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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome refers to a set of symptoms, which occur as a result of compression of the median nerve at the wrist. It is one of the most common of the nerve entrapment conditions.

The carpal tunnel is small, rigid passageway made up of ligaments and bones that is situated at the base of the hand. It houses the median nerve as it runs from the forearm into the palm of the hand and the flexor tendons that bend the fingers and thumb.

The median nerve controls sensations to the palm side of the thumb, index finger and long fingers of the hand. It also controls the movement of the small muscles at the base of the thumb. When a thickening from irritated tendons or other swelling narrows the carpal tunnel, it can cause compression of the median nerve. This pressure on the median nerve gives rise to the symptoms of carpal tunnel syndrome.

The symptoms of carpal tunnel syndrome can vary from mild to severe. Usually they start gradually and occur intermittently, but over time may become constant. One or both hands may be affected by the condition.

Symptoms of carpal tunnel syndrome may include the following:

  • Numbness or pins and needles in the hand and fingers
  • Wrist, palm, or forearm pain.
  • Electric shock-like feeling in thumb, index, and long fingers.
  • Pain or numbness that is worse at night or disturbs sleep.
  • Pain that increases the more the hand or wrist is used.
  • Decreased grip strength, difficulty forming fist, grasping small objects, or performing manual tasks

Carpal tunnel syndrome typically occurs only in adults, and more often in women than men. While some individuals are predisposed to the condition because they are born with a smaller carpal tunnel, a wrist injury or diseases such as diabetes, rheumatoid arthritis, thyroid disease, a local cyst or tumor, and pregnancy, may increase the risk. Additionally mechanical problems in the wrist joint, work stress, and repeated use of vibrating tools can contribute to the development of carpal tunnel syndrome.

Diagnosis of Carpal tunnel syndrome includes a complete medical history, a comprehensive clinical exam, diagnostic imaging as needed, as well as electrodiagnostic studies (EMG and nerve conduction). Treatment recommendations will depend on the severity of the condition. Non-surgical management of mild to moderate cases may include physical therapy, non-steroidal anti-inflammatory drugs, splints, rest, and modification of activities. Treatment of any underlying contributing diseases is important. When symptoms worsen or are severe, surgery may be recommended.