1 00:00:07,133 --> 00:00:10,453 Speaker 1: You're listening to the Saturday Morning with Jack team podcast 2 00:00:10,613 --> 00:00:11,693 Speaker 1: from News Talks AB. 3 00:00:13,373 --> 00:00:15,413 Speaker 2: It is that time on a Saturday morning where we 4 00:00:15,453 --> 00:00:18,093 Speaker 2: catch up with our doctor, doctor Brian Betty, and this 5 00:00:18,173 --> 00:00:21,413 Speaker 2: week we are talking carpal tunnel, which I know next 6 00:00:21,413 --> 00:00:23,173 Speaker 2: to nothing about. Good morning, Brian. 7 00:00:23,413 --> 00:00:24,293 Speaker 3: Oh Ciro Jack. 8 00:00:24,413 --> 00:00:27,213 Speaker 2: So, carple tunnel is one of the two most common 9 00:00:27,253 --> 00:00:29,453 Speaker 2: conditions to affect people's hands. 10 00:00:30,053 --> 00:00:34,053 Speaker 3: Yeah, Look, we see it all the time in general practice, 11 00:00:34,133 --> 00:00:37,093 Speaker 3: and it's a condition that's caused by something called the 12 00:00:37,133 --> 00:00:39,133 Speaker 3: medium nerve. It's a nerve that runs down the arm 13 00:00:39,173 --> 00:00:41,733 Speaker 3: and it goes through the wrist and as it goes 14 00:00:41,773 --> 00:00:44,173 Speaker 3: through the risk it goes through this narrow tunnel called 15 00:00:44,213 --> 00:00:47,733 Speaker 3: the carpol tunnel, surrounded by bone and ligament, and it 16 00:00:47,733 --> 00:00:50,533 Speaker 3: gets compressed and as it gets compressed, it starts to 17 00:00:50,573 --> 00:00:54,133 Speaker 3: cause symptoms. So we know about one to five percent 18 00:00:54,173 --> 00:00:56,653 Speaker 3: of the population get it at some point, and it's 19 00:00:56,733 --> 00:01:00,613 Speaker 3: twice as common a woman as men, and that's the coast. Structurally, 20 00:01:00,653 --> 00:01:05,053 Speaker 3: their risk is slightly narrower than the men's wrists happens 21 00:01:05,093 --> 00:01:09,213 Speaker 3: between the ages about sixty and there's certain things that 22 00:01:09,213 --> 00:01:14,013 Speaker 3: put you at increased risk. So that's pregnancy diabetes, fireroid conditions, 23 00:01:14,453 --> 00:01:18,773 Speaker 3: and actually repetitive manual labor. So things like using jackhammers 24 00:01:19,093 --> 00:01:22,733 Speaker 3: or hammering all day can actually start to cause the problem. 25 00:01:23,053 --> 00:01:25,053 Speaker 2: That's interesting. So how do you recognize it? 26 00:01:25,733 --> 00:01:29,453 Speaker 3: Well, Look, I suppose the commonest thing that people say 27 00:01:29,493 --> 00:01:31,693 Speaker 3: to me when they come in. They start to describe 28 00:01:31,693 --> 00:01:34,253 Speaker 3: they're waking up at night and they're noticing that their 29 00:01:34,333 --> 00:01:37,173 Speaker 3: hand is very tingly or numb and they have to 30 00:01:37,213 --> 00:01:39,653 Speaker 3: shake it out to get the feeling back into the hand. 31 00:01:40,093 --> 00:01:42,893 Speaker 3: And that's often what we start to see. Now it's 32 00:01:42,893 --> 00:01:47,053 Speaker 3: often with the palm aspect of the thumb, the index finger, 33 00:01:47,093 --> 00:01:49,013 Speaker 3: and the middle finger. They start to notice this in 34 00:01:49,773 --> 00:01:52,413 Speaker 3: and occasionally people sort of say, well, look I start 35 00:01:52,413 --> 00:01:54,573 Speaker 3: to get this electric shock thing when I'm holding a 36 00:01:54,613 --> 00:01:58,733 Speaker 3: steering wheel or holding the newspaper. Now, over time, the 37 00:01:58,773 --> 00:02:01,293 Speaker 3: pain can start to go up the arm up towards 38 00:02:01,293 --> 00:02:04,173 Speaker 3: the elbow, and if you leave it, the hand starts 39 00:02:04,173 --> 00:02:08,253 Speaker 3: to become weak. So people describe they can't sort of 40 00:02:08,293 --> 00:02:10,853 Speaker 3: hold onto cups and they may drop things. We'll feel 41 00:02:10,853 --> 00:02:13,813 Speaker 3: a bit clumsy. So it can progress over time and 42 00:02:13,853 --> 00:02:16,853 Speaker 3: start to infare with grip with the hand. 43 00:02:17,333 --> 00:02:18,733 Speaker 2: So how do you diagnose it? 44 00:02:19,413 --> 00:02:22,053 Speaker 3: Well, look. Often it's just a really careful history. So 45 00:02:22,453 --> 00:02:24,813 Speaker 3: it's that thing when someone comes in and says, I'm 46 00:02:24,853 --> 00:02:26,413 Speaker 3: waking up at night and having to shake up my 47 00:02:26,493 --> 00:02:28,733 Speaker 3: hand and you start to think, well, you know, is 48 00:02:28,733 --> 00:02:30,973 Speaker 3: this carpul tunnel. It can be other things, but that's 49 00:02:30,973 --> 00:02:33,573 Speaker 3: