Carpal Tunnel Syndrome
Overview
Carpal tunnel syndrome (CTS) occurs when the median nerve in your wrist is squeezed. Your wrist has a tight space called the carpal tunnel in the hand, which is made of ligament and bone. This tunnel holds the median nerve and the tendons that help move your fingers.
The median nerve provides sensation to your thumb, index finger, middle finger, and part of your ring finger (but not your pinky). It also controls some small muscles at the base of your thumb. For people who experience Carpal tunnel syndrome, you may experience middle finger nerve pain and thumb and pointer finger numbness.
Causes
Carpal tunnel syndrome can happen for different reasons. However, according to research women and older people are more likely to get it. Besides that, the common Carpal tunnel syndrome causes include:
- Genetics: Traits that run in families can play a role. Some people naturally have a smaller carpal tunnel or their anatomy may affect the nerve space.
- Repetitive Hand Use: Doing the same hand and wrist movements over and over can strain the tendons in the wrist, leading to swelling that presses on the nerve.
- Hand and Wrist Position: Activities that involve bending the hand or wrist a lot over time can also put pressure on the nerve.
- Pregnancy: Hormonal changes during pregnancy can cause swelling that presses on the nerve.
- Health Conditions: Conditions like diabetes, rheumatoid arthritis, and thyroid problems are linked to carpal tunnel syndrome.
Symptoms
Carpal Tunnel Syndrome (CTS) can cause various symptoms that affect the hand and wrist. The symptoms typically develop gradually and may vary in severity. Here are some Carpal Tunnel Syndrome symptoms:
- Numbness and Tingling
- Pain or Discomfort
- Weakness
- Burning Sensation
- Hand Clumsiness
The symptoms of carpal tunnel syndrome (CTS) can differ from one person to another. They may be affected by what’s causing the problem, how much the nerve is compressed, and differences in each person’s body.
Diagnose Carpal Tunnel Syndrome
Carpal Tunnel Syndrome diagnosis usually involves a doctor checking your symptoms, examining your hand and wrist, and sometimes doing extra tests to confirm the diagnosis and make sure it’s not something else. Here’s how carpal tunnel syndrome diagnosed:
Medical History and Symptom Assessment
Your neurologist will ask about your symptoms: when they began, how they impact your daily life, and what makes them better or worse.
They will also ask about existing health issues, past hand or wrist injuries, and activities you do for work or fun that might strain your hands and wrists.
Physical Examination
Your neurologist will check your hand, wrist, and arm to look for signs of carpal tunnel syndrome (CTS). They’ll test your sensation, strength, and reflexes in the affected hand.
They might also do special tests like tapping over the wrist to see if it causes tingling (Tinel’s sign) or a wrist flexion test to see if it brings on symptoms (Phalen’s test) to check for nerve compression.
Electrodiagnostic Tests
If the neurologist is unsure about the diagnosis after the physical examination or needs more confirmation, they might suggest electrodiagnostic tests like nerve conduction studies (NCS) and electromyography (EMG).
Nerve conduction studies check how well electrical signals move through the median nerve, helping to identify nerve compression and assess damage severity.
Electromyography measures the electrical activity in muscles to see if there’s any muscle damage or loss of nerve supply due to nerve compression.
Imaging Studies (if necessary)
Sometimes, the neurologist might order imaging tests like X-rays, ultrasound, or MRI (Magnetic Resonance Imaging) to look at the structures of your wrist. This helps rule out other possible causes of your symptoms, such as arthritis or wrist fractures.
Differential Diagnosis
Your neurologist will also consider other conditions that can cause symptoms similar to carpal tunnel syndrome (CTS), like a pinched nerve in the neck (cervical radiculopathy), peripheral neuropathy, or other nerve entrapment problems.
Clinical Diagnosis
Based on your medical history, physical exam, and test results, your neurologist will diagnose Carpal Tunnel Syndrome (CTS).
The Carpal Tunnel Syndrome treatment plan may include wearing a splint, taking medication, doing physical therapy, or in some cases, having carpal tunnel syndrome surgery.
Treatment
Treating carpal tunnel syndrome (CTS) promptly is important. If conditions like diabetes or arthritis are contributing, they should be addressed first.
Non-Surgical Treatments
Non-surgical treatment can help manage carpal tunnel syndrome symptoms temporarily, but they don’t fix the underlying nerve problem or provide long-term relief.
- Splinting/Bracing: Wearing a splint on the hand and wrist at night can help ease carpal tunnel symptoms.
- Steroid Injection: An injection of steroid into the carpal tunnel can temporarily relieve CTS symptoms.
Carpal Tunnel Surgery Treatments
Carpal tunnel release surgery is common for CTS and can be done in two ways:
- Open Release Surgery: This traditional surgery involves cutting the wrist to release the ligament and create more space in the carpal tunnel. It’s usually done with local anesthesia and as an outpatient procedure.
- Endoscopic Surgery: This involves making small incisions and using a camera to guide the surgeon in cutting the ligament. It may lead to quicker recovery but carries a higher risk of complications.
