What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition that causes pain and numbness in the fingers and hands, and sometimes the arms. It happens when a nerve in the wrist called the “median nerve” gets pinched or squeezed.

The median nerve goes through a tunnel in the wrist. This tunnel is formed by the bones of the wrist and a tough band of tissue called a “ligament”. Experts do not know exactly how the nerve can get pinched. But they think it might happen when:

●Tendons that go through the same tunnel get swollen (tendons are bands of tissue that connect muscles to bones)

●Tissues surrounding the tendons harden or get swollen

●People use their hands for work that involves repetitive or forceful movements

The median nerve carries signals about sensation. In other words, it tells the brain what the hand is feeling. The nerve gets information from these parts of the hand:

●Thumb

●Index finger

●Middle finger

●Parts of the ring finger

●Parts of the palm closest to the thumb

Women are more likely than men to get carpal tunnel syndrome. Being overweight probably increases the risk of carpal tunnel syndrome. Certain health conditions also might increase the risk, including diabetes and rheumatoid arthritis. Women who are pregnant are also more likely to get carpal tunnel syndrome, but it usually goes away after the baby is born.

What are the symptoms of carpal tunnel syndrome?

The symptoms include pain and tingling in the thumb and the index, middle, and ring fingers. Symptoms are typically worst at night and can wake you up from sleep. Often the symptoms affect both hands, but one hand might have worse symptoms than the other.

In some cases, pain and tingling can extend to the whole hand or even up to the wrist and forearm. Rarely, pain and tingling extends past the elbow to the shoulder.

The symptoms can also flare up when you do things that involve bending and unbending your wrist or raising your arms. Some activities can trigger symptoms in people with carpal tunnel syndrome. But they do not actually cause the condition. Examples include:

●Driving

●Reading

●Typing

●Holding a phone

In many people, symptoms come and go. But some people eventually have symptoms all the time. They can end up having trouble moving their fingers or controlling their grip.

Is there a test for carpal tunnel syndrome?

Yes. Electrical tests of the nerves can show if you have carpal tunnel syndrome, but these tests are not always necessary.

Your doctor will probably be able to tell if you have carpal tunnel syndrome by learning about your symptoms and doing an exam. During the exam, he or she might tap on or press on your wrist, or ask you to hold your hands in ways that are known to make symptoms worse.

Your doctor might also order electrical nerve tests. These tests can confirm that you have carpal tunnel syndrome. They include:

Nerve conduction studies

Nerve conduction studies can show whether the median nerve is carrying electrical signals the right way. In people with carpal tunnel syndrome, signals can be slow or weak.

Electromyography

Electromyography, also called EMG, can show whether the muscles in the hand and wrist are responding the right way to electrical signals. This test is most useful in figuring out if symptoms are related to carpal tunnel syndrome or another problem.

Should I see a doctor or nurse?

Yes. See your doctor or nurse if you have the symptoms described above, and they bother you.

How is carpal tunnel syndrome treated?

Treatments are often combined and can include:

Wrist splints

Some people feel better if they wear splints at night that keep their hands in a “neutral position.” The neutral position is when the wrist is not bent forward or backward and the fingers are curled naturally toward the palm.

Doctors often suggest splints for women who get carpal tunnel syndrome during pregnancy. They usually don’t need other treatments, since in most cases, symptoms improve after the baby is born.

Steroid shots or pills

Steroids are a group of medicines that control inflammation and swelling. To treat carpal tunnel syndrome, doctors sometimes inject steroids into the carpal tunnel. People who do not want to get a shot can take steroids in pill form instead. But the pills are less effective than the shot.

Other physical treatments

There is weak evidence that yoga or another treatment called “carpal bone mobilization” might help some people with carpal tunnel syndrome. For carpal bone mobilization, a physical or occupational therapist moves the bones in your wrist around in a special way.

Surgery

Doctors offer surgery to people who have ongoing or severe nerve damage that is causing the symptoms of carpal tunnel syndrome. Surgery for carpal tunnel syndrome involves cutting the ligament that stretches across the wrist to form the tunnel.

Can carpal tunnel syndrome be prevented?

It’s unclear whether there is any way to prevent carpal tunnel syndrome. People sometimes think that the condition happens because they use a computer too much. But studies have shown that computer use is probably not related to carpal tunnel syndrome.

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