How Is Restless Leg Syndrome Different To Neuropathy

 Today's post comes from breathesleeplivewell.com (see link below) and talks about something which confuses many people with either peripheral neuropathy or restless leg syndrome ie: what's the difference? Because they are both neurological disorders, some doctors will tell you that your restless leg syndrome is another version of neuropathy and some of the treatments are also the same for both conditions but there are significant differences and these are highlighted here. The fact that people can have both problems at the same time, confuses the issue even further but it is important for you to see both conditions as being different, while at the same time hopefully taking the same medication for both (the less pills you have to swallow the better!)  
 

Restless legs or neuropathy, which is it?
November 11, 2012  David Ostransky, DO, DABSM

Restless Legs Syndrome, Peripheral Neuropathy, or Both?

Restless Legs Syndrome (RLS) is one of the most important causes of insomnia to recognize – because it is so common (5-15% of the general population), and it responds so well to treatment. It is often related to heredity factors (40%), but other causes include anemia, iron deficiency, neuropathies, kidney failure, and the use of certain medications. It is important to differentiate this condition from peripheral neuropathy, because of the symptoms are so similar, sometimes RLS and peripheral neuropathy occur together in some patients, and the use of some of the same medications for these conditions. Patients and primary care providers often have a difficult time differentiating between the two conditions.

Peripheral neuropathy may be caused by many different conditions including the following:

Diabetes Mellitus
Shingles
Vitamin Deficiency, especially B12 and folate
Alcohol
Auto immune disorders including lupus, rheumatoid arthritis, vasculitis, amyloidosis, or Guillain Barre
HIV infection, and its complications
Inherited disorders, Charcot Marie Tooth
Exposure to toxins, heavy metals, gold, lead, arsenic, mercury, and pesticides
Medications, including chemotherapy drugs, antibiotics, & isoniazid
Peripheral vascular disease

RLS is described by patients as the experience of vague or unpleasant sensations involving usually the lower extremities, but sometimes the upper extremities. This discomfort appears primarily during periods of inactivity, particularly during the transition from wake to sleep, or during the day, sitting on a plane, lone car rides, or sitting in a movie theater. RLS patients often have difficulty describing the sensations, rarely using conventional terms of discomfort such as “numbness, tingling, or pain,” but rather bizarre terms such as “pulling, searing, drawing, creepy, crawly, fluttering, shimmering, butterflies, or boring sensations,” with the sensations often causing anxiety. Distinct from sensory neuropathy patients, these unpleasant sensations are typically relieved by movement or counter stimulation (rubbing, massaging, hot water) of the affected part. Although, these manoeuvers are effective while being performed, the discomfort returns as soon as the individual becomes inactive or tries to return to bed. The International RLS Study Group has developed diagnostic criteria:

Minimal Criteria-IRLS Group

1. Desire to move the limbs usually associated with paresthesias/dysesthesias

2. Motor restlessness

3. Symptoms are worse or exclusively present at rest with at least partial or temporary relief by activity

4. Symptoms worse in evening/night

Supportive Criteria- IRLS Group

1. Positive response to dopaminergic treatment

2. Periodic limb movements (leg movements after sleep)

3. Positive family history( 40%)

Important differences between RLS and peripheral neuropathy(PN) are as follows:

1. Peripheral neuropathy occurs as a consequence of damage to the peripheral nervous system, whereas RLS occurs as a consequence of an imbalance of chemicals that control movement in the basal ganglia of the brain. Because there are different types of nerve fibers, motor, sensory, and autonomic, PN is a much more heterogeneous condition (more than 100 types) with a lot more variability of symptoms compared to RLS.

2. Though, the symptoms of PN and RLS may be somewhat similar, such as numbness, tingling, and prickly sensations, PN patients do not report the relief that occurs with movement that RLS patients report. PN patients often focused on the discomfort that they experience, RLS patients seem to focus on the anxiety that they experience as a consequence of the discomfort.

3. The diagnosis of PN is typically based on electromyography and nerve conduction velocity (yes, the sticking of needles into your muscles) whereas the diagnosis of RLS is based on history, specifically meeting the International RLS criteria. Sometimes, we draw a serum ferritin level (iron studies) and blood count

4. Treatment considerations for RLS include agents used to treatment Parkinson’s disease like ropirinole, pramipexole, sinemet, neupro, gabapentin (Neurotin), and horizont, benzodiazepines, opiates, and anticonvulsants, whereas PN sometimes are given medications such as gabapentin (Neurotin), lyrica, and antidepressants to manage the pain.

