Carpal Tunnel Syndrome: Symptoms, Causes, Treatments
Carpal tunnel syndrome is a trauma of the carpal tunnel which is a narrow passageway on the palm side of your wrist made up of bones and ligaments. The median nerve runs through this passageway and controls the sensation and movement in your thumb and first three fingers. When it’s compressed, the result is numbness, tingling, weakness, and pain in the hand.
Carpal Tunnel Syndrome: Pain and Tingling
Carpal tunnel develops slowly. At first, you’re most likely to notice it at night or when you first wake up in the morning. The feeling is similar to the “pins-and-needles” sensation you get when your hand falls asleep. During the day, you may notice pain or tingling when holding things, like a phone or a book, or when driving. Shaking or moving your fingers usually helps.
Carpal Tunnel Syndrome Symptoms: Weakness
As carpal tunnel syndrome progresses, you may begin to notice weakness in the thumb and first two fingers, and it may be difficult to make a fist or grasp objects. You may find yourself dropping things, or you may have trouble doing things like holding a utensil or buttoning your shirt.
Carpal Tunnel Syndrome: Sensation Problems
Carpal tunnel syndrome can also cause a feeling of numbness in the hands. Some people feel like their fingers are swollen, even though no swelling is present, or they may have trouble distinguishing between hot and cold.
Carpal Tunnel Syndrome: Causes
There usually isn’t one definitive cause of carpal tunnel syndrome. Because the carpal tunnel is narrow and rigid, anytime there is swelling or inflammation in the area, the median nerve can be compressed and cause pain. Symptoms may be present in one or both hands. But, usually symptoms develop in the dominant hand first.
Women are three times more likely than men to get carpal tunnel syndrome. Certain conditions can also increase your risk. These include:
- Diabetes, gout, hypothyroidism, and rheumatoid arthritis
- Sprain or fracture of the wrist
Carpal Tunnel Syndrome: Work Environment?
It’s a common belief that frequent typing can lead to carpal tunnel syndrome. But it’s actually three times more common among assembly line workers than it is among data-entry personnel, and frequent use of vibrating hand tools increases the risk. In contrast, one study found that even heavy computer use, up to seven hours a day, did not make people more likely to develop carpal tunnel syndrome.
Carpal Tunnel Syndrome Left Untreated
As the condition worsens, symptoms may become chronic. Pain may radiate up the arm all the way to the shoulder. Over time, if untreated, carpal tunnel syndrome can cause the muscles on the thumb side of your hand to waste away. At this point, even with treatment, strength and sensation may never be completely restored.
Carpal Tunnel Syndrome: Diagnosis
There are several tests to perform. First, the Tinel test involves tapping on the median nerve to see if it causes tingling in the fingers. In the Phalen test, the doctor will have you press the backs of your hands together for a minute to see if this causes numbness or tingling.
To confirm the diagnosis, a nerve conduction study is done. In this test, electrodes are placed on the hands and wrists, and small electric shocks are applied to measure how quickly the median nerve transmits impulses. Another test, called electromyography, uses a fine needle inserted into a muscle to measure electrical activity and assess damage to the median nerve.
Carpal Tunnel Syndrome: Treatment
Underlying causes such as diabetes or arthritis will need treatment. Then your doctor may advise resting the hand and wrist and wearing a brace to limit movement. Night use is important to prevent the wrist from curling during sleep, which can make symptoms flare up. Non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen, along with cold compresses, may reduce pain.
Carpal Tunnel Syndrome: Medications
When carpal tunnel symptoms are more severe, your doctor may recommend corticosteroids by injection or by mouth. Steroids can temporarily reduce inflammation around the median nerve and ease symptoms. Injection of a local anesthetic such as lidocaine can also relieve symptoms. Other things that may help are diuretics (water pills) which reduce swelling, and also vitamin B6 supplements.
Carpal Tunnel Syndrome: Surgery
If surgery is needed, it’s typically done on an outpatient basis under local anesthesia. The ligament overlying the top of the carpal tunnel is cut to relieve pressure. The healed ligament will allow more space in the carpal tunnel. Sometimes the procedure is done endoscopically, using a tiny camera inserted through a very small incision to guide the procedure.
Carpal Tunnel Syndrome: Strengthening Exercises:
Once carpal tunnel symptoms subside, a physical therapist can teach you stretching and strengthening exercises to help prevent pain, numbness, and weakness from coming back. A physical or occupational therapist can also teach you the correct ways to perform tasks so that the median nerve is less likely to become inflamed again, causing symptoms to return.
Chiropractic Medicine for Carpal Tunnel Syndrome
Several studies suggest that chiropractic manipulation of the wrist, elbow, and upper spine can improve carpal tunnel syndrome. There is also some evidence that acupuncture may help restore nerve function and relieve symptoms.
Carpal Tunnel Syndrome: Prevention
Though there is no definitive way to prevent carpal tunnel syndrome, these things can help:
- Good posture
- Ergonomic tools and workstations
- Stretching hands and wrists regularly
- Taking frequent rest breaks to shake arms and legs, lean back, and change position throughout the work day.
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