Carpal tunnel syndrome typically occurs as a result of pressure on the median nerve in the carpal tunnel of the wrist (a narrow passageway surrounded by bones and ligaments on the palm side of the hand).
When pressure is applied to the median nerve, it can lead to a range of uncomfortable symptoms that significantly affect daily life.
In this article, Dr. Yousef Sarhan, Consultant in Physical Medicine and Rehabilitation, and Consultant in Orthopedic and Joint Surgery, explains the key information and treatment methods for carpal tunnel syndrome.
Symptoms of Carpal Tunnel Syndrome
Carpal tunnel syndrome is a common condition that affects the hand and usually develops gradually.
In the beginning, the affected person may only experience mild symptoms that can worsen over time.
The common symptoms of this case include:
Tingling and Numbness
The affected individual may feel tingling and numbness in the fingers or hand, often involving the thumb, index finger, middle finger, and ring finger, while typically sparing the little finger.
This sensation may be accompanied by feelings resembling electric shocks in these fingers.
These symptoms often occur while holding something, such as a steering wheel, phone, or book. Additionally, the person may wake up at night due to this sensation.
Weakness in the Hand
The person may notice difficulty in gripping or controlling objects with the affected hand.
Causes and Risk Factors of Carpal Tunnel Syndrome
As mentioned earlier, carpal tunnel syndrome involves pressure or irritation of the median nerve.
However, in many cases, there is no single cause of carpal tunnel syndrome, or the cause may not be known.
The risk factors that increase the likelihood of developing this case include:
Wrist Fractures or Dislocations
Fractures or dislocations in the wrist can cause changes in the space within the carpal tunnel, and these changes can put pressure on the median nerve.
Anatomical Factors
Some people have a naturally smaller carpal tunnel, making them more susceptible to developing this case.
Gender
Women are more likely to develop this syndrome because the carpal tunnel in females is generally smaller than in males.
This condition in women may also be influenced by the effect of hormones on the lining of the tendons in the carpal tunnel.
Certain Health Conditions
Some health issues can negatively affect the nerves and cause damage.
For example, diabetes is one of the conditions that can increase the risk of nerve damage.
Inflammation
Inflammatory conditions such as rheumatoid arthritis or gout can cause swelling in the lining around the wrist tendons, which increases pressure on the median nerve.
Obesity
Obesity is a known risk factor associated with carpal tunnel syndrome.
Fluid Retention
Fluid retention in the body can increase pressure within the carpal tunnel, leading to irritation of the median nerve.
This condition often occurs during pregnancy and menopause.
Other Medical Conditions
Certain medical conditions can increase the likelihood of developing this syndrome, such as
- thyroid disorders.
- kidney failure.
- Lymphedema.
Excessive or Repetitive Use of the Hand
Repetitive use of the hand, such as frequent wrist flexion, can lead to increased pressure on the median nerve, contributing to the worsening of nerve damage.
Read More: Trigger finger
Treatment Methods for Carpal Tunnel Syndrome
Non-surgical approaches are typically tried first. If these treatments do not achieve the desired results, surgical intervention may be necessary.
Here’s an explanation of both:
Non-Surgical Treatments for Carpal Tunnel Syndrome
The most common non-surgical treatments include:
Wearing a Splint
A splint keeps the wrist in a neutral position, helping to relieve pressure on the median nerve. It is often recommended to wear the splint at night.
Physical Therapy for Carpal Tunnel Syndrome
A physical therapist can assist in strengthening the muscles around the wrist and improving its flexibility.
Posture Adjustment
A therapist may suggest ways to modify how daily tasks are performed to ensure comfort and safety.
This includes improving sitting or standing posture and how to use objects.
Over-the-Counter Medications
A doctor may recommend medications like nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen to reduce inflammation and relieve pain.
It’s important not to take these medications for more than 10 consecutive days without consulting a doctor.
Corticosteroids for Carpal Tunnel Syndrome
A doctor may prescribe anti-inflammatory medications such as corticosteroids, usually given through injections in the affected hand.
Surgical Treatment for Carpal Tunnel Syndrome
If the above treatments fail to alleviate symptoms, the doctor may recommend surgery to release the carpal tunnel.
This surgery involves making an incision in the ligament that connects the wrist to the palm, allowing more space inside the carpal tunnel. This procedure reduces pressure on the nerves and tendons.
This surgery is relatively simple, and patients can typically return home the same day.
References:
- Carpal tunnel syndrom – Symptoms and causes – Mayo Clinic. (2024, February 6). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/symptoms-causes/syc-20355603
- Carpal Tunnel Syndrom. (2024, May 1). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/4005