Carpal Tunnel Syndrome

Carpal tunnel syndrome is also known as median nerve compression, and it causes you to experience tingling, numbness, and pain in your forearm and hand. The condition is caused by a major nerve in your hand being compressed or squeezed as it travels through your wrist.

For most patients, carpal tunnel syndrome gets worse over the years. Leaving this condition untreated for long can lead to permanent dysfunction in your hand. You may lose the sensations in your fingers or experience weakness in your hand. It’s important to get a diagnosis and treatment as soon as possible to help your hand stay strong for years to come.  

 

Causes

Carpal tunnel syndrome is usually caused by a combination of factors instead of being attributed to one cause.

Heredity may play a factor in who gets the condition. Some people have naturally small carpal tunnels that may change the amount of space for the nerve.

Repetitive hand use for prolonged periods may aggravate the tendons in your wrist, causing swelling that subjects your nerve to pressure.

Hand and wrist positions that require extension or flexion of your wrist and hand for long periods can increase the pressure in your median nerve. 

Pregnancy causes hormonal changes that may result in swelling that subjects your nerve to pressure

Health conditions such as rheumatoid arthritis and diabetes may contribute to the development of carpal tunnel syndrome.

 

Symptoms 

The condition often starts gradually with the following symptoms:

Numbness or tingling in your hand or fingers like an electric shock are symptoms of carpal tunnel syndrome. The sensation may travel from your wrist all the way up to your arm. You usually experience these sensations when you are using the steering wheel or holding your phone. The feeling may go away on its own, but eventually, it will become constant.

Weakness is another symptom that may cause you to drop objects. Your hand and ability to grip objects become compromised, leading to difficulties in doing everyday tasks.

Risk factors

1. Anatomic factors such as wrist dislocation or fracture can alter the space within your carpal tunnel to put pressure on your median nerve.  
2. Sex is another factor because more women suffer from this condition than men.  
3. Nerve-damaging conditions such as diabetes and rheumatoid arthritis may lead to the development of carpal tunnel syndrome.
4. Inflammatory conditions may affect the lining around your tendons and put pressure on your median nerve. 

Diagnosis 

The doctor must run certain tests to identify if you are suffering from carpal tunnel syndrome. Sometimes there are other conditions to blame for your pain, and identifying them can give you the treatment you need to get back to 100%. 

Physical examination 

This is the first step in assessing your condition because it’s important to assess your health to help your doctor treat your condition. Your doctor will examine your wrist and hand and perform several tests to check your status. The doctor will check your levels of pain and discomfort and where they originate from to pinpoint the cause.

X-ray may be recommended by your doctor to exclude other causes of wrist pain such as a fracture or arthritis.   

Ultrasound may also be used to get a great picture of your median nerve and bones. The test can check whether your median nerve is being compressed.

Electromyography is a test that checks the tiny electrical discharges in your muscles to identify the damage to your muscles that are controlled by your median nerve. 

 Not all of the tests above identify carpal tunnel syndrome. Some of the tests are used to rule out other conditions that cause similar symptoms to carpal tunnel syndrome. 

Treatment

Carpal tunnel syndrome can be treated when the symptoms start. Simple things can be done to alleviate the condition, such as:

1. Rest your hands more often
2. Apply cold packs on your wrist to minimize swelling
3. Avoid doing activities that worsen your symptoms

 Nonsurgical treatment

 Your doctor will often recommend non-surgical treatments first, such as:

 Wrist splinting holds your wrist while you are sleeping to alleviate nighttime symptoms of carpal tunnel syndrome. This solution is often recommended for pregnant women because it does not require medication.

Nonsteroidal anti-inflammatory drugs can help you with the pain of carpal tunnel syndrome for a short time.

Corticosteroid injections can help alleviate a lot of the symptoms of carpal tunnel syndrome. The doctor may need to use an ultrasound machine to help guide the injection to its proper place. 

The injection can decrease the swelling and inflammation to lower the pressure on your median nerve. It’s better to take the injections rather than the oral corticosteroids because injections are more effective.  

If arthritis is the cause of your carpal tunnel syndrome, then treating arthritis can help alleviate your symptoms. 

Surgery

Surgery may be needed if your symptoms persist despite treatment. The goal of the surgery is to relieve pressure from your nerve by cutting the ligament pressing on it.

Two techniques

Endoscopic surgery uses a tiny camera or endoscope to see the inside of your carpal tunnel inserted through a small incision. The surgeon uses that camera to guide the instruments in performing the surgery. An ultrasound can also be used as an alternative to an endoscope to guide the surgery. This type of surgery causes less pain and may make for an easier recovery process. 

Open surgery has your surgeon cut an incision in the palm of your hand over the carpal tunnel and proceeds to cut through the ligament to free your nerve. 

You need a doctor to examine you to ensure that you do have carpal tunnel syndrome. It’s unwise to self-medicate because you may misdiagnose your condition. 

Set an appointment in the office to correctly diagnose and treat your condition.