Although surgery can provide quick symptom relief, recovery time varies based on CTS severity and can take months to years. Surgery usually resolves CTS permanently, and it’s rare for symptoms to return afterward. However, all surgeries come with risks such as infection, nerve damage, stiffness, or scar pain.
What will happen if carpal tunnel syndrome is not treated?
If carpal tunnel syndrome isn’t treated, symptoms like hand pain, numbness, and weakness can get worse. Long-term nerve compression can cause lasting damage, leading to persistent wrist weakness and loss of feeling in the hand. Without treatment, carpal tunnel syndrome can make daily activities harder and lower your quality of life.
Does carpal tunnel go away?
Carpal tunnel syndrome can get better with treatments like wearing a splint, doing therapy, or having surgery, but whether it goes away completely depends on how bad it is and how your body responds. Sometimes, symptoms can still be there even after trying treatment.
How long does carpal tunnel last?
The time carpal tunnel syndrome lasts varies based on its severity and the treatment you receive. Mild cases may improve with rest and adjusting how you use your hands. Serious cases might require ongoing treatment such as using a splint, having therapy, or surgery for lasting relief.
Can carpal tunnel be cured?
Carpal tunnel syndrome can be managed with treatments like wearing a splint, doing therapy, or having surgery. Most people feel much better with these treatments. However, some may still have mild symptoms even after getting treatment.
Does carpal tunnel cause swelling?
Carpal tunnel syndrome can lead to mild swelling in the wrist, along with pain and numbness. The swelling happens because of extra fluid that can press on the nerve in the wrist. Changing how you use your hands and wearing a wrist splint can help reduce swelling, relieve pain, and make symptoms better.
What does carpal tunnel feel like?
Carpal tunnel syndrome feels like pain, numbness, tingling, or a pins-and-needles sensation in the hand and fingers. It can also cause aching or throbbing discomfort that gets worse when using your hand, especially at night. Your grip strength might weaken, and your fingers may feel swollen or clumsy due to pressure on the nerve in the wrist.
What are the Risk Factors?
Anyone can develop carpal tunnel syndrome. However, risk factors for carpal tunnel syndrome include repetitive hand movements, wrist anatomy, and conditions like diabetes, rheumatoid arthritis, and hypothyroidism. Additionally, pregnancy, obesity, and fluid retention can increase pressure on the median nerve, contributing to the condition.
How to prevent carpal tunnel?
To prevent carpal tunnel syndrome:
- Take breaks often from doing the same hand movements.
- Use tools that are good for your hands and keep your wrists in a healthy position.
- Stretch your hands and wrists regularly and avoid doing things that put too much strain on them.
When To See A Doctor
If you experience numbness, tingling, pain, or weakness in your hand or wrist that affects your daily activities or sleep, visit your neurologist right away. Difficulty gripping objects, performing delicate tasks, or noticing weaker hand muscles are also signs that warrant medical attention. If you have diabetes, arthritis, or a job that involves repetitive hand movements or using vibrating tools, you may be at higher risk for Carpal Tunnel Syndrome (CTS). Early diagnosis and treatment can help ease symptoms and prevent long-term nerve damage.
Summary
Carpal Tunnel Syndrome (CTS) results from compression of the median nerve within the carpal tunnel of the wrist. This tunnel, bordered by bones and ligaments, accommodates the median nerve and tendons essential for finger movement. The median nerve controls sensation in the thumb, index, middle, and part of the ring finger, as well as some thumb base muscles. Symptoms of CTS commonly include numbness, tingling, pain, weakness, and burning in the affected hand.
CTS can be triggered by various factors. Research shows that women are three times more likely to develop CTS than men, and the prevalence increases with age. Genetic factors, repetitive hand use, and poor wrist positioning contribute to the condition. Health conditions such as diabetes, rheumatoid arthritis, and thyroid disorders also elevate risk. Hormonal changes during pregnancy can lead to temporary CTS, affecting up to 40% of pregnant women.
Diagnosis typically involves assessing medical history, performing a physical examination, and conducting electrodiagnostic tests like nerve conduction studies (NCS) and electromyography (EMG). Imaging studies, such as X-rays or MRIs, may be used to rule out other conditions. Differential diagnosis is essential to exclude similar conditions such as cervical radiculopathy and peripheral neuropathy.
Non-surgical treatments include splinting, steroid injections, and lifestyle adjustments. If these methods fail, carpal tunnel release surgery—either open or endoscopic—may be necessary. Surgery is effective in approximately 80% of cases, offering long-term relief, although recovery times can vary and risks like infection or nerve damage are possible.
Preventive measures include taking frequent breaks from repetitive tasks, ergonomic adjustments, and hand stretches. Untreated CTS can lead to progressive symptoms and long-term nerve damage. Early diagnosis and intervention are crucial for effective symptom management and preventing permanent impairment.
-Disclaimer-
This information is intended for educational purposes only and should not be considered a substitute for professional medical advice. If you have concerns about Carpal Tunnel Syndrome or any other medical condition, please see a doctor for an accurate diagnosis and personalized treatment suggestions.
