Carpal tunnel syndrome

So i think i just reached another level on my List of what else can go wrong !!!!

Everyone has had a minor problem with a finger, hand, or wrist. Most of the time our body movements do not cause problems, but it's not surprising that symptoms occur from everyday wear and tear or from overuse. Finger, hand, or wrist problems can also be caused by injuries or the natural process of aging.

Your fingers, hands, or wrists may burn, sting, or hurt, or feel tired, sore, stiff, numb, tingly camera, hot, or cold. Maybe you can't move them as well as usual, or they are swollen. Perhaps your hands have turned a different color, such as red, pale, or blue. A lump or bump might have appeared on your wrist, palm, or fingers. Home treatment is often all that is needed to relieve your symptoms.

Finger, hand, or wrist problems may be caused by an injury. If you think an injury caused your problem, see the topic Finger, Hand, and Wrist Injuries. But there are many other causes of finger, hand, or wrist problems.
Overuse problems
Carpal tunnel syndrome is caused by pressure on a nerve (median nerve camera) in the wrist. The symptoms include tingling, numbness, weakness, or pain of the fingers and hand.

Overuse problems
Carpal tunnel syndrome is caused by pressure on a nerve (median nerve camera) in the wrist. The symptoms include tingling, numbness, weakness, or pain of the fingers and hand. See a picture of carpal tunnel syndrome camera.


The carpal tunnel is a narrow space in the wrist. It contains wrist bones and a ligament (transverse carpal ligament) across the wrist where the palm and forearm meet. Tendons and the median nerve pass through this space to your hand. The median nerve supplies feeling and some movement to part of the hand.
Carpal tunnel syndrome is usually caused when an illness or other problem makes the carpal tunnel space too small. This puts pressure on the median nerve and causes pain, tingling, and other symptoms.

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer David Pichora, MD, FRCSC - Orthopedic Surgery

5 Steps to Make Physical Therapy Work for Your RA

5 Steps to Make Physical Therapy Work for Your RA

WebMD Feature

By Jeannette Moninger

Reviewed By David Zelman, MD

Doing physical therapy exercises can help your RA by making you stronger and more flexible. That can help you feel better.

"When you get up and move, you'll actually have less pain and more energy," says Brett Cook, a physical therapist at Independence Rehab in Sandy, Utah.

Cook knows what he's talking about, and not just because of his medical background. At the age of 1, he was diagnosed with juvenile rheumatoid arthritis. "I understand the pain and fatigue of living with RA," Cook says. "I also know firsthand that physical therapy for RA vastly improves one's quality of life."

Follow these five suggestions from Cook and other RA experts to make physical therapy a successful part of your rheumatoid arthritis treatment.

1. Work With a Pro

Ask your rheumatologist to recommend a physical therapist who has experience working with people with rheumatoid arthritis.

"We can create an individualized physical therapy program based on your RA symptoms and disease progression," says Jim Long, senior physical therapist at Cleveland Clinic's Lutheran Hospital.

A physical therapist can also make sure you're doing the exercises correctly and show you new ones to try, so you'll be less likely to get frustrated and give up.

2. Adopt a "No Excuses" Policy for Physical Therapy

If you're tempted to say, "I hurt too much today. I'll do my exercises tomorrow," don't give up. Instead, work a different, less painful part of your body.

For instance, if your knees are your most painful joint, "do some seated wrist and arm exercises like bicep curls," Cook says. Warm-water exercises are also good because the water's buoyancy relieves pressure on your joints, and the warmth is soothing.

As with any kind of exercise program, you're more likely to do it if you make a habit of doing it at the same time every day. Schedule your workout time on a calendar and treat it just like you would a doctor's appointment. Don't cancel!

3. Stiff Joints? Turn Up the Heat

Mornings can be tough since joints get stiff overnight. A warm shower does more than wake you up -- it also serves as your therapeutic warm-up. Moist heat increases muscle relaxation, boosts blood supply to the painful area, and relieves muscle spasms.

"I'm more likely to follow through on my physical therapy exercises once the water's soothed me," says Audrey Sawyer Mills, who has RA. Her home in Houston is equipped with a hot tub, whirlpool sauna, and a shower rail.

