American Medical Association Family Medical Guide - American Medical Association [440]
During acute episodes of MS or when a person has difficulty walking or talking, doctors often prescribe corticosteroid drugs to reduce inflammation in the nervous system. Medications are also available that can relieve long-term problems such as muscle spasms and stiffness, help restore bladder control, and alleviate pain, fatigue, depression, and, in some cases, tremors.
To help people whose attacks do not respond to treatment with corticosteroids, doctors sometimes use a procedure called plasmapheresis, which removes inflammatory proteins from the blood. For people who have frequent, severe episodes, immunoglobulin (a preparation of infection-fighting antibodies) is sometimes given intravenously. These treatments, however, may not be effective.
Exercising regularly, eating a nutritious diet, and maintaining a healthy weight can help relieve some symptoms and improve the person’s ability to cope with impairments. Doctors also recommend staying cool (such as with air-conditioning in the summer) to help prevent fatigue. Physical therapy can help strengthen muscles and maintain range of motion in joints. Occupational therapy can help the person learn easier, more efficient ways to perform everyday tasks. Equipment such as braces, walkers, canes, and wheelchairs can help some people stay active. Support groups such as those sponsored by local chapters of the National Multiple Sclerosis Society are excellent sources of information, help, and encouragement.
Carpal Tunnel Syndrome
Carpal tunnel syndrome is a disorder caused by compression of the median nerve as it passes through a narrow channel (called the carpal tunnel) in the wrist formed by the wrist bones and a strong ligament (a tough, elastic tissue that holds bones together). Tendons (strong fibrous bands that join muscle to bone) also pass through the channel. The compression usually results from repetitive manual activities that put excessive stress on the surrounding tissues, causing the ligament to thicken and the tendons to swell. The median nerve carries sensations from the thumb, index finger, middle finger, part of the ring finger, and the palm of the hand to the spinal cord. The median nerve also controls the muscles of the hand and forearm that enable the wrist, fingers, and thumb to move and the forearm to rotate.
Carpal tunnel syndrome is fairly common and occurs frequently in pregnant and menopausal women (probably because of fluid retention or hormonal changes) and in people with medical conditions such as acromegaly (a disorder that makes the bones abnormally long and the hands and feet unusually large). People who have diabetes (see page 889) or hypothyroidism (see page 903) or who are obese also seem to be susceptible because of swelling or a buildup of fluid in the carpal ligament, or from thickening of connective tissue. Carpal tunnel syndrome may also result from an inflammatory condition such as rheumatoid arthritis (see page 918) or from an injury such as a bone dislocation or fracture.
Carpal tunnel syndrome
Carpal tunnel syndrome is pain, numbness, or tingling in the thumb, first two fingers, part of the ring finger, and the palm caused by excessive, prolonged pressure on the median nerve as it passes through a narrow passage in the wrist called the carpal tunnel.
Activities that involve repetitive or strenuous use of the hands and wrists—such as working on a keyboard or an assembly line, doing dental work, or knitting or sewing—most often cause carpal tunnel syndrome. People who use jackhammers, chain-saws, or other machines that repeatedly jar the nerves also are at increased risk of carpal tunnel syndrome.
Ulnar tunnel syndrome is similar to carpal tunnel syndrome, but it affects the ulnar nerve, which carries sensations to the ring and little fingers, to the outer part of the palm, and to the elbow. Ulnar tunnel syndrome can occur on its own or along with carpal tunnel syndrome. Ulnar tunnel