Carpal tunnel syndrome
The transverse carpal ligament and the carpal bones, which are little wrist bones, surround the narrow passage known as the carpal tunnel on the palm side of your wrist. Carpal tunnel syndrome is a rather common condition that occurs when a major nerve, known as the median nerve, passing through this tunnel is compressed. The median nerve provides sensation to the palm side of the thumb and to the index, middle, and a part of the ring finger. Additionally, it regulates a few little muscles at the base of the thumb. This nerve is compressed, resulting in discomfort, tingling, and numbness in the hand. If the condition is left untreated, it can lead to permanent damage to the nerve.
What are the symptoms of carpal tunnel syndrome?
The symptoms typically appear gradually and can include:
- Numbness, tingling, or pain in your fingers exceptthe little finger
- As many individuals sleep with their wrists curled during the night, pain could keep you awake.
- Electric shock-like sensation in the fingers
- Decreased sensation in the fingertips
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Difficulty while doing regular activities like
- Brushing your teeth
- Holding a steering wheel, coffee mug, newspaper, or book
- Writing
- Using the computer keyboard
- Weakness in hands resulting in dropping objects
- Inability to button a shirt due to decreased grip strength.
If not addressed, this condition could result in the muscles near the base of the thumb losing their shape and shrinking.
Which factors contribute to carpal tunnel syndrome?
Carpal tunnel syndrome is a multi-factorial condition. Your carpal bones and the ligaments keeping them together form the carpal tunnel, a small canal in your wrist. Through this tunnel pass your medial nerve and the tendons (tissues that connect muscles to the bones). The following are some of the elements and ailments that may contribute to the pinching of nerves at the wrist due to a narrowing of the space there:
- Swelling brought on by wrist trauma or damage
- Deformities in the wrist or hand
- Working with vibrating equipment or a computer keyboard and mouse, for example, requires repetitive hand and wrist movements over an extended length of time.
- Fluid retention during pregnancy or menopause
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Medical conditions like
- Overactive pituitary gland
- Underactive thyroid gland
- Rheumatoid arthritis
- Kidney failure
- Diabetes
- Tumor or cyst in the canal
- Medications
How is carpal tunnel syndrome diagnosed?
Early detection of the illness aids in halting the median nerve's future degeneration. Among the symptoms of carpal tunnel syndrome are:
Medical history: During medical history, the patient may be asked about the activities during which the symptoms appear, like holding a newspaper, phone, etc., and whether the pain keeps them awake at night.
Physical examination: A physical examination includes feeling the fingers and inspecting the wrist for symptoms like soreness, edema, or warmth. The doctor may carry out certain particular tests that could duplicate the symptoms and aid in the diagnosis because many people experience discomfort while bending their wrists or when the nerve is pressed. In order to determine whether the symptoms arise from other illnesses, the doctor may also perform examinations of the hands, arms, shoulders, and neck.
Electrodiagnostic tests: Testing procedures known as electrodiagnostic procedures are used to assess the electrical activity of nerves and muscle fibers in order to assess the degree of damage to the median nerve.
X-ray: To rule out further causes, such as arthritis or trauma, an X-ray may be advised.
Ultrasound: Ultrasound helps to identify if the median nerve is abnormally large.
What is the treatment for carpal tunnel syndrome?
The treatment depends on the severity of the condition. Non-surgical therapies are the first course of treatment. If non-surgical treatments are ineffective at relieving symptoms and halting irreversible nerve damage, surgical options may be considered.
Non-surgical treatments
Modifications to your activity level: The doctor may advise avoiding activities that make your symptoms worse. This might aid in halting the condition's progression.
Bracing or splinting the wrist: It can help relieve nerve pressure by holding the wrist straight while you sleep. It is also helpful while performing your regular activities that can cause your symptoms.
Medications: Medications such as NSAIDs (non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen) may help relieve pain and inflammation. Steroid injections, such as cortisone administered into the carpal tunnel, are frequently beneficial to temporarily reduce uncomfortable symptoms.
Exercises: Particular exercises, such as those that allow the median nerve to glide easily through the carpal tunnel, may be helpful.
Surgical treatments
The carpal tunnel release, which includes chopping the ligament pressing on the nerve, is the most frequent surgical technique. There are two ways to go about it.
Open release surgery: This comparatively conventional technique entails making a wrist incision and then severing the ligament.
Endoscopic surgery: It entails making a small incision through which a camera and tubing are introduced to help with the process of observation. To sever the ligament and relieve pressure on the nerve, a tiny knife is introduced into the tube.
How is the carpal tunnel syndrome prevented
Prevention of carpal tunnel syndrome could be difficult as it can be caused by a number of factors involved in a person's day-to-day life. However, the following preventive measures may help reduce your risk for the condition:
- Performing stretching exercises before and after activity
- Keeping your wrists straight while sleeping and using tools
- Avoiding frequent curling and extending your wrists
- Relaxing your grip
- Taking short and frequent breaks
- Improving your posture
- Keeping your hands warm