What is Carpal Tunnel Syndrome?
BDS (Bachelor of Dental Surgery), 10 years of experience
What is the meaning of Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a common disorder that causes numbness, pain, tingling, and weakness in the wrist and the hand.
This condition is a result of an increase in pressure within the wrist on a nerve known as the median nerve. The median nerve is present on the palm side of the hand (also known as carpal tunnel) and it helps in providing sensation (the ability to feel) to the thumb, index finger, middle finger, and half of the ring finger.
The carpal tunnel is a narrow passage that is present on the palm side of the hand and is surrounded by carpal bones (bones that make up the sides and bottom part of the tunnel and are formed in a semi-circle) and ligaments (a strong tissue holding the tunnel together).
Carpal tunnel syndrome can occur in one or both hands.
In today’s article, we will be discussing carpal tunnel syndrome.
- What are the causes of Carpal Tunnel Syndrome?
- What are the risk factors for Carpal Tunnel Syndrome?
- What are the symptoms of Carpal Tunnel Syndrome?
- How to diagnose Carpal Tunnel Syndrome?
- What is the treatment for Carpal Tunnel Syndrome?
- What are the complications of surgery for Carpal Tunnel Syndrome?
- How to prevent Carpal Tunnel Syndrome?
What are the causes of Carpal Tunnel Syndrome?
The various causes of carpal tunnel syndrome include:
- Congenital (present at birth)
- Genetics (small carpal tunnels may have a family history)
- Underlying medical conditions like:
- Diabetes
- Thyroid disorders
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- High blood pressure
- Fluid retention in cases of pregnancy or during menopause (stopping of the menstrual cycle)
- Trauma or fracture of the wrist
- Autoimmune diseases (when the body’s immune system attacks its own tissue) like rheumatoid arthritis (an inflammatory disorder that affects many joints)
- Infections
- Tumor growing inside the wrist
- Obesity
- Excessive consumption of alcohol
- Amyloidosis (a disease that occurs due to the abnormal protein deposits in the body)
Repeated motion of the wrist in activities like:
- The use of the keyboard or the mouse
- Prolonged use of vibrating hand tools
- Typing
- Playing the piano
These activities cause swelling and compression of the median nerve. This may not necessarily cause carpal tunnel syndrome but may contribute to the worsening of the condition already present.
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What are the risk factors for Carpal Tunnel Syndrome?
Carpal tunnel syndrome may be more commonly seen in cases of:
- Wrist dislocation or wrist fracture
- Presence of smaller carpal tunnel
- More common in women
- Diabetes
- Rheumatoid arthritis
- Breast cancer medications
- Obesity
- Pregnancy
- Menopause
- Thyroid diseases
- Kidney failure
- Carpentry
- Desk job involving excessive use of mouse and the keyboard
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What are the symptoms of Carpal Tunnel Syndrome?
The various symptoms of carpal tunnel syndrome are:
- Numbness or tingling sensation in the thumb and the fingers of the hand
- Numbness or tingling sensation of the palm of the hand
- Pain that may extend to the elbow
- Clumsiness while gripping objects with the hand
- Pain in the wrist or the hands
- Difficulty in carrying bags
- Weakness in the muscles of one or both the hands
- Problems in coordination in one or both the hands
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How to diagnose Carpal Tunnel Syndrome?
- Physical examination: The doctor will first physically examine the patient and test the sensations on the thumb and the fingers, and the strength of the muscles in the hand.
- Ask about the symptoms: The doctor will inquire about the symptoms the patient is experiencing. Staying awake at night due to pain in the wrist, numbness or tingling sensation in the thumb and the fingers, difficulty in gripping objects could indicate the presence of carpal tunnel syndrome.
- Tinel’s sign: In this test, the doctor taps over the median nerve to check for the tingling sensation in the fingers.
- Wrist flexion test or Phalen test: The patient tests his or her elbow on a table allowing the wrist to fall forward in this test. A person with carpal tunnel syndrome will experience tingling and numbness in the fingers within one minute. The more quickly the symptoms occur, the more severe is carpal tunnel syndrome.
- X-ray: An x-ray of the wrist could rule out other causes of wrist pain like fracture or arthritis.
- Electromyography: This test helps in measuring the small electrical discharges that are produced in the muscles. A thin needle-like electrode (rod-like structure) is inserted into specific muscles to check for their electrical activity as they contract and relax. Any damage to the muscles controlled by the median nerve is detected by this method.
- Nerve conduction study: In this test, two electrodes are taped to the skin and a small shock wave is passed through the median nerve to check if the electrical impulses slow down in the carpal tunnel.
What is the treatment for Carpal Tunnel Syndrome?
Carpal tunnel syndrome can be treated in the following ways:
- Non-surgical treatment:
-
- A wrist splint should be worn at night.
- The doctor may prescribe nonsteroidal anti-inflammatory drugs like ibuprofen.
- Cortisone injections (a type of corticosteroid) may be given by the doctor to relieve pain and swelling.
- Modifications to the workplace environment like:
- Moving the keyboard of the computer.
- Changing the position of the hands or the wrist while performing activities.
- Lowering or raising the chair.
- Use of splints, heat treatments, and exercises as suggested by the doctor.
- Surgical treatment:
-
- Surgical treatment is recommended when non-surgical methods of treatment have failed, or in severe cases of carpal tunnel syndrome.
- The goal of the surgery is to relieve pressure. This is done by cutting the ligament that is pressing on the median nerve.
- The surgery is performed under local anesthesia (the surgical area is numbed) or an intravenous or IV (directly into the vein) anesthetic.
- The surgery can be performed in the following ways:
- Endoscopic surgery:
-
- A telescope-like device with a camera on one end known as an endoscope is used by the surgeon to see inside the carpal tunnel in this method.
- The surgeon cuts through the ligament through one or two small incisions made in the hand or the wrist.
- The endoscope is used to see inside the carpal tunnel.
- This type of surgery is less painful than open surgery.
- Open surgery:
-
- An incision is made by the surgeon in the palm of the hand over the carpal tunnel.
- The surgeon then cuts through the ligament to free the nerve.
- The ligament gradually grows back together after the surgery, but the carpal tunnel will have more space and the pressure on the median nerve is relieved. The internal healing takes many months, however, the healing of the skin takes place in a few weeks.
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What are the complications of surgery for Carpal Tunnel Syndrome?
The complications associated with carpal tunnel syndrome surgery are:
- Infection
- Injuries to the nerve or the blood vessels
- Scar formation
- Incomplete ligament release
- Soreness
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How to prevent Carpal Tunnel Syndrome?
Carpal tunnel syndrome can be prevented by the following methods:
- Short and frequent breaks should be taken from repetitive activities that involve the use of hands.
- Rotation of the wrists and stretching of the palms and fingers.
- Avoid sleeping on your hands.
- A snug-fitted wrist splint can be worn at night.
- A pain-relieving medication like aspirin or ibuprofen can be taken to relieve the pain.
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We hope we have answered all your questions about carpal tunnel syndrome through this article.
If you want more information about carpal tunnel syndrome and its treatment, contact the Orthopedic Surgeon.
We aim to provide you with information through this article. We do not recommend any medicine or treatment to anyone. Only a doctor can give you good advice and the correct treatment plan.
