I thought I might chime in as I'm both a steel player and a physician that specializes in physical medicine and rehabilitation.
If you look at the
figure above, you can see the "
carpal tunnel" (the white area in the cross section). Basically, it's an unyielding "vault" containing various tendons, arteries and the
Median nerve (which is the most delicate of the structures).
The "tunnel is bordered in the back by the
Carpal bones of the wrist....and in front by a tough gristle like fiborous band called the Flexor Retinaculum or more commonly the
Tranverse Carpal Ligament.
Long story short............The space in the tunnel is small and anything that reduces that space increases the pressure on the contents within the tunnel. The tendons and artery withstand pressure well....
the median nerve doesn't. [It's the Median nerve which gives the sensation and muscle control to your thumb, index and long fingers so necessary for picking and bar control].
With repeated wrist and hand use (i.e. steel guitar playing), the TV Ligament can become irritated and inflamed. When things become inflamed...they swell, and in this case the swelling increases the pressure within the tunnel. Since the only other border of the tunnel consists of very "unyielding" bones, the tunnel cannot expand, thus internal pressure in the Carpal Tunnel builds up which may ultimately "squish" the nerve and damage it.
Diagnosis is made by clinical symptoms: numbness in the thumb, first 2 fingers (initially during sleep or hand usage), clumsiness, thumb weakness and atrophy). The longer the pressure is allowed to continue the greater the potential for nerve damge, which at best recovers very slowly...if at all.
Nerve Conduction Studies, which measure the "elapsed time" for a nerve impulse to travel a certain distance can confirm the problem.
Treatment usually takes one of 2 paths depending on how close to permanent nerve damage is estimated.
Conservative care: includes anti-inflammatories, steroid injections and wrist immobilization splints; all aimed at halting and reversing symptoms due to inflammation. Mild or moderate CTS may be treated this way.
If the nerve is deemed to be in jeopardy,
surgery is recommended. This is usually done through a scope to lessen scarring and post-op recovery time (12 weeks+/-). Basically the ligament is cut, decreasing the pressure in the tunnel.
Caveats:
a)
See your MD !!!!!!!........"an ounce of prevention is worth a pound of cure".
b)A trial of conservative care may be fine unless you have significant risk of nerve damage....at that point avoiding surgery might be likened to "burying your head in the sand".
c) prevent nerve damage...... recovery is tediously slow at best....and if severe enough, the damage can be irreversible.