Carpal tunnel syndrome is a condition that occurs when the median nerve, which runs from the forearm into the hand, becomes compressed. The carpal tunnel is a narrow passageway on the palm side of the hand, formed by bones and ligaments. When this passageway becomes narrower, it can pressure the median nerve. This pressure creates a limited area for blood flow that leads to pain, pin sensations, or numbness in the hand, the wrist, and the forearm.
What is the Cause of Carpal Tunnel Syndrome?
There are several possible causes of carpal tunnel syndrome or median nerve compression. One of the most common causes is repetitive motion and use of the hands. This tends to happen with people who have desk jobs or work in factory environments where the hands and wrists are prone to repetitive movements. Athletes are also at risk for carpal tunnel syndrome due to the repetitive motions often associated with their sport. Other causes include injury or trauma to the wrist, pregnancy, and arthritis.
Another common cause is activities where the wrist or hand must be highly flexed. For example, typing on a keyboard for long periods can strain the carpal tunnel and lead to median nerve compression.
Not everyone who experiences repetitive wrist motion or extreme flexed movements will develop carpal tunnel syndrome, and those motions are not always the root cause. Hereditary (born with less anatomical space for the nerve) and pre-existing health conditions (diabetes and arthritis) also contribute to the development of carpal tunnel syndrome.
What are the Symptoms of Carpal Tunnel Syndrome?
The symptoms of median nerve compression are a pain in the hand, wrist, and forearm. The symptoms are worse at night and patients often report having to shake their hand or wrist to ” wake it up.” Patients may also experience numbing, burning, pins and needles, or shock-like feelings that move along the fingers, hands, wrist, and forearm.
Other symptoms of carpal tunnel syndrome may include:
- Burning, tingling, or numbness in the palm and fingers, especially the thumb and index finger
- Pain that radiates from the wrist to the arm
- Weakness in the hand
- A feeling of swelling in the hand even though there is no visible swelling
How is carpal tunnel syndrome diagnosed?
A doctor will ask about your symptoms and medical history. They will also give you a physical exam. The exam may include checking your grip strength and feeling for tenderness in your wrist and hand.
You may also have tests, such as:
- X-rays. These images can show if you have arthritis or other problems in the bones of your wrist.
- Nerve conduction studies. This test measures how well electrical signals move through your median nerve.
- Ultrasound. This imaging test uses sound waves to show possible swelling of the tendons in your carpal tunnel.
The various degrees of carpal tunnel diagnosis.
There are four different types of carpal tunnel syndrome. Type I is the most common, accounting for 95% of carpal tunnel cases. This type is caused by repetitive motion and overuse injuries. An injury or trauma causes type II carpal tunnel syndrome to the wrist, such as a fracture. Type III carpal tunnel syndrome is caused by a systemic disease, such as diabetes or rheumatoid arthritis. The last type, type IV carpal tunnel syndrome, is caused by a mass in the carpal tunnel, such as a tumor.
Treatment Options for Carpal Tunnel Syndrome
If carpal tunnel syndrome is left untreated, the symptoms will eventually become more severe and can lead to permanent damage to the median nerve.
There are several treatment options available for carpal tunnel syndrome. These include:
- Wrist splinting: A wrist splint is a device that helps to keep the wrist in a neutral position and prevents it from moving into extreme positions. This can help relieve symptoms by taking the pressure off the median nerve.
- Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs can help to reduce inflammation and pain.
- Steroid injections: Steroid injections can also help to reduce inflammation and pain.
- Surgery: In some cases, carpal tunnel syndrome may require surgery to release the pressure on the median nerve. This is usually only done when other treatments have failed to provide relief.
Carpal Tunnel Surgery
Carpal tunnel release is a specific surgery that involves cutting the transverse carpal ligament to limit the amount of pressure placed on your median nerve and create better blood flow.
Carpal tunnel release is generally considered safe with a low risk of complications. The most common complication is postoperative pain, which can be managed with medication. Infection and nerve injury are rare but possible complications of any surgery. You should discuss all potential risks and complications with your surgeon.
If you or someone you know may be suffering from carpal tunnel syndrome, contact a physician today.