Symptoms of carpal tunnel syndrome include pain, numbness, tingling, and weakness in the wrist and hand. The condition occurs when the median nerve, which runs from the forearm to the palm of the hand, is compressed or squeezed at the wrist. We will discuss the causes, symptoms, diagnosis, treatment, and prevention of carpal tunnel syndrome in this blog post. The median nerve controls the sensations and movements of the thumb and the first three fingers, except the little finger.
The main cause of carpal tunnel syndrome is increased pressure on the median nerve at the wrist. This pressure can result from:
Repetitive or prolonged use of the hand and wrist in activities such as typing, sewing, knitting, or playing musical instruments
Anatomical factors such as a narrow carpal tunnel, a wrist injury or fracture, or arthritis that changes the shape of the small bones in the wrist
Hormonal changes such as pregnancy, menopause, or thyroid disorders that cause fluid retention and swelling in the wrist
Medical conditions such as diabetes, obesity, kidney failure, or rheumatoid arthritis that affect the nerves or cause inflammation
Genetic factors that make some people more prone to developing carpal tunnel syndrome
The symptoms of carpal tunnel syndrome usually start gradually and worsen over time. They may include:
Tingling or numbness in the thumb and the first three fingers, especially at night or when waking up
Pain or burning sensation in the hand and wrist that may radiate to the arm or shoulder
Weakness or clumsiness in the hand and difficulty gripping or holding objects
Dropping things or feeling like you have less sensation in your fingers
There are different types of symptoms that may occur depending on the severity of the condition and the activities that trigger them. Some people may experience mild or occasional symptoms, while others may experience severe or constant symptoms that interfere with their daily lives.
An examination and medical history are used to diagnose carpal tunnel syndrome. Your doctor may ask you about your symptoms, when they started, how they affect your activities, and if you have any medical conditions. To confirm the diagnosis and rule out possible causes of your symptoms, the doctor may also perform some tests, such as:
Tinel’s sign: The doctor taps on the median nerve at the wrist to see if it causes tingling or numbness in your fingers
Phalen’s maneuver: The doctor asks you to press the backs of your hands together with your wrists flexed for about a minute to see if it causes pain or numbness in your fingers
Durkan test: The doctor presses on the carpal tunnel for about 30 seconds to see if it causes pain or numbness in your fingers
Nerve conduction study: The doctor attaches electrodes to your skin and sends small electric shocks to measure how fast the median nerve sends signals from your wrist to your hand
Electromyography (EMG): The doctor inserts a thin needle into your muscles and records their electrical activity to see if there is any damage to the median nerve
X-ray: The doctor takes an image of your wrist to check for any fractures or arthritis that may affect the carpal tunnel
Ultrasound: The doctor uses sound waves to create an image of your wrist to measure the size of the median nerve and detect any swelling or compression
Depending on how severe your symptoms are and how much they affect your quality of life, carpal tunnel syndrome can be treated in a variety of ways. Carpal tunnel syndrome is treated in a variety of ways, focusing on relieving pain and numbness, restoring function, and preventing further nerve damage. Some of the treatment options include:
Self-care: You can try some simple measures at home to ease your symptoms such as:
Taking frequent breaks from activities that involve using your hand and wrist
Applying ice packs or heat pads to reduce swelling and pain
Wearing a wrist splint at night or during activities that aggravate your symptoms to keep your wrist in a neutral position
Taking over-the-counter pain relievers such as ibuprofen or naproxen to reduce inflammation and discomfort
Doing gentle stretching exercises for your hand and wrist to improve blood circulation and flexibility
Medications: If self-care measures are not enough, your doctor may prescribe some medications to help you with your symptoms such as:
Corticosteroids: These are anti-inflammatory drugs that can be injected into the carpal tunnel to reduce swelling and pressure on the median nerve. They can provide temporary relief for severe symptoms but may have side effects such as weight gain, high blood pressure, or increased blood sugar.
Nonsteroidal anti-inflammatory drugs (NSAIDs): These are oral medications that can also reduce inflammation and pain. They may have side effects such as stomach ulcers, bleeding, or kidney problems.
Diuretics: These are medications that can help remove excess fluid from your body and reduce swelling in your wrist. They may have side effects such as dehydration, low blood pressure, or electrolyte imbalance.
Surgery: If your symptoms are severe or do not improve with conservative treatments, your doctor may recommend surgery to relieve the pressure on the median nerve. There are two main types of surgery for carpal tunnel syndrome:
Open surgery: The surgeon makes an incision in the palm of your hand and cuts the transverse carpal ligament, which is a band of tissue that forms the roof of the carpal tunnel. This creates more space for the median nerve and reduces the compression. The incision is then closed with stitches and a bandage.
Endoscopic surgery: The surgeon makes one or two small incisions in your wrist or hand and inserts a thin tube with a camera and a cutting tool (endoscope) into the carpal tunnel. The surgeon then cuts the transverse carpal ligament using the endoscope and removes it. The incisions are then closed with stitches and a bandage.
Despite similar outcomes and risks, endoscopic surgery may have a shorter recovery period and less pain and scarring. Surgery can result in infection, bleeding, nerve damage, stiffness, or recurrence of symptoms.
Some cases of carpal tunnel syndrome may not be preventable, especially those that are related to genetic factors or medical conditions. However, you can take some steps to reduce your risk or delay the onset of carpal tunnel syndrome by:
Avoiding or modifying activities that involve repetitive or prolonged use of your hand and wrist
Using ergonomic tools and equipment that fit your hand size and shape and allow you to maintain a neutral wrist position
Taking frequent breaks and stretching your hand and wrist during work or leisure activities
Keeping your wrist warm and avoiding exposure to cold temperatures
Maintaining a healthy weight and managing any chronic conditions such as diabetes, thyroid disorders, or arthritis
Seeking medical attention if you have any symptoms of carpal tunnel syndrome
Due to compression of the median nerve in the hand and wrist, carpal tunnel syndrome causes pain, numbness, tingling, and weakness. The condition can be caused by a variety of factors, including repeated hand and wrist use, anatomical variations, hormonal changes, medical conditions, or genetics. Several tests can be used to diagnose it, including nerve conduction studies, electromyography, X-rays, ultrasounds, or MRIs. Based on the severity of the symptoms and the impact it has on daily life, it can be treated with self-care measures, medications, or surgery. It can be prevented or delayed by avoiding or modifying activities that put stress on the wrist, using ergonomic tools and equipment, taking breaks, stretching the hand and wrist, keeping the wrist warm, maintaining a healthy weight and managing chronic conditions.
