Carpal tunnel syndrome

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a compression of the median nerve as it passes into the arm.
The median nerve is located in the palm of your hand (also called the carpal tunnel).
The middle nerve provides a feeling (the ability to feel) to your thumb, forefinger, long finger and part of the thumb.
It gives an impulse to the muscle that goes to the thumb. Carpal tunnel syndrome can occur in one or both hands.

Swelling inside your wrist causes compression in carpal tunnel syndrome. This can lead to numbness, weakness and tingling on the side of your hand near your thumb.

What causes carplanel tunnel syndrome?

Pain in the carpal tunnel occurs due to excessive pressure in the joint and the median nerve.
 Inflammation can cause swelling. The most common cause of this inflammation is a basic health condition that causes swelling of the joints and sometimes obstruction of blood flow.

Some of the most common conditions associated with carpal tunnel syndrome are:

  • Diabetes
  • Thyroid dysfunction
  • Fluid retention during pregnancy or menopause
  • High blood pressure
  • Autoimmune disorders such as rheumatoid arthritis
  • Fractures or trauma of the joint

Carpal tunnel syndrome can worsen if the joint is overstretched more than once.
Repeated movements of your joint contribute to swelling and compression of the median nerve. This could be a potential cause:

  • Position the joints while using the keyboard or mouse
  • Prolonged exposure to vibration due to the use of hand or electric tools
  • Any repeated movement that stretches your wrist excessively, such as playing the piano or knocking.

Who is at risk?

Women are three times more likely to have carpal tunnel syndrome than men.
Carpal tunnel syndrome is most often diagnosed between the ages of 30 and 60.
Certain conditions increase the risk of developing it, including diabetes, high blood pressure, and arthritis.

Lifestyle factors that may increase the risk of carpal tunnel syndrome include smoking, high salt intake, sedentary lifestyle, and high body mass index (BMI).

Examples of jobs that often involve repetitive joint movements:

  • Production
  • Line/tape work
  • Laviatur occupations
  • Construction works

People employed in these occupations may be at higher risk of developing carpal tunnel syndrome.

What are the symptoms of carpal tunnel syndrome?

Symptoms are usually found along the nerve pathway due to compression of the median nerve.
Your hand can often “fall asleep” and drop objects. Other symptoms include:

  • Numbness, tingling, and pain in the thumb and first three fingers of your hand
  • Pain and stinging that travel along your arm
  • Joint pain at night that interferes with sleep
  • Weakness in the muscles of the arm

How it is diagnosed?

Doctors can diagnose CTS using a combination of your history, physical examination, and tests called nerve conduction studies.

A physical examination includes a detailed assessment of your hands, wrists, shoulders, and neck to see if there are other causes of nerve pressure.

Your doctor will look at your joints for signs of tenderness, swelling, and any deformities.

They will check the feel of the fingers and the strength of the muscles in your hand.

Nerve conduction studies are diagnostic tests that can measure the conduction velocity of your nerve impulses.

If the nerve impulse is slower than normal as the nerve passes into the arm, you may have carpal tunnel syndrome.

How is carpal tunnel syndrome treated?

Treatment of CTS depends on how severe the pain and symptoms are and whether there is weakness.

In 2008, the Academy of Orthopedic Surgeons published guidelines for effective carpal tunnel treatment. The recommendation was to try to manage the pain in the carpal tunnel without surgery, if possible.

Non-surgical options include:

  • Avoid positions that overstretch your wrist
  • Splints for the joints that keep the hand in a neutral position, especially at night
  • Mild painkillers and anti-inflammatory drugs
  • Treat any underlying conditions you may have, such as diabetes or arthritis
  • Steroid injections into the carpal tunnel area to reduce inflammation

Surgery may be necessary if there is severe damage to the median nerve.
Carpal tunnel syndrome surgery involves cutting a strip of tissue in the joint that crosses the median nerve to reduce the pressure on your nerve.
Factors that determine success or failure are the patient’s age, the duration of symptoms, diabetes mellitus and whether there is weakness (which is usually a late sign). The outcome is usually good.

How to prevent carpal tunnel syndrome?

You can prevent CTS by changing your lifestyle, which reduces the risk factors for its development.

Treating conditions such as diabetes, high blood pressure and arthritis reduce the risk of developing carpal tunnel syndrome.

Paying attention to your hand and avoiding activities that overstretch your wrist are also important strategies for reducing symptoms. Physical therapy exercises can also be helpful.

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