorder. However, if they do not work, surgery is the solution to consider. If the pain and/or numbness are very intense, or if the muscles are atrophied or even weakened, surgery is also necessary. Each year, just over 130,000 people are operated on for carpal tunnel syndrome, says L’Assurance Maladie.
“The operation will consist of removing what is compressing the nerve in this canal. We will come and release the nerve either in the open, which consists of opening and scraping around the nerve anything that can compress it; or without opening in making a very small incision and removing what is around the nerve”, explains Dr. Laurent Grange.
In order to prevent the appearance of this disorder, Dr. Grange explains that one of the solutions is to “diversify the gestures” and avoid those “which risk causing tendonitis, which will swell the tendons and reduce the space for the nerve”.