4. Include Aerobic Exercise

Aerobic exercise is an essential part of physical therapy for RA. "Weight-bearing activities build and strengthen bone while reducing your risk of other health problems like heart disease and diabetes that often accompany rheumatoid arthritis," Long says.

Pair up with a walking partner or sign up for a class for people with arthritis. "You're less likely to bail on an activity if you know others are counting on you to show up," Long says.

Check with your local Arthritis Foundation office to find a health club near you that offers arthritis-friendly exercise programs including aquatic, tai chi, yoga, and walking activities.

5. Set Goals for Your PT

The first few years after her diagnosis, Mills felt she was in too much discomfort to manage any physical therapy. Her pain and mobility got worse until the once-active young mother was using a cane. "I was a 30-year-old trapped in a 90-year-old's body," Mills says.

Determined to "get better for my kids," Mills began working with a physical therapist and vowed to do her exercises every day, even through painful flare-ups. "I was especially motivated because I saw how rheumatoid arthritis affected my mom's ability to get around and enjoy life," she says.

Let family and friends know about the goals you've set for your physical therapy. You'll be more motivated to follow through, and loved ones can cheer you along the way.

In addition to keeping up with her kids, Mills' other goal was to get back to the gym. Today, she teaches spin class three days a week and competes in body-building competitions. "People say they'd never guess I have a debilitating form of arthritis," Mills says. "I wouldn't be the active person I am today if I didn't make physical therapy for RA a priority every single day."

View Article Source

Reviewed by David Zelman, MD on March 13, 2013

© 2011 WebMD, LLC. All rights reserved.

Heart Disease and Rheumatoid Arthritis

Heart Disease and Rheumatoid Arthritis

Rheumatoid arthritis almost doubles the risk of having a heart attack within the first 10 years of getting an RA diagnosis, according to the American College of Rheumatology. The good news is that a heart-healthy lifestyle and certain medications may help protect the heart.

Inflammation Link

Inflammation is a major part of rheumatoid arthritis. It's also linked to heart disease and the risk of having a heart attack.

Some researchers think the inflammation in RA may cause higher levels of inflammation in the body generally, including in the coronary arteries, which supply the heart with blood.

Some RA treatments may also make heart disease more likely.  They include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Prednisone and other steroid drugs

Reducing Your Risk

You can take steps to help make a heart attack less likely:

• Don't smoke.
• Eat a diet rich in fruits, vegetables, low-fat protein (such as poultry, fish, legumes, nuts and seeds, and low-fat dairy), and whole grains.
• Avoid foods high in sodium, saturated fats, trans fats, and cholesterol.
• Get plenty of physical activity and exercise.
• Get regular checkups.
• Get regular tests for high blood pressure, blood sugar levels, and high cholesterol; Talk to your doctor about your health history and your family history of heart disease.
• Stay at a healthy weight; obesity makes heart disease more likely.

Can RA Medications Reduce the Risk of Heart Attack?

Medications such as methotrexate, other DMARDs, and biologics -- all used to control RA inflammation -- may help reduce the risk of heart disease, according to findings published in the journal Arthritis Research and Therapy. Your doctor can help you see if your medications and doses are appropriate for your heart's health.

If you have high cholesterol, your doctor may also prescribe statins.

WebMD Medical Reference

View Article Source

Reviewed by David Zelman, MD on March 13, 2013

© 2013 WebMD, LLC. All rights reserved.

Is RA Affecting Your Energy?

Next Steps

• Keep Up Your Good Sleep Habits
  It's great that you're sleeping enough. Getting good sleep on a regular basis makes you feel better. Keep this habit going!
• Manage Your Time
  It's OK to say "no" more often and weed out commitments that drain you. That will give you more time to rest, exercise, eat right, and relax -- all of which can give you more energy.
• Ask for Help
  Asking for help can feel awkward at first, but nudge yourself: It's a great skill to build. Take these steps:

  • Give yourself permission to need help. You're still independent.
  • Don't worry about owing someone a favor. Saying "thank you" is enough.
  • Remember that others usually want to help. It makes them feel good.
• Stay Connected With Your Doctor
  Keep those lines of communication open. Your doctor truly wants to know how you're doing and should be willing to change your treatment plan, if needed.
• Stick With Good Food Choices
  You're a nutritional rock star if you're mostly eating vegetables, fruits, whole grains, and lean protein. A treat every now and then is fine, of course. Just keep the big picture healthy and allow yourself some treat foods now and then.
• Exercise for Energy
  Challenge yourself to move more often. Regular exercise can boost energy and mood and reduce pain.

