Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome or CTS is a progressively painful hand and arm condition, brought on by increased pressure on the median nerve at the wrist. In other words, it is a pinched nerve in the wrist.

Some of the symptoms of Carpal Tunnel Syndrome may include numbness, tingling and pain in the arm, hand, and fingers. A space in the wrist called the carpal tunnel is where the median nerve and nine tendons pass from the forearm into the hand. Carpal tunnel syndrome happens when pressure builds up from swelling in this tunnel and puts pressure on the nerve. When the pressure from the swelling becomes great enough to disturb the way the nerve works, numbness, tingling and pain may be felt in the hand and fingers.

What Causes Carpal Tunnel Syndrome?

The precise cause of Carpal Tunnel Syndrome is usually unknown. Pressure on the nerve can happen result from various factors, such as:

Swelling of the lining of the flexor tendons (called "tenosynovitis")
Joint dislocations
Fractures
Arthritis (which can narrow the tunnel)
Keeping the wrist bent for long periods of time

During pregnancy, fluid retention can also cause swelling in the tunnel and symptoms of carpal tunnel syndrome. However, these often go away after delivery. Thyroid conditions, rheumatoid arthritis and diabetes can also be associated with carpal tunnel syndrome. The condition may also be caused by a combination of these or other factors.

Signs and Symptoms of Carpal Tunnel Syndrome

The symptoms of Carpal tunnel syndrome usually include wrist or hand:

Pain
Numbness
Tingling

...or a combination of the three.

The numbness or tingling most often takes place in the thumb, index, middle and ring fingers. Although symptoms are usually worse during the night, they may also be present during daily activities, such as driving or reading a newspaper.

You may also notice a weaker grip, occasional clumsiness, and a tendency to drop things. In severe cases, sensation may be permanently lost and the muscles at the base of the thumb slowly shrink. This is known as "thenar atrophy". Atrophy can occur in the late stages of carpal tunnel, and may cause partial or total paralysis of the region.

Diagnosis

If you have symptoms of Carpal Tunnel Syndrome, you should make an appointment with a hand specialist for a professional diagnosis. It is important to provide a detailed history, including medical conditions, how the hands have been used, and whether you have suffered any prior injuries.

An x-ray may be taken to check for other potential causes of symptoms, such as arthritis or a fracture. In some cases, laboratory tests may be done if there is a suspected medical condition that is associated with Carpal Tunnel Syndrome. Electrodiagnostic studies, such as NCV-nerve conduction velocities and EMG – electromyogram, may also be performed. These are used to confirm the diagnosis of Carpal Tunnel Syndrome, as well as to check for other potential nerve problems.

Treatment

Symptoms of Carpal Tunnel Syndrome may often be relieved without surgery. Identifying and treating medical conditions, changing the patterns of hand use, or keeping the wrist splinted in a straight position may help reduce pressure on the nerve. Wearing wrist splints at night may also relieve the symptoms that interfere with sleep. In some cases, a steroid injection into the carpal tunnel may help relieve the symptoms by reducing swelling around the nerve.

For more information about Carpal Tunnel Syndrome, and the simple, safe, and effective treatments that are available, schedule an appointment with Dr. Sagini by calling 239-337-2003.