5. Many conditions may result in with patients having both PN and RLS, such as chronic renal failure with dialysis, neurological conditions such as multiple sclerosis, spinal cord insults and diabetic neuropathy .

http://breathesleeplivewell.com/2012/11/11/restless-legs-or-neuropathy-which-is-itb/

CLUE TO GENETICS OF CONGENITAL HEART DEFECTS EMERGE FROM DOWN SYNDROME

Down syndrome is the most common chromosomal abnormality in humans, involving a third copy of all or part of chromosome 21. In addition to intellectual disability, individuals with Down syndrome have a high risk of congenital heart defects. However, not all people with Down syndrome have them -- about half have structurally normal hearts.

 Geneticists have been learning about the causes of congenital heart defects by studying people with Down syndrome. The high risk for congenital heart defects in this group provides a tool to identify changes in genes, both on and off chromosome 21, which are involved in abnormal heart development.

Researchers at Emory University School of Medicine, with colleagues at Johns Hopkins University, Oregon Health Science University, and University of Pittsburgh, report results from the largest genetic study of congenital heart defects in individuals with Down syndrome in the journal Genetics in Medicine.

The team found that infants with congenital heart defects, in the context of Down syndrome, were more likely to have rare, large genetic deletions. Those deletions tended to involve genes that affect cilia, cellular structures that are important for signaling and patterning in embryonic development.

These new findings, along with other recent studies, suggest that the risk for congenital heart defects in Down syndrome can come from several genes and environmental factors, in addition to the substantial risk from the extra chromosome 21.

"In Down syndrome, there's a 50-fold increase in risk for heart defects, which is enormous," says senior author Michael Zwick, PhD, associate professor of human genetics and pediatrics at Emory. "Studying congenital heart defects in the 'at risk' Down syndrome population can make it possible to reveal genes that impact the risk of heart defects in all children, including those with typical number of chromosomes."

"Understanding the origin of heart disorders in individuals with Down syndrome may reveal aspects of biology that would allow better personalization of their health care, since genetic alterations that affect the heart may also affect other organs, such as the lungs or gut," Zwick says.

"Our partnership with families who have a child with Down syndrome and our investment in a comprehensive clinical data and biorepository will continue to provide resources to study not only heart defects, but also other Down-syndrome associated medical conditions such as cognitive function, leukemia, and dementia," says co-author Stephanie Sherman, PhD, professor of human genetics at Emory University School of Medicine.

Sherman says the study was a collaborative effort involving participants with Down syndrome, their families and assessment sites across the United States, including those mentioned above along with Kennedy Krieger Institute, Children's National Medical Center and Ohio Nationwide Children's Hospital.

The first author was Emory postdoctoral fellow Dhanya Ramachandran, PhD, working with Zwick. Emory co-authors included assistant professors Lori Bean, PhD, Tracie Rosser, PhD and David Cutler, PhD, in the Department of Human Genetics, and Jennifer Mulle, PhD, assistant professor of epidemiology in the Rollins School of Public Health. Ken Dooley, MD, associate professor of pediatrics at Emory and pediatric cardiologist at Children's Healthcare of Atlanta, reviewed medical records and made definitive diagnoses for all study participants.

The study included 452 individuals with Down syndrome. 210 had complete atrioventricular septal defects (AVSDs), a serious heart defect that is relatively common among those with Down syndrome (about 20 percent). The remaining 242 had structurally normal hearts. The Emory team used high density microarrays to probe more than 900,000 sites across the human genome to detect structural variation, including deletions or duplications of DNA.

An atrioventricular septal defect means that the central region of the heart separating the atria from the ventricles has failed to form properly. Such defects increase the workload on the heart, and a complete AVSD leads to heart failure: fluid buildup in the lungs and difficulty breathing, requiring surgery in the first year of life.

The team's results add to evidence for a connection between AVSDs and cilia. Ciliopathies are a class of genetic disorders that include kidney, eye, and neurodevelopmental disorders. Cells in the airways have mobile cilia which sweep mucus and dirt out of the lungs, but almost every cell in the body has a primary (sensory) cilium.

