What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome (CTS) causes tingling, numbness, or weakness in your hand due to median nerve compression. Carpal Tunnel Syndrome is the most common cause of the category of peripheral nerve disorders called entrapment neuropathies. The carpal tunnel is a narrow passage formed on the palm of your hand by bones and ligaments of the hand . The name ‘Carpal Tunnel Syndrome’ appears to have been coined by Moersch in 1938.

Causes of Carpal Tunnel Syndrome

Pressure on the median nerve is the main cause of Carpal Tunnel Syndrome. There is a passageway through your wrist known as the carpal tunnel. The median nerve runs through this passage to your hand from your forearm. It conveys nerve signals for muscle movement around your thumb base (motor function).

If the median nerve gets compressed or squeezed in the carpal tunnel space, it may cause Carpal Tunnel Syndrome. A fracture in the wrist can narrow the carpal tunnel. This will irritate the median nerve. Similarly, inflammation caused by rheumatoid arthritis can also lead to Carpal Tunnel Syndrome.

Many times, Carpal Tunnel Syndrome has no clear cause. A mixture of risk factors may  lead to the development of the disease. Moreover, conditions like obesity, rheumatoid arthritis, high sugar in the blood (diabetes), hypothyroidism, pregnancy, and repetitive motions of the wrist in a particular job can also cause Carpal Tunnel Syndrome. The uncomfortable sensations grow progressively in Carpal Tunnel Syndrome. It mainly deteriorates during the night. They mainly affect the thumb, index finger, middle finger, and ring finger.

Other factors related to Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a common neurological disease. The prevalence of the disease in the general population ranges between 2.7% to 5.8%. The disease is characterized as progressive. The condition advances with an increase in age, neurophysiological severity, hypothyroidism, and diabetes. Females are more prone to have this disease as they have smaller carpal tunnels.

What are the symptoms of Carpal Tunnel Syndrome?

The symptoms of Carpal Tunnel Syndrome include:

• There will be a sensation of burning, tingling, pain, or itching numbness in the palm, thumb, index finger, the middle finger, and half of the ring finger.
• You may feel a shock that moves into your fingers.
• The sensation of tingling moves up into your arm or shoulders when you wake up in the morning.
• The fingers will become numb at night.
• There will be pain and muscle cramps as the disease progresses.
• You may feel irritation around the median nerve. This will lead to slower nerve impulses, inability to use the thumb, and less strength and coordination in the hand muscles.
• Your skin will be dry. There will be swelling or changes in the skin color of the hand.
• Weakness and atrophy of the muscles in the thumb.
• You will find it difficult to bend your thumb at a right angle, away from the palm.

What happens when you visit a doctor with the condition of CTS?

Your doctor generally asks the following questions:

• For how long are you having these problems?
• Did you experience the disease suddenly or gradually over time?
• What is the present condition? Is it worse or is it the same?
• Are there any certain activities in your lifestyle that you suspect to be the cause of Carpal Tunnel Syndrome?

Diagnosing Carpal Tunnel Syndrome

You should visit a physician for the diagnosis of Carpal Tunnel Syndrome. The physician may carry out a physical examination, understand the history of your symptoms, and recommend you to get an X-Ray and Electromyography done.

Physical examination like bending the wrist, tapping on the nerve, or simply pressing on the nerve will be done to know your reaction. X-Rays might not be very helpful. A nerve conduction study, which is a variation of Electromyography, may be done to confirm if any of the diagnostic  methods do not give a confirmatory result.

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What are the risk factors linked to Carpal Tunnel Syndrome?

The risk of getting Carpal Tunnel Syndrome becomes high if:

• You are a female. Women are three times more vulnerable to get Carpal Tunnel Syndrome.
• Family history of members having smaller carpal tunnels.
• You are doing a job that involves repetitive movement or motions with your hand, arm, or wrists over and over, like the assembly line worker, sewer or knitter, baker, cashier, hairstylist, or a musician.
• You have a fractured or dislocated wrist
• You have diabetes, rheumatoid arthritis, thyroid disorders, kidney failure, and lymphedema.
• You are pregnant or have menopause, then the fluid retention may increase the pressure within your carpal tunnel, irritating the median nerve. This may also lead to Carpal Tunnel Syndrome.
• You are taking a breast cancer medication called Anastrozole.

What are the complications of Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome complications are rare. They mainly include atrophy and weakness of the muscles at the base of the thumb in the palm of the hand. If not corrected early enough, this can be a permanent complication. This can lead to a lack of dexterity in the affected fingers.

How to treat Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome should be treated without delay. You should bring the following changes in your lifestyle:

• You should take breaks at frequent intervals to give rest to your hand.
• You should apply ice bags to reduce swelling.
• You should avoid activities that can worsen your condition.

Medication: Wrist splinting, NSAIDs like ibuprofen, and corticosteroids like cortisone are the non-surgical methods that may help relieve pain. Corticosteroids decrease inflammation and swelling, which relieves pressure on the median nerve.

Surgery: The surgical method of treatment is carried out when the condition is severe and non-surgical methods are not effective. Endoscopic surgery and open surgery are two types of surgeries that are involved in the treatment. Either one of them can be used. Endoscopic surgery may result in less pain than open surgery in the first few days or weeks after surgery.

It takes several months to heal completely. The skin where surgical cuts are made heals in a couple of weeks.

Your physician will usually check if the ligament is healed completely. They may encourage you to use your hands. However, you should limit excessive hand gestures or unusual wrist movements.

Other treatments

To help you deal with Carpal Tunnel Syndrome, you should incorporate other treatments into your care plan. To find a cure that provides ease and comfort, you may need to experiment a bit . Always consult your physician before seeking supplementary care.

• Yoga: Yoga techniques help in providing strength and balance to the upper body and joints. It provides relief from pain and improves grip strength. Always consult your doctor before doing yoga.
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• Ultrasound therapy: Ultrasound of high intensity increases the temperature in the specific region of tissues in the body. This facilitates healing and provides comfort.

Lifestyle tips to prevent or mitigate Carpal tunnel syndrome

You should follow the below-mentioned steps to get temporary relief from CTS:

• You should make a habit of taking short, frequent breaks from activities that involve work of hands and repetition of the same for a long time.
• You should do light exercise and follow a balanced diet to lose weight.
• You should rotate and stretch your palms and fingers at regular intervals. It is also important to rotate your wrist from time to time.
• Wear a wrist bandage at night before going to sleep.
• You should not sleep by tucking your hands under  your body.

Check with your doctor if pain, numbness, burning, and tingling sensations persist.

Conclusion

Carpal tunnel syndrome is a common clinical problem Mild symptoms related to Carpal Tunnel Syndrome can be managed without invasive measures to some extent. However, Carpal tunnel release surgery is the final step that most people undergo to get relief from the pain.

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