What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome is a condition in which compression of the median nerve located in the wrist causes pain, numbness, weakness and tingling sensations in the hand. It is also referred to as the median nerve compression syndrome.
Carpal tunnel is a narrow passageway of the median nerve that connects muscles of the thumb and provides sensory supplies to the thumb, index, middle and ring finger. This path is formed by carpal bones and transverse carpal ligament. Sometimes the tissue surrounding the tunnel swells and put pressure on the median nerve which then leads to carpal tunnel syndrome.
What causes Carpal Tunnel Syndrome?
Carpal tunnel syndrome is caused by multiple factors but is most prevalent in women and older people. Other risk factors include:
- Repetitive motions like typing on a keyboard.
- Over extended positioning of wrist during work.
- Long term exposure to vibrations for example power tool.
- Trauma or fracture to wrist bones
Other medical conditions that can cause carpal tunnel syndrome include;
- Rheumatoid arthritis
What are the Symptoms of Carpal Tunnel Syndrome?
- Numbness, tingling and burning sensations in your thumb and other fingers in the hand.
- Weakness and loss of proprioception lead to dropping things and weak grip on objects.
- Pain and tingling feelings can be felt in the forearm and shoulder
- Difficulty in performing daily tasks like dressing up.
- Night symptoms are common due to the position of the wrists. Patient(s) may awake from sleep due to shock-like-sensations in the hand.
How is Carpal Tunnel Syndrome Diagnosed?
Your doctor can diagnose carpal tunnel syndrome. The doctor will take complete history and a detailed examination of your wrist, hand, forearm and shoulder.
1-Nerve conduction study:
These are diagnostic tests in which nerve impulses/signals travelling in hand are measured. The speed of conduction helps to diagnose carpal tunnel syndrome
2- Electromyography (EMG) test:
An EMG study can tell us the electrical activity of muscles. It is useful to diagnose carpal tunnel syndrome.
Ultrasound uses high frequency sound waves to visualise soft tissue for median nerve compression.
X- Rays are done to exclude other conditions like arthritis, bone fractures and ligament injury.
MRI studies helps to get better results of soft tissues in the wrist and hand. Your doctor would recommend this for any abnormality of soft tissue.
How is Carpal Tunnel Syndrome Treated?
The management and treatment of carpal tunnel syndrome depends on the severity of symptoms. The main purpose is to decrease the continuous injury to the median nerve. In the early course of diagnosis, your doctor will recommend non-surgical treatment option to get relief from symptoms.
- Wrist splint/Bracing
Wrist splints or bracing, immobilises the limbs which facilitates in reducing pressure on the median nerve.
Non-steroidal anti-inflammatory drugs like Dexibuprofen, Naproxen and Etoricoxib decreases inflammation and relief from pain.
- Lifestyle modification
Changing and modifying your job helps to minimise the risk of carpal tunnel syndrome.
- Hand and wrist exercises
Specific hand wrist exercises are helpful to reduce compression on the median nerve. Your doctor and physiotherapist can recommend specific exercises.
- Steroids injections
Your doctor may recommend cortisone or corticosteroids injections for severe symptoms of carpal tunnel syndrome. Steroids has role in reducing inflammation immediately. These are potent anti-inflammatory drugs
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If there are persistent symptoms after medications and other non-surgical treatments, then surgical procedures are performed to treat the disease.
The most common procedure is 'Carpal Tunnel Release' which can be done by open incision and endoscopic technique.