What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome, (CTS), also known as median nerve compression, is a painful condition affecting the hand. It occurs when the median nerve, which controls movement and sensation in the thumb and first three fingers, becomes compressed within a narrow passageway in the wrist called the carpal tunnel. This compression leads to a constellation of uncomfortable symptoms, including pain, numbness, tingling, and weakness in the affected hand.

What Causes Carpal Tunnel Syndrome?

CTS arises from increased pressure on the median nerve within the carpal tunnel. Several factors can contribute to this compression:

• Swelling: Conditions such as hypothyroidism, rheumatoid arthritis, diabetes, or pregnancy can cause swelling, reducing the space available for the median nerve.
• Space-Occupying Lesions: Cysts, tumors, or bone fractures can physically compress the nerve.
• Repetitive Motion: Overuse of the hands and wrists, common in activities like typing, writing, or using vibrating tools, can inflame the tendons and compress the nerve.

Recognizing the Symptoms

CTS often manifests with a gradual onset of symptoms. Common indicators include:

• Numbness and Tingling: Sensations of burning, tingling, or itching numbness typically affect the palm of the hand and fingers, particularly the thumb, index, and middle fingers.
• Weakness: Decreased grip strength hinders daily activities such as grasping objects or forming a fist.
• Nighttime Discomfort: Symptoms often intensify at night due to wrist flexion during sleep.
• Advanced Symptoms: In severe or untreated cases, muscle atrophy in the base of the thumb and impaired temperature sensation may develop.

Who is at Risk?

Carpal tunnel syndrome disproportionately affects women, who are three times more likely to develop the condition than men. This disparity may be attributed to the smaller carpal tunnel size in women. Additionally, the dominant hand is often more susceptible to severe symptoms.

Diagnosing Carpal Tunnel Syndrome

Healthcare providers employ various methods to diagnose carpal tunnel syndrome:

• Medical History and Physical Examination: A thorough evaluation of the hands, arms, shoulders, and neck helps identify tenderness, swelling, or other abnormalities.
• Laboratory Tests: Blood tests may be ordered to rule out underlying conditions like diabetes.
• Imaging Studies: X-rays can detect arthritis or fractures, while ultrasound imaging can visualize the median nerve.
• Neurological Tests: The Tinel test and Phalen’s maneuver help to elicit symptoms associated with carpal tunnel syndrome. Nerve conduction studies measure the nerve’s ability to transmit signals.

Splints help to maintain a neutral wrist position to eliminate symptoms of carpal tunnel syndrome.

Treatment Options

Treatment for CTS varies depending on the severity of symptoms.

• Non-Surgical Treatment:
  • Splinting immobilizes the wrist in a neutral position to reduce nerve compression.
  • Rest and modification of activities help to alleviate symptoms.
  • Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can provide temporary relief.
  • Corticosteroid injections can reduce inflammation and pressure on the nerve.
  • Alternative therapies like yoga or acupuncture may offer some benefit for certain individuals.
• Surgical Treatment:
  • Carpal tunnel release surgery involves cutting the carpal ligament to relieve pressure on the median nerve.
  • Open release surgery and endoscopic surgery are the two primary surgical techniques.

Preventing Carpal Tunnel Syndrome

Implementing preventive measures can significantly reduce the risk of developing carpal tunnel syndrome:

• Ergonomic Practices: Maintain proper posture and wrist position while working at a computer or performing repetitive tasks.
• Frequent Breaks: Take short breaks to rest your hands and wrists.
• Wrist Stretches: Incorporate stretching exercises to improve flexibility.
• Strength Training: Strengthen the muscles in your hands and forearms.

By understanding the causes, symptoms, and treatment options for carpal tunnel syndrome, individuals can take proactive steps to manage and prevent this painful condition.