Carpal tunnel syndrome is a painful and progressive condition that occurs when the median nerve in the wrist is compressed. In simple words, it occurs when there is a pinched nerve in the wrist. There is a space in the wrist called the carpal tunnel where the median nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome occurs when swelling in this tunnel puts pressure on the nerve.
It causes numbness and tingling in fingers, hand and arm. The anatomy of the wrist, repetitive hand motions and health problems can further contribute to the symptoms. Early diagnosis and treatment are important as it gets worse with time.
Causes of Carpal Tunnel Syndrome
Some common causes include:
- Swelling of the lining of the flexor tendons called tenosynovitis
- Wrist fracture
- Joint dislocations
- Fluid build-up during pregnancy
Thyroid conditions, rheumatoid arthritis and diabetes can also be associated with carpal tunnel syndrome.
The relationship between work and carpal tunnel syndrome is still unclear. The positions of extreme wrist extension and flexion are known to increase the pressure within the carpal canal, thus applying more pressure on the nerve. The intensity, duration and frequency of work activity and their relationship to carpal tunnel syndrome are still unclear.
Symptoms of Carpal Tunnel Syndrome
Carpal tunnel syndrome symptoms start gradually without a specific injury. Numerous patients find that their symptoms come and go at first. However, the symptoms may occur more frequently or may persist longer as the condition worsens.
- One of the first symptoms includes tingling or numbness in fingers, like the middle or ring fingers, which comes and goes. The little finger is not affected.
- Sometimes there is a sensation like an electric shock that radiates to the thumb and index, middle, and ring fingers. The pain or tingling sensation may travel up the forearm towards the shoulder. These symptoms often occur while holding something like a phone, steering wheel, pen or reading a book.
- The patients may experience weakness and clumsiness in the hand which makes it difficult to perform fine movements such as buttoning the shirt. They may have a tendency to drop objects due to the numbness, weakness or loss of proprioception, which refers to the awareness of where your hand is in space.
- Some night-time symptoms are also quite common. Since many people sleep with their wrists bent, some of the symptoms may awaken you from the sleep.
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Most patients relieve these symptoms by moving or shaking their hands. The numbness may become constant over time.
The doctor will take a detailed history of all the medical conditions. He will ask you how the hands have been used and check if any prior injury is important while diagnosing carpal tunnel syndrome. You may have to take an x-ray to check for arthritis or a fracture. In some cases, laboratory tests may be done. Further, electro-diagnostic studies may also be conducted to confirm the diagnosis and check for other possible nerve problems.
Prevention and Treatment
The treatment aims at relieving the symptoms and the progression of carpal tunnel syndrome by reducing the pressure on the median nerve.
Some tips to prevent and reduce the discomfort include:
1 – Resting the wrist and hand: The more you rest the hand, the greater will be the chances of relieving it.
2 – Controlling the triggers: Identify the triggers causing the carpal tunnel syndrome. If it is stemming from repetitive hand movements, take a break and give the hand some time to recover.
3 – Cold Compress: Place an ice pack on the wrist if the problem flares up but remember to wrap the ice in a towel or cloth before placing it. Ice should never be applied directly on to the skin.
4 – Wrist Splints: The wrist splints help in keeping the wrist in the same position and prevent it from bending. You can wear them while sleeping and during the day if they don’t interfere with your daily activities. Wrist splints are available over the counter at pharmacies. If you are unsure of which one to buy, your doctor or pharmacist can advise you.
5 – Occupational Therapy: Visiting a therapist could be beneficial as they can teach you how to do repetitive tasks differently instead of doing it in the same way. They will advise you on the correct posture and position that you could adopt while working.
6 – Compression Gloves: Copper gloves are a great alternative to consider. You can easily wear them at work as they are not restrictive like wrist splints and allows more movement to the hands. They provide sufficient amount of compression that helps with the blood flow on the compressed area. They also help in reducing inflammation, pain and numbness. With proper rest and compression gloves, you can go back to your usual work in no time.
The good news is that carpal tunnel syndrome is completely treatable. Mild cases can respond to non-surgical care while advanced cases can be treated very effectively with surgery.