"The finding that ciliome genes may be disrupted in children with Down syndrome and AVSD may indicate differences in life-time care for these individuals," Zwick says. "This is a suggestive result that needs replication in a larger group."

To confirm and strengthen the findings, Zwick and his team are currently performing an independent study of individuals with Down syndrome, using whole genome sequencing to further delineate alterations in genes that perturb heart development in children.

HOMOEOPATHIC REMEDIES FOR PREMENSTRUAL SYNDROME

Premenstrual syndrome (PMS) has a wide variety of symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. It's estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.

Symptoms tend to recur in a predictable pattern. But the physical and emotional changes you experience with premenstrual syndrome may vary from just slightly noticeable all the way to intense.

Causes--Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition:

·         Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.

·         Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that is thought to play a crucial role in mood states, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems.

·         Depression. Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms.

Symptoms-The list of potential signs and symptoms for premenstrual syndrome is long, but most women only experience a few of these problems.

Emotional and behavioral symptoms-Tension or anxiety, Depressed mood, Crying spells, Mood swings and irritability or anger, Appetite changes and food cravings,Trouble falling asleep (insomnia), Social withdrawal, Poor concentration

Physical signs and symptoms-Joint or muscle pain, Headache, Fatigue, Weight gain related to fluid retention, Abdominal bloating, Breast tenderness, Acne flare ups,Constipation or diarrhea,

TOP HOMOEOPATHIC REMEDIES

SEPIA 200-CM- Sepia is the top l Homeopathic treatment for premenstrual syndrome. The main aspect which is covered by Sepia is treatment of irritability in women with PMS. This Homeopathic medicine is of great help for women who suffer from extreme irritability a few days before periods. Irritability is mostly accompanied by an aversion to indulge in any kind of physical or mental labour. PMS with marked indifference to words the loved ones. Tearfulness difficulty in concentrating , a desire to get away from everything, extreme anger, fits of screaming  are present .Here, Sepia acts as a  remedy to calm the minds of women suffering from irritable conditions. A special symptom that needs mention is bearing down pains in uterus accompanying mental irritability. In most of the women requiring Homeopathic medicine Sepia, some sort of irregularity in their menstrual cycle or periods is often found. The skin of the patient is oily and desire for salty or very sweet food. Pimples are associated with menses.

IGNATIA 200--Ignatia is a  Homeopathic medicine that is very beneficial for treatment of PMS and is the best remedy for depression and mood swings in women with PMS. Ignatia can be taken by all women suffering from a sad and depressed emotional state before periods. Along with sadness, there is an aversion to company. Such women desire to be left alone and keep on weeping for long. Women who experience sudden mood swings prior to their menstrual cycle can also benefit by the use of  Ignatia. The mood suddenly changes from joy to sadness and Ignatia is the best natural remedy.

PULSATILLA 200-CM- Pulsatilla is of great help for women with increased sensitivity towards every little thing during PMS. The smallest of things tend to affect women deeply and they also start to weep over little, insignificant issues. They start to cry in public and usually feel better when offered sympathy. Open air makes them feel good. The women who can benefit from Pulsatilla may also have the problem of suppressed or delayed menses frequently. In most cases, there is also a total absence of thirst for water. Tendency to gain weight before menses and possibly headache, nausea, and dizziness

LACHESIS 200-CM-Lachesis is the top medicine  for women suffering from pain in various parts of the body as part of PMS. Such women experience pains a few days before the expected date of periods. Excessive headache stands out and as the periods begin to flow, all the pains vanish. The most prominent mental state is of talking to an extreme extent and there may also be an extreme heated up sensation in body. The heated feeling is accompanied by an aversion to wear tight clothing.

CONIUM MAC 200-CM--Conium is the best  remedy for treating breast tenderness in women as part of Premenstrual Syndrome. Conium is very beneficial for women who undergo swelling, enlargement and pain in breast before their periods. The pain gets worse by touching. Along with pain, the breast also becomes hard.

CALCAREA CARB 200-CM—PMS with fluid retention particularly swollen tender breasts , painful joints, lack of energy , depression , tearfulness, irritability, anxiety and fear of insanity

BRYONIA 30-In Bryonia there is  excessive heaviness and pain in breasts before menses. The pain is accompanied by the need to hold the breast to get some relief.In Bryonia  constipation is associated with pms.