  • Find an exercise buddy. You may be less likely to skip a workout if someone else is expecting you.
  • Make it fun. Walk, bike, garden -- whatever you enjoy.

  Don't wait until you feel like it. Get out there anyway, and just tell yourself you'll do as much as you can.

Rheumatoid Arthritis: Avoiding 6 Common Mistakes

                      Treating RA With Biologics

Rheumatoid Arthritis: Avoiding 6 Common Mistakes

Most people with rheumatoid arthritis can live full, active lives despite their disease. But living a good life with RA often means you need to work at managing your disease and get the help you need. Take care to avoid these six common mistakes.

RA Mistake 1: Not Seeing a Rheumatologist

If you’re like most people with RA, the first doctor you saw for your joint symptoms was a primary care physician. But a specialist has more training in treating RA.

Just 20 years ago, RA was often treated with medications that relieved pain but didn't stop ongoing joint damage. Today, there are many new, effective -- and highly complex -- treatments for rheumatoid arthritis that do both. It's important to see a rheumatologist, who has the training and experience to prescribe and monitor those medications.

If you haven't seen a rheumatologist, your primary care doctor should be able to refer you to one. The American College of Rheumatology (ACR) also lists rheumatologists in your area. 

Mistake 2: Becoming a Couch Potato

When you have joint pain and fatigue, it's hard to get up and get moving. But regular exercise is one of the best things that you can do for your health. While rest is also important for managing your disease, too much inactivity can make pain, fatigue, and stiffness worse.

Even when your RA is flaring, you can -- and should -- do gentle range-of-motion exercises. Range-of-motion exercises help maintain joint movement and flexibility by taking joints through their full span of movements. No weights are used.

You may also be able to gently exercise in water during flares.

When your disease is less active, you should be more active. Add exercises to build muscle strength and joint stability and improve aerobic fitness.

Talk to your rheumatologist or a physical or occupational therapist about the best and safest exercises for you. Walking can be a good exercise for people with RA, and it doesn't even require going to a gym! Warm-water aerobic exercise may be another choice to consider -- the water gives sore joints some additional support.

Mistake 3: Skipping Doctor Appointments

While you may not feel the need to see your rheumatologist when your RA is less active, keeping your appointments is still important. 

During regular visits, your doctor will:

• Monitor the course of your disease
• Determine how well your treatment is working
• Look for harmful side effects
• Adjust your treatment, if necessary

In addition to seeing your doctor, you also may need periodic lab tests or X-rays. It's important that keep those appointments, too.

Mistake 4: Not Taking Prescribed Medications

Pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) may help your joints feel better. But they do nothing to stop the joint damage that is going on inside. That requires a more powerful disease-modifying antirheumatic drug (DMARD) or biologic response modifier, or both.Years ago, doctors started RA treatment with aspirin and other pain relievers. If the disease got worse, they then prescribed a DMARD. Today, doctors are likely to prescribe a DMARD or a biologic (or both) early on, particularly for aggressive RA.

In fact, ACR guidelines recommend that all people diagnosed with RA be given a DMARD, regardless of how active or severe their RA is. Studies have shown that starting powerful drugs earlier may be more effective in reducing or preventing joint damage.

If your rheumatologist recommends a DMARD or biologic and you don't take it, you may be risking serious joint damage that cannot be repaired. If you have active RA and your doctor has not recommended one of these drugs, ask if you need one.

Mistake 5: Skipping Medication When You Feel Good

You may be tempted to skip your medications on days when you’re feeling better. But failing to take your medications could cause the pain -- or even your rheumatoid arthritis -- to get worse.

If you take medication for pain and inflammation, you should take it consistently. Missing a dose could cause the pain to return, and it may be more difficult to relieve. The same is true for joint inflammation. It's better to keep it under control than allow it to flare and try to get it under control again.

To control your RA, some medications need to stay in your bloodstream at therapeutic levels. If you miss a dose of medication, you should take it as soon as you remember (but don't take a double dose). If you miss a dose often -- even if you are feeling better at the time -- blood levels of the drug may drop and could cause a flare of your RA.