the most common one. So we often examine the wrist 50 00:02:33,653 --> 00:02:35,693 Speaker 3: and we'll do this thing where we sort of push 51 00:02:35,733 --> 00:02:38,493 Speaker 3: the wrist over and hold it, and by putting it 52 00:02:39,013 --> 00:02:42,333 Speaker 3: into this ninety degree position holding that, people start to 53 00:02:42,333 --> 00:02:46,933 Speaker 3: get the numbness and the fingers I've just described. Now. Specifically, 54 00:02:47,013 --> 00:02:50,013 Speaker 3: we'll often order what's called a nerve conduction study. So 55 00:02:50,093 --> 00:02:52,533 Speaker 3: this is where they put electrodes on your arm. They 56 00:02:52,893 --> 00:02:55,653 Speaker 3: put an electric shock down the arm, and what they 57 00:02:55,693 --> 00:02:58,453 Speaker 3: see is the electric shock slows down as it goes 58 00:02:58,453 --> 00:03:01,213 Speaker 3: through the wrist, and that pretty much tells us that's 59 00:03:01,253 --> 00:03:04,693 Speaker 3: exactly what's going on. Now. If we are concerned about 60 00:03:04,693 --> 00:03:08,293 Speaker 3: another condition like diabete, is the thire or something like that, 61 00:03:08,373 --> 00:03:10,773 Speaker 3: we may order some blood tests and occasionally we'll do 62 00:03:10,773 --> 00:03:13,013 Speaker 3: an X rate to look for arthritis and things like that. 63 00:03:13,213 --> 00:03:15,053 Speaker 2: Yeah, that's got to cleve a little test, isn't it. 64 00:03:15,053 --> 00:03:18,213 Speaker 2: Doing the you know, the electric measure down the arm. 65 00:03:18,253 --> 00:03:19,693 Speaker 2: So what do you do about it? If you are 66 00:03:19,773 --> 00:03:21,853 Speaker 2: diagnosed with a couple of times, yeah. 67 00:03:21,653 --> 00:03:23,653 Speaker 3: Well look a look. It depends on how bad it is. 68 00:03:23,813 --> 00:03:27,813 Speaker 3: So often just avoiding activities that trigger it may be 69 00:03:27,933 --> 00:03:30,093 Speaker 3: a good thing to do, like if you're hammering or whatever, 70 00:03:30,173 --> 00:03:32,493 Speaker 3: just don't hammer and you know, just just stop that. 71 00:03:33,213 --> 00:03:35,013 Speaker 3: And often we'll say, look, go to the chemist and 72 00:03:35,053 --> 00:03:37,653 Speaker 3: get a risk sprint splint. So this is a splint 73 00:03:37,693 --> 00:03:39,413 Speaker 3: you put onto your wrist. You often wear it at 74 00:03:39,493 --> 00:03:42,493 Speaker 3: night and it just keeps your wrist straight so your 75 00:03:42,493 --> 00:03:45,093 Speaker 3: wrist doesn't flop over. Because it's flopping over that causes 76 00:03:45,133 --> 00:03:47,613 Speaker 3: the pressure on the nerve and often that just stops 77 00:03:47,613 --> 00:03:49,893 Speaker 3: the symptoms. So just a risk splint is a very 78 00:03:49,893 --> 00:03:51,573 Speaker 3: simple thing you can do and wear it at night 79 00:03:51,613 --> 00:03:57,533 Speaker 3: and the problem goes away. However, progressions progresses past that, 80 00:03:58,173 --> 00:04:00,053 Speaker 3: and you start to get the weakness and the pain 81 00:04:00,173 --> 00:04:02,573 Speaker 3: up the arm, and it's happening during the day. We 82 00:04:02,613 --> 00:04:05,533 Speaker 3: send you off to an orthopedic surgeon and they do 83 00:04:05,613 --> 00:04:08,493 Speaker 3: something called a car tunnel release where they under local 84 00:04:08,533 --> 00:04:12,053 Speaker 3: anesthetic they just cut the ligament that that goes across 85 00:04:12,813 --> 00:04:16,533 Speaker 3: what's called the carpal tunnel. Releases the pressure and pretty 86 00:04:16,533 --> 00:04:19,253 Speaker 3: well one hundred percent of the time the problem is cured. 87 00:04:19,533 --> 00:04:20,973 Speaker 3: So yeah, done deal. 88 00:04:21,213 --> 00:04:24,093 Speaker 2: So yeah, very very soon there is something you can do. 89 00:04:24,213 --> 00:04:26,693 Speaker 3: Yeah, that's absolutely yeah, well. 90 00:04:26,693 --> 00:04:30,093 Speaker 2: Very good, you know, and I I knew next to 91 00:04:30,133 --> 00:04:33,733 Speaker 2: nothing about carpal tunnels. Thank you very much for that. 92 00:04:35,653 --> 00:04:36,933 Speaker 3: Oh good, Jack, no problems. 93 00:04:37,453 --> 00:04:40,213 Speaker 2: Really appreciate your time. That is doctor Brian Betty with 94 00:04:40,293 --> 00:04:41,013 Speaker 2: us this morning. 95 00:04:41,773 --> 00:04:44,893 Speaker 1: For more from Saturday Morning with Jack Tame, listen live 96 00:04:44,973 --> 00:04:47,773 Speaker 1: to news talks that'd be from nine am Saturday, or 97 00:04:47,853 --> 00:04:49,773 Speaker 1: follow the podcast on iHeartRadio.