MELILOTUS Q--Melilotus is  an excellent remedy for  relieving headache occurring as a part of Premenstrual Syndrome. Melilotus can be used when the headache occurs with vomiting some days before periods. The head feels extremely heavy and full. As the menstrual flow begins, the head pain and heaviness vanish.

CARBO VEG 30, CHINA 30--Both Carbo veg and China are excellent remedies  for pms with symptoms of bloating are very effective in giving immediate relief . Both are best suited for women who have a distended abdomen   before menses. Eating is followed by extreme heaviness and distension in abdomen. This is accompanied by excessive gas in abdomen. The accumulation of wind in abdomen may also lead to pain. The women may also experience vomiting, which usually contains undigested food.

SILICEA 30--Silicea is the  remedy for extreme constipation before menses. Silicea is very beneficial for women who have great difficulty in passing stool or poop. A lot of straining is required in order to pass stool. The stool even slips back after being partially expelled.  Silicea helps in easy expulsion of stool without putting in much effort.

NUX VOMICA 30-Nux Vomica is helpful  when the urge to pass stool is very frequent. But the stool passed is very scanty and unsatisfactory. This can be accompanied by pain in abdomen.

BOVISTA 30-Bovista is the best remedy for diarrhoea  before menses. Bovista is of great help for all those women who pass loose stool before periods. The women may also experience heavy bleeding and Inter Menstrual Bleeding episodes

NATRUM MUR 200- Natrum Mur is an effective remedy for women  with pimples who are mainly reserved in nature. They may have weeping episodes while alone. Craving for salt may be found in women requiring Natrum Mur.

With Neuropathy Dont Let Your Body Fall Into A Disuse Syndrome

Today's short post from neuropathydr.com (see link below) is as good an argument for exercising if you have neuropathy as you'll find. One of the best reasons for exercising (however uncomfortable the idea feels) is that your muscles, joints and nervous system will degenerate through disuse. Especially as you get older and the pain and your lifestyle mean that your life by definition becomes more sedentary, it's important to keep as active as possible. If your neuropathy is affecting more parts of your body than just your feet and legs (autonomic neuropathy) then it's vital to keep moving in some way or other, so that the organs, muscles and joints still have something to work for. The article is short but makes the point very clearly. Well worth a read.

Disuse Syndrome
Posted by john on February 13, 2017

In our last post, we discussed how exercise can help control the symptoms of your underlying illness (whatever caused your autonomic neuropathy). Today we’re going to discuss the effects of not exercising, which are called disuse syndrome.

Use Vs. Disuse

When you’re thinking about starting an exercise program and you’re thinking about how dangerous it can be, you also need to consider the effects of not starting an exercise program.

The effects of not exercising are called disuse syndrome. If your level of activity seriously out of sync with your level of inactivity, you can develop:

• Decreased physical work capacity

• Muscle atrophy

• Negative nitrogen and protein balance

• Cardiovascular deconditioning

• Pulmonary restrictions

• Depression

The effects of any of these symptoms of disuse syndrome in combination with your autonomic neuropathy symptoms can make a bad situation even worse.

The very nature of your autonomic neuropathy can affect the systems that are most sensitive to the effects of exercise. Any exercise program you begin should be designed and monitored by a medical professional well versed in the effects of autonomic neuropathy, like your NeuropathyDR® clinician.

Autonomic neuropathy can have a serious effect on the very systems in the body that are directly affected by exercise. Make sure you talk to your healthcare provider before you start an exercise program and let them monitor your progress.

For more information on coping with neuropathy, get your Free E-Book and subscription to our newsletters at http://neuropathydr.com.

http://neuropathydr.com/disuse-syndrome/

TOP HOMOEOPATHIC REMEDIES FOR PREMENSTRUAL SYNDROME

Premenstrual syndrome (PMS) has a wide variety of symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. It's estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.

Symptoms tend to recur in a predictable pattern. But the physical and emotional changes you experience with premenstrual syndrome may vary from just slightly noticeable all the way to intense.

Causes--Exactly what causes premenstrual syndrome is unknown, but several factors may contribute to the condition:

·         Cyclic changes in hormones. Signs and symptoms of premenstrual syndrome change with hormonal fluctuations and disappear with pregnancy and menopause.