Mistake 6: Accepting Depression

Living with RA isn't easy. It can be painful and unpredictable and make it hard to do the things you enjoy. It's understandable that you may become sad at times, but you don't have to accept depression as a part of your disease.

Ask your doctor to refer you to a mental health professional who works with people with chronic diseases. Counseling may help you develop better skills for coping with RA. Attending a support group, such as those offered by the Arthritis Foundation, may also help.

If you still experience feelings of depression, let your doctor know. Some people with rheumatoid arthritis benefit from taking antidepressants. Simply accepting depression can take the joy out of life and make it more difficult to manage your disease.

WebMD Medical Reference

Can Your Diet Help Relieve Rheumatoid Arthritis?

If you have rheumatoid arthritis (RA), you may have heard that a specific diet or certain foods can ease your pain, stiffness, and fatigue. 

Eating certain foods or avoiding certain foods may help your rheumatoid arthritis symptoms. But the Arthritis Foundation says there is no specific arthritis diet.

If you find certain foods make your rheumatoid arthritis symptoms worse and others make your symptoms better, it makes sense to make some changes to your diet. It's best to do that with advice from your doctor or a nutritionist, to make sure you get all the nutrients you need. 

Can a Mediterranean Diet Help Rheumatoid Arthritis?

The traditional Mediterranean diet is loaded with fruits, vegetables, nuts, olive oil, legumes, and fish. Those foods are rich in nutrients that are good for you. 

However, many other things also affect your health. A good diet is key, but it's not an RA cure. Your RA treatment plan should include traditional medicine, as well a healthy diet and other good habits.  

Will Going Gluten-Free Relieve Joint Pain?

Gluten is a protein found in wheat, rye, and barley. It's also found in many packaged and restaurant foods. When people who have celiac disease eat gluten, their bodies react by attacking the small intestine and preventing the body from absorbing nutrients. Over time, this can slow growth or lead to anemia, osteoporosis, and intestinal cancer.

What does celiac disease have to do with rheumatoid arthritis (RA)? Research shows that having an autoimmune disease (like RA) increases your change of getting another (like celiac disease or diabetes). Plus, there’s evidence to suggest that people with RA, but not celiac disease, have improved symptoms when they avoid gluten.

Going gluten-free doesn’t work for everyone. In some cases, it may keep the body from getting the nutrients it needs or make other illnesses worse. Unlike wheat products, gluten-free foods are low in fiber and they don’t have to be fortified, so they’re often lacking important vitamins and minerals. What’s more, many gluten-free products are higher in fat and calories.

Before you decide to go gluten-free, talk to your doctor or dietitian, and get screened for celiac disease. If you start the diet before being tested, doctors won’t be able to tell if you have it or not.

What Vitamins and Minerals Are Important for Rheumatoid Arthritis?

Folic acid, or folate, is a B vitamin that helps your body make red blood cells. If you take the drug methotrexate, folic acid may help you to avoid some of the drug's side effects.

Supplementing your diet with bone-boosting calcium and vitamin D is important, especially if you take corticosteroids (like prednisone) that can cause bone loss. Bone loss is more likely in people with rheumatoid arthritis. Check with your doctor to see how much calcium and vitamin D you need to get daily through foods, supplements, and sunlight.

Can Your Diet Help Relieve Rheumatoid Arthritis?

(continued)

Omega-3 Fatty Acids and Rheumatoid Arthritis

Omega-3 fatty acids are found in fish such as salmon, tuna, and trout; walnuts; tofu and other soybean products; flaxseed and flaxseed oil; and canola oil. They may help curb inflammation.

Fish oil supplements also contain omega-3 fatty acids. Some people with RA report less pain and joint tenderness when taking fish oil, according to the American College of Rheumatology.

You may not notice any benefit at first from taking a fish oil supplement. It may take weeks or months to feel a difference.

Talk to your doctor before taking any supplements. Your doctor can check on the dose you need, since the dose used in medical studies was much higher than what you'd get from a normal supplement without a prescription.   

Alcohol and Rheumatoid Arthritis

If you take any RA medication, ask your doctor if it's OK for you to drink alcohol. Avoid alcohol if you take methotrexate, because liver damage could be a serious side effect.