Carpal Tunnel Syndrome is a common condition that causes pain, numbness, and tingling in the hand and arm. This syndrome gets worse over time, so early diagnosis and treatments are important since, in the early stages, carpal tunnel can still be relieved through simple measures such as wearing a wrist splint or doing wrist exercises.
The carpal tunnel is a narrow passageway in the wrist that is about an inch wide. It protects the flexor tendons, that bend the fingers and thumb; and the median nerve, which controls most of the sensation and movement in the hands and fingers.
Carpal tunnel syndrome occurs when the tunnel becomes narrowed or when tissues surrounding the flexor tendons swell, which puts pressure on the median nerve. These tissues are called the synovium. Normally, the synovium lubricates the tendons, making it easier to move your fingers.
When the synovium swells, it takes up space in the carpal tunnel and, over time, crowds the nerve. This abnormal pressure on the nerve can result in pain, numbness, tingling, and weakness in the hand.
The most common cause of carpal tunnel, which is an inflammation, is an underlying medical condition that causes swelling in the wrist, and sometimes obstructed blood flow. Some of the most frequent conditions linked with carpal tunnel syndrome are:
- Thyroid dysfunction
- Fluid retention from pregnancy or menopause
- High blood pressure
- Autoimmune disorders such as rheumatoid arthritis
- Fractures or trauma to the wrist
Carpal tunnel syndrome can be made worse if the wrist is overextended repeatedly. Repeated motion of your wrist contributes to swelling and compression of the median nerve. This may be the result of:
- Positioning of your wrists while using your keyboard or mouse
- Prolonged exposure to vibrations from using hand tools or power tools
- Any repeated movement that overextends your wrist, such as playing the piano or typing
Carpal tunnel syndrome can be treated, but it also depends on how severe your pain and symptoms are. In 2008, the Academy of Orthopaedic Surgeons released guidelines for the effective treatment of carpal tunnel. Their recommendation was to try to manage carpal tunnel pain without surgery, if possible.
Nonsurgical options include:
- Avoiding positions that overextend your wrist
- Wrist splints that hold your hand in a neutral position, especially at night
- Mild pain medication and medications to reduce inflammation
- Treatment of any underlying conditions you may have, such as diabetes or arthritis
- Steroid injections into your carpal tunnel area to reduce inflammation
Surgery may be necessary if there is severe damage to the median nerve. Surgery for carpal tunnel syndrome involves cutting the band of tissue in the wrist that crosses the median nerve so as to lessen the pressure on your nerve. Factors that determine success or failure are age of the patient, duration of symptoms, and diabetes mellitus. The outcome is usually good.