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About Carpal Tunnel Syndrome
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Carpal tunnel syndrome is caused by pressure on the median nerve. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of the hand. When the median nerve is compressed, symptoms can include numbness, tingling, and weakness in the hand and arm.
For individuals who do not find nonsurgical treatments much helpful, surgery is considered. In such cases, carpal tunnel surgery can alleviate chronic pain and discomfort and restore normal function and mobility of the hand.
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome happens when the median nerve of the wrist is compressed in the carpal tunnel at the base of the hand. The median nerve is responsible for providing motor and sensory function to our thumb and three fingers of the hand. When it gets compressed by the carpal tunnel, its functions are impeded and you start getting symptoms of carpal tunnel syndrome. Symptoms include numbness, pain, and tingling sensation in the hand and arm.
Carpal tunnel syndrome is a fairly common condition. As it involves compression of one of the major nerves of the hand, the condition has a huge impact on the functioning of the hand itself. Carpal tunnel syndrome gets worse with time, which makes an early diagnosis and treatment quite necessary. When the symptoms are mild, simple measures and precautions like wearing a splint and avoiding activities that involve extreme movements of the wrist can provide some relief. But if the pressure on the median nerve sustains, it can worsen symptoms and lead to severe nerve damage. Carpal tunnel release surgery is the most successful solution for carpal tunnel syndrome. The surgery has proven effective in eliminating all symptoms of the condition and avoiding any damage to the median nerve.
Causes
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Anatomic factors. A wrist fracture or dislocation, or arthritis that deforms the small bones in the wrist, can alter the space within the carpal tunnel and put pressure on the median nerve.
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People who have smaller carpal tunnels may be more likely to have carpal tunnel syndrome.
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Sex. Carpal tunnel syndrome is generally more common in women.
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Nerve-damaging conditions.
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Inflammatory conditions.
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Medications.
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Obesity.
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Body fluid changes.
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Other medical conditions. Certain conditions, such as menopause, thyroid disorders, kidney failure and lymphedema, may increase the chances of carpal tunnel syndrome.
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Workplace factors.
Symptoms
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Carpal tunnel syndrome symptoms usually start gradually and include:
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Tingling or numbness. You may notice tingling and numbness in the fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not the little finger. You might feel a sensation like an electric shock in these fingers.
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The sensation may travel from the wrist up the arm.
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Many people "shake out" their hands to try to relieve their symptoms. The numb feeling may become constant over time.
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Weakness. You may experience weakness in the hand and drop objects.
DIAGNOSIS
During the physical exam for carpal tunnel syndrome, your doctor will ask you questions about your symptoms, medical history, occupation, and general health. Your affected hand and wrist will be carefully examined with the help of several tests. During the tests, the doctor may do one or all of the following things.
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Tap along or press down the median nerve at the inside of your rest to see if any numbness or tingling is caused.
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Bend and hold your wrist in a flexed position to check for tingling and numbness in your hand.
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Lightly touch your fingers with a special instrument when your eyes are closed to check the sensitivity in your fingertips
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Check for muscle atrophy at the base of your thumb
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Check for the weakness of the muscles at the base of your thumb
After a physical exam, some tests are performed to ascertain the extent of the condition and the damage to the median nerve. Some of the tests that may be performed and listed as follows
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Nerve conduction test: A nerve conduction test measures the signals that travel and your nerves. This test can detect if your median nerve is not conducting its signal properly and can help your doctor to a certain extent of median nerve damage.
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Electromyogram or an EMG: An electromyogram measures the electrical activity in the muscle and shows the extent of muscle and nerve damage.
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X-rays: X-rays are perfect for obtaining images of dense structures like bones. If you have limited function of the wrist and experience pain in movements, your doctor can order an x-ray to exclude any other causes for your symptoms like arthritis, fracture, or ligament injury.
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Magnetic resonance imaging or an MRI: MRI scans provide a better image of soft tissues. An MRI can help your doctor to determine any other causes for your condition and can help him look for abnormal tissues which might be affecting the median nerve. It can also help the doctor to determine if there are any problems with the nerve itself, like an injury, tumor, or scarring.
How to Prevent it:
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Reduce your force and relax your grip. If your work involves a cash register or keyboard, for instance, hit the keys softly. For prolonged handwriting, use a big pen with an oversized, soft grip adapter and free-flowing ink.
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Take short, frequent breaks. Gently stretch and bend hands and wrists periodically. Alternate tasks when possible. This is especially important if you use equipment that vibrates or that requires you to exert a great amount of force. Even a few minutes each hour can make a difference.
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Watch your form. Avoid bending your wrist all the way up or down. A relaxed middle position is best. Keep your keyboard at elbow height or slightly lower.
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Improve your posture. Incorrect posture rolls shoulders forward, shortening the neck and shoulder muscles and compressing nerves in the neck. This can affect the wrists, fingers and hands, and can cause neck pain.
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Change your computer mouse. Make sure that your computer mouse is comfortable and doesn't strain your wrist.
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Keep your hands warm. You're more likely to develop hand pain and stiffness if you work in a cold environment. If you can't control the temperature at work, put on fingerless gloves that keep the hands and wrists warm.
OUR SPECIALISTS DOCTORS
Dr. ABCD
MBBS,
10 yrs of experience
Dr. ABCD
MBBS,
10 yrs of experience
Dr. ABCD
MBBS,
10 yrs of experience
The Surgery
The surgical treatment for carpal tunnel syndrome is known as carpal tunnel release. A carpal tunnel release surgery can be performed under two different techniques. Both aim at relieving the pressure on the median nerve by increasing the size of the carpal tunnel, by severing the ligament that forms the roof of the tunnel. The two techniques of carpal tunnel release surgery are:
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Open carpal tunnel release surgery: A small incision is made in the palm of your hand to view the inside of the wrist. During the procedure, your doctor will cut the transverse carpal ligament to increase the size of the tunnel and relieve the pressure on the median nerve.
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Endoscopic carpal tunnel release surgery: Endoscopic carpal tunnel release surgery involves a smaller insertion and uses a miniature camera to see the inside of the hand and wrist. A special instrument is used to sever a part of the carpal ligament which reduces the pressure on the median nerve.