·         Chemical changes in the brain. Fluctuations of serotonin, a brain chemical (neurotransmitter) that is thought to play a crucial role in mood states, could trigger PMS symptoms. Insufficient amounts of serotonin may contribute to premenstrual depression, as well as to fatigue, food cravings and sleep problems.

·         Depression. Some women with severe premenstrual syndrome have undiagnosed depression, though depression alone does not cause all of the symptoms.

Symptoms-The list of potential signs and symptoms for premenstrual syndrome is long, but most women only experience a few of these problems.

Emotional and behavioral symptoms-Tension or anxiety, Depressed mood, Crying spells, Mood swings and irritability or anger, Appetite changes and food cravings,Trouble falling asleep (insomnia), Social withdrawal, Poor concentration

Physical signs and symptoms-Joint or muscle pain, Headache, Fatigue, Weight gain related to fluid retention, Abdominal bloating, Breast tenderness, Acne flare ups,Constipation or diarrhea,

TOP HOMOEOPATHIC REMEDIES

SEPIA 200-CM- Sepia is the top l Homeopathic treatment for premenstrual syndrome. The main aspect which is covered by Sepia is treatment of irritability in women with PMS. This Homeopathic medicine is of great help for women who suffer from extreme irritability a few days before periods. Irritability is mostly accompanied by an aversion to indulge in any kind of physical or mental labour. PMS with marked indifference to words the loved ones. Tearfulness difficulty in concentrating , a desire to get away from everything, extreme anger, fits of screaming  are present .Here, Sepia acts as a  remedy to calm the minds of women suffering from irritable conditions. A special symptom that needs mention is bearing down pains in uterus accompanying mental irritability. In most of the women requiring Homeopathic medicine Sepia, some sort of irregularity in their menstrual cycle or periods is often found. The skin of the patient is oily and desire for salty or very sweet food

IGNATIA 200--Ignatia is a  Homeopathic medicine that is very beneficial for treatment of PMS and is the best remedy for depression and mood swings in women with PMS. Ignatia can be taken by all women suffering from a sad and depressed emotional state before periods. Along with sadness, there is an aversion to company. Such women desire to be left alone and keep on weeping for long. Women who experience sudden mood swings prior to their menstrual cycle can also benefit by the use of  Ignatia. The mood suddenly changes from joy to sadness and Ignatia is the best natural remedy.

PULSATILLA 200-CM- Pulsatilla is of great help for women with increased sensitivity towards every little thing during PMS. The smallest of things tend to affect women deeply and they also start to weep over little, insignificant issues. They start to cry in public and usually feel better when offered sympathy. Open air makes them feel good. The women who can benefit from Pulsatilla may also have the problem of suppressed or delayed menses frequently. In most cases, there is also a total absence of thirst for water. Tendency to gain weight before menses and possibly headache, nausea, and dizziness

LACHESIS 200-CM-Lachesis is the top medicine  for women suffering from pain in various parts of the body as part of PMS. Such women experience pains a few days before the expected date of periods. Excessive headache stands out and as the periods begin to flow, all the pains vanish. The most prominent mental state is of talking to an extreme extent and there may also be an extreme heated up sensation in body. The heated feeling is accompanied by an aversion to wear tight clothing.

CONIUM MAC 200-CM--Conium is the best  remedy for treating breast tenderness in women as part of Premenstrual Syndrome. Conium is very beneficial for women who undergo swelling, enlargement and pain in breast before their periods. The pain gets worse by touching. Along with pain, the breast also becomes hard.

CALCAREA CARB 200-CM—PMS with fluid retention particularly swollen tender breasts , painful joints, lack of energy , depression , tearfulness, irritability, anxiety and fear of insanity

Carpal Tunnel Syndrome CTS

Carpal tunnel syndrome(CTS) is really a compression neuropathy of median nerve.It's constriction of median nerve because it passes beneath the flexor retinaculum.Carpus is really a word derived from the Greek word "karpos" meaning "wrist."

CTS, or median neuropathy in the wrist is a nerve disorder within the wrist that causes pain,hand weakness,lack of feeling often within the thumb and the first three fingers.It calls for compression, stretching, irritation, of median nerve in the wrist joint and could greatly decrease athletic performance involving strong hand and wrist actions.The carpal canal in the wrist joint is really a cramped space,crowded with flexor tendons and also the median nerve.Any tension within this canal can compress the median nerve.It's more common in women compared to men and occurs typically later (40-60 yrs).Sometimes it is observed in young individuals secondary to trauma.

