Carpal tunnel syndrome

Carpal tunnel syndrome is the common condition causing pain, numbness, tingling in the hand and arm that is caused by compression of the median nerve (the major nerve of the hand). It should be diagnosed and treated in early stages as it may get worse over time.

Evidence has proved that 3% of women and 2% of men will be diagnosed with carpal tunnel syndrome at least once in their lifetime. The incidence is high in women older than 55 years of age.

In most of the cases, carpal tunnel symptoms develop gradually without any specific reason. Usually, the symptoms come and go but, if the condition gets severe, the symptoms may occur more frequently and persist for a longer duration.

The first symptom is numbness or tingling in your thumb, index and middle fingers that awaken you at night. You may also feel discomfort in the wrist and hand.

  • Pinching and needle-like sensation or pain in the hand
  • Your fingers may feel stiff when you wake up
  • You may also experience weakness in your hand, and tend to drop the objects very often. This is due to the numbness in your hand or weakness of the thumb’s pinching muscles that are controlled by the median nerve.
  • With moderate pain, you may not be able to brush your hair or hold a fork, pinch an object and open a jar using a screwdriver.

Not all pain in the hands is caused by carpal tunnel syndrome. It may also be due to an injury to the muscles, ligaments and tendons, or nerve problems and inflammation in the thumb joint or wrist.

Consult the doctor immediately when you have the symptoms mentioned above and if the symptoms interfere with the normal activities. Remember!! If you ignore the condition, you may end up with permanent nerve damage.

This condition is caused by the compression of the median nerve that runs from your forearm in your wrist (carpal tunnel) to your hand. Other carpel tunnel syndrome causes include:

  • Reduced blood flow to the hands
  • Obesity
  • Conditions such as rheumatoid arthritis, gout, diabetes, and hypothyroidism
  • Repeated hand movements
  • Bone spurs; as they take up space in the carpal tunnel and put more pressure on the median nerve

Carpal tunnel syndrome is a work related condition caused by:

  • Forceful hand movements
  • Hand-arm vibration
  • Working for long hours in the same position (on hand)

Risk factors include:

  • Gender - Women and older people are more likely to develop the condition.
  • Heredity
  • Repetitive hand use
  • Pregnancy
  • Health conditions; such as menopause, obesity, and thyroid gland imbalance
  • Alterations in balance of body fluids
  • Inflammatory conditions such as rheumatoid arthritis

Your doctor will talk to you about the general health, asks about the symptoms and medical history. Then he or she would perform a physical examination to test the feeling of the fingers and muscle strength in your hand.

The doctor would bend the wrist, and tap or press on the nerve to put pressure on the median nerve.

Other tests are also recommended such as:

  • Electromyogram - to determine if muscle damage has occurred
  • Nerve conduction study - to diagnose the condition and to determine other conditions
  • MRI scans, X-rays, and CT scan tests are also performed to determine if there are problems with the nerve itself and to determine the causes for your symptoms

As mentioned above, the condition should be treated as early as possible once you start experiencing the symptoms to prevent complications. The carpal tunnel syndrome treatment depends on how severe your pain and symptoms are, and if there is a weakness.

Non-surgical treatment

If you get diagnosed with the condition in early stages, the symptoms can be relieved without surgery. These treatment options include:

Braces or splints Also called as carpal tunnel splints; wearing these at night keep your wrist from refraining bending during night. You can also wear them during the day while doing the activities that aggravate the symptoms.
NSAIDs Over-the-counter drugs such as ibuprofen and naproxen can help relieve pain and inflammation.
Activity changes Check for the activities that aggravate the symptoms and prevent them from doing very often.
Nerve gliding exercises These carpel tunnel syndrome exercises make your nerve move freely and help to slow down or stop disease progression.
Steroid injection These powerful agents are injected directly into the carpal tunnel to relieve pain and other symptoms.

If the non-surgical options do not manage the symptoms, the doctors would suggest you go for the carpal tunnel surgery. Before that, discuss with your doctor regarding the risks and complications associated with the surgery. There are two different surgical techniques, but the goal is common; to manage the symptoms.

Open carpal tunnel release – A large incision is made on the palm over the carpal tunnel and cuts the ligament to free the nerve.

Endoscopic carpal tunnel release – Ligament is cut through one or small incisions in your hand. This technique results in less pain compared to open technique.

It may take few weeks to resolve the condition.

Follow these tips to get temporary relief from the symptoms:

  • Take regular breaks from repetitive activities that involve hand usage.
  • Rotate your wrists and stretch your palm and fingers.
  • Take OTC drugs such as aspirin and ibuprofen if the pain is severe.
  • Avoid sleeping on the hands.