Carpal Tunnel Syndrome

Wrist/hand

Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a common condition that causes numbness, tingling, and pain in the hand and wrist. This is caused by compression of the median nerve, which is a large nerve running through the carpal tunnel in your wrist. The carpal tunnel is a narrow passageway formed by bones and a ligament on the palm side of your wrist. When the tissues surrounding the median nerve swell, they compress the nerve within the carpal tunnel, causing the characteristic symptoms of CTS.

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Signs and symptoms of carpal tunnel syndrome

Symptoms of carpal tunnel syndrome usually develop slowly and often affect the hand for activities such as writing. Here are some common signs and symptoms:

Numbness, tingling, or burning sensation: This sensation usually affects the thumb, index finger, middle finger, and half of the ring finger. This feeling can be worse at night and often wakes people up from sleep.
Pain: Aching pain in the wrist and palm that may radiate up the arm.
Weakness: Difficulty grasping objects or loss of strength in the affected hand.
Clumsiness: Dropping objects due to hand weakness or numbness.

It is important to note that these symptoms can sometimes be caused by other conditions affecting the hand or wrist. Consultation with a health care professional is essential for proper diagnosis.

What are the Causes & Risk Factor?

Several factors can contribute to carpal tunnel syndrome:

Repetitive hand and wrist movements: Jobs or activities that involve repetitive gripping, forceful exertion, or prolonged hand vibration can increase the risk of CTS. Examples include typing, assembly line work, playing certain musical instruments, and using power tools.
Fluid Retention: Conditions that cause fluid retention, such as pregnancy, obesity, and menopause, swelling of the carpal tunnel, can contribute to median nerve compression.
Certain medical conditions: Diabetes, rheumatoid arthritis, and thyroid disorders can increase the risk of CTS.
Wrist Injuries: A fracture or dislocation of the wrist bones can damage the carpal tunnel or surrounding tissue, causing CTS.
Anatomy: Some individuals may have a naturally narrow carpal tunnel, making them more prone to nerve compression.

Predisposing factors of carpal tunnel syndrome

Certain factors can increase the risk of developing carpal tunnel syndrome:

Occupations: People whose jobs require frequent hand and wrist movements are at higher risk.
Gender: Women are more likely to develop CTS than men.
Age: The risk of CTS increases with age.
Pregnancy: Fluid retention during pregnancy can contribute to CTS.
Obesity: Being overweight can increase fluid retention and put pressure on the median nerve.

Diagnosis of carpal tunnel syndrome

A diagnosis of carpal tunnel syndrome usually includes:

Physical examination:

Physical examination: A health care professional palpates the wrist to identify areas of pain or tenderness.
Sensory testing: They may test your sensation in your thumb, fingers, and palm to assess possible nerve involvement.
Fallon’s test: This involves tapping the top of the wrist to see if it triggers tingling or pain in the hand, which is an indication of CTS.

Imaging tests:

X-rays: X-rays can help identify bone abnormalities in the wrist that may contribute to CTS.
Electromyography (EMG) and nerve conduction studies (NCS): These tests measure the electrical activity of muscles and nerves in the hand and arm. Abnormal findings may indicate nerve compression in CTS.

Based on a physical examination and the results of any tests performed, a healthcare professional can diagnose carpal tunnel syndrome.

Treatment options for hip osteoarthritis

Treatment for carpal tunnel syndrome aims to relieve pressure on the median nerve and manage symptoms. Here’s an overview of common treatment options:

Non-surgical treatment:

This is the first line of treatment for most cases of CTS. This usually includes:

Wrist Splint: Wearing a splint at night to keep the wrist in a neutral position and prevent further compression of the median nerve.
Activity modification: Avoiding activities that aggravate symptoms, such as repetitive gripping or forceful hand movements.
Anti-inflammatory medications: Over-the-counter pain relievers (ibuprofen, acetaminophen) or corticosteroid medications may be used to reduce inflammation and pain.
Physical therapy: A therapist can provide exercises to improve hand and wrist flexibility and strength, which can help manage symptoms and prevent further complications.

conservative measures

Surgery is considered if non-surgical treatments fail to provide significant relief after a trial period (usually several months). Here is the most common surgical procedure for CTS:

Carpal tunnel release: This minimally invasive surgery involves cutting the ligament at the base of the palm to create more space for the median nerve inside the carpal tunnel. The procedure can be performed endoscopically (using a camera and small instruments) or with a small open incision.

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