Night symptoms and waking at night-the hallmark of the illness-can be managed effectively with night-time wrist splinting in many patients. The role of medications, including corticosteroid injection in to the carpal canal, is unclear. Surgery to chop the transverse carpal ligament works well at relieving symptoms and preventing ongoing nerve damage, but established nerve dysfunction as static (constant) numbness, atrophy, or weakness are often permanent and do not respond predictably to surgery.

Anatomy of carpal tunnel

The carpal tunnel is definitely an inelastic fibro-osseous tunnel defined by the carpal bones and also the flexor retinaculum.Flexor retinaculum is a strong fibrous band which bridges anterior concavity of carpus and converts it into carpal tunnel.

Flexor retinaculum is marked by joining the next four points-

i)pisiform bone
ii)tubercle of scaphoid bone
iii)hook of hamate bone
iv)crest of trapezium
Top of the border is formed by joining the foremost and the second points,and also the lower border by joining the 3rd and fourth points.

Attachments

Medially towards the pisiform bone and to the hook from the hamate. Laterally to tubercle of scaphoid, and also the crest of the trapezium.

The structures passing superficial towards the flexor retinaculum are:

(i)the tendon of palmaris longus,(ii)the palmar cutaneous branch from the median nerve,(iii)the palmar cutaneous branch from the ulnar nerve;(iv)the ulnar vessels;and also the ulnar nerve.

The structures passing deep towards the flexor retinaculum are:

(i)the median nerve,(ii)the tendons from the flexor digitorum superficialis,(iii) the tendons from the flexor digitorum profundus,(iv)the tendon of flexor pollicis longus,(v) the ulnar bursa, and (vi)the radial bursa.


Reasons for carpal tunnel syndrome-

Any space occupying lesion inside the carpal tunnel may be responsible.Numerous factors may bring about the condition and these generally fall under one of the following categories.

(i)Factors which boost the structures within the carpal tunnel-

Inflammation from the flexor tendon sheath(tenosynovitis) as a result of repeated or sustained flexor activity (gymnast,cyclists).
Scarring and shortening from the ligament that covers the median nerve.
(ii)Factors which cuts down on the size of carpal tunnel-
Arthritic changes secondary to some colle's fracture.
Fluid retention while pregnant.
Other causes which might cause stretching from the nerve is prolonged hyperextension or hyperflexion.

Risk factor for carpal tunnel syndrome-

Diabetes,hyperthyroidism,pregnancy,rheumatoid arthritis symptoms, gout, ganglion cyst, prolonged forceful standing and walking on hands, tasks that need repititive hand or wrist actions.

Women are 3 times more likely than men to build up carpal tunnel syndrome, perhaps since the carpal tunnel itself might be smaller in women compared to men. The dominant hand is generally affected first and produces probably the most severe pain. Persons with diabetes or any other metabolic disorders that have an effect on the body's nerves making them more susceptible to compression will also be at high risk. Carpal tunnel usually occurs only in grown-ups.

The risk of developing carpal tunnel is not confined to folks a single industry or job, but is particularly common in those performing assembly line work - manufacturing, sewing, finishing, cleaning, and meat, poultry, or fish packing. Actually, carpal tunnel syndrome is 3 times more common among assemblers than among data-entry personnel.

Indications of carpal tunnel syndrome

Paraesthesias(numbness,burning,tingling) is felt within the first three fingers(radial) and radial 1 / 2 of the fourth.
the condition increase in the night when there is additional problem of normal lower resting blood pressure level.
Variable relief from nocturnal symptoms is obtained by hanging the arm within the side of the bed or shaking the hand,actions which boost the resting blood pressure and therefore blood supply to the nerve.
Sharp pain that could shoot from the wrist in the arm or to the fingers, especially during the night.
The hand might be clumsy and weak.
Morning stiffness or cramping of hand.
Thumb weakness,frequent dropping of objects,wherewithal to make a fist.
Shiny,dried-out skin of hand.
Reduced performance in almost any sport requiring grip.
Inside a severe case,there might eventually be evident wasting and weakness from the median nerve innervated small muscles from the hand.
Differential diagnosis-

Entrapment of C6/7 nerve root which doesn't give increased pain to repeated wrist movements.
Osteoarthritis of base of thumb.