Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a common condition that causes numbness, tingling, pain or weakness in your hand. It occurs when the median nerve becomes compressed in a narrow space in the wrist called the carpal tunnel. This space is bordered by bones on 3 sides and a thick band of tissue on the volar (palm) side. It contains the median nerve and 9 flexor tendons.

What are the symptoms of carpal tunnel syndrome?

Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. The symptoms of carpal tunnel syndrome can include:

  • Numbness, tingling, or burning sensation in the hand or fingers, especially the thumb, index, middle, and ring fingers.
  • Pain or discomfort in the hand, wrist, forearm, or even in the shoulder.
  • Weakness in the hand, difficulty gripping objects or performing manual tasks.
  • Swelling or inflammation in the wrist.
  • A feeling of clumsiness or decreased coordination.

These symptoms can start gradually and worsen over time, often affecting one or both hands. The symptoms may be more noticeable at night or upon waking up in the morning. If you experience any of these symptoms, it is important to see a healthcare professional for proper diagnosis and treatment.

What are the causes of Carpal tunnel?

There are several factors that can contribute to this pressure, including:

  • Repetitive Hand and Wrist Movements: Activities that involve repetitive hand and wrist movements, such as typing, playing an instrument, or assembly line work, can increase the risk of developing carpal tunnel syndrome.
  • Anatomical Factors: Some people are born with a smaller carpal tunnel or other anatomical variations that can increase the risk of CTS.
  • Medical Conditions: Certain medical conditions, such as rheumatoid arthritis, diabetes, and hypothyroidism, can increase the risk of developing CTS.
  • Hormonal Changes: Hormonal changes that occur during pregnancy, menopause, or with the use of oral contraceptives can contribute to the development of carpal tunnel syndrome.
  • Trauma: Injuries to the wrist, such as fractures or sprains, can cause swelling and inflammation that can compress the median nerve.
  • Obesity: Being overweight or obese can increase the pressure on the median nerve.

Identifying and addressing these risk factors can help reduce the likelihood of developing carpal tunnel syndrome or minimize its severity.

How is carpal tunnel syndrome diagnosed?

Early diagnosis and treatment are important to avoid permanent damage to the median nerve.

Carpal tunnel syndrome (CTS) can be diagnosed through a combination of a medical history, physical examination, and sometimes additional tests. Here are the most common methods of diagnosis:

  • Medical History: Your doctor will ask you about your symptoms, when they started, and what activities make them better or worse.
  • Physical Examination: Your doctor will examine your wrist and hand, looking for signs of swelling, tenderness, or weakness.
  • Tinel’s Sign: During a physical exam, your doctor may tap on the median nerve in your wrist to see if you experience tingling or numbness.
  • Phalen’s Maneuver: Your doctor may also ask you to hold your arms out in front of you, flex your wrists, and press the backs of your hands together for one minute to see if this reproduces your symptoms.
  • Nerve Conduction Studies: These tests measure the speed of nerve impulses and can help determine if there is any damage to the median nerve.
  • Electromyography (EMG): This test measures the electrical activity of muscles and can help determine if there is any muscle damage due to CTS.
  • Ultrasound imaging can show abnormal size of the median nerve. Magnetic resonance imaging (MRI) can show the anatomy of the wrist but to date has not been especially useful in diagnosing carpal tunnel

 Based on the results of these tests, your doctor can diagnose carpal tunnel syndrome and recommend an appropriate treatment plan.

What is the treatment for CTS

  • he treatment for carpal tunnel syndrome (CTS) depends on the severity of the condition and the individual’s specific situation. Some common treatments for CTS include:
  • Wrist Splinting: Wearing a wrist splint at night or during activities that aggravate the condition can help relieve symptoms by keeping the wrist in a neutral position and reducing pressure on the median nerve.
  • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain and inflammation associated with carpal tunnel syndrome.
  • Physical Therapy: Specific exercises and stretches can help improve range of motion and reduce symptoms.
  • Steroid Injections: Corticosteroid injections into the carpal tunnel can help reduce inflammation and relieve symptoms.
  • Surgery: Carpal tunnel release surgery is an option for more severe cases or cases that do not respond to other treatments. During this procedure, the surgeon cuts the ligament that is pressing on the median nerve, relieving pressure and reducing symptoms. Recurrence of carpal tunnel syndrome following treatment is rare. Less than half of individuals report their hand(s) feeling completely normal following surgery. Some residual numbness or weakness is common.

It is important to discuss treatment options with a healthcare professional who can provide guidance based on an individual’s specific situation and needs.

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