Carpal tunnel syndrome

carpal tunnel

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition in which the median nerve (which runs from the arm into the hand) is compressed as it passes through the carpal tunnel at the wrist.

What are the symptoms of carpal tunnel syndrome?

Symptoms of carpal tunnel syndrome include:

  • tingling and numbness in the fingers and palm of the hand;
  • pain in the wrist or hand, which may radiate up the arm or down to your fingers, and can be severe; and
  • a sense of weakness in the hands and a loss of grip strength, which can make it difficult to grasp small objects.

Symptoms may be worse at night when people may sleep with their wrists flexed (palm bent towards front of forearm).

Causes of carpal tunnel syndrome

The carpal tunnel is a narrow passageway at the base of the hand that contains the median nerve and tendons of the hand. A reduction in space in the carpal tunnel, for example if the tendons of the hand become swollen or thickened, leaves less space in the tunnel for the median nerve and it becomes compressed. The median nerve is a large nerve that supplies sensation to the thumb and most of the first 3 fingers. It also supplies movement to some of the muscles in the hand.

Any condition that narrows the carpal tunnel or enlarges the tissues within it can result in carpal tunnel syndrome.

Risk factors

Risk factors that are associated with carpal tunnel syndrome include:

  • trauma or injury to the wrist such as sprain or fracture;
  • conditions such as rheumatoid arthritis or thyroid gland disorder;
  • a cyst or tumour in the canal;
  • fluid retention during pregnancy or menopause;
  • activities involving repetitive use of the wrist and hand or vibrating tools;
  • being female: women are more likely to develop carpal tunnel syndrome than men.

Diagnosis of carpal tunnel syndrome

Your doctor will ask about your symptoms and perform a physical examination. Sometimes tests such as a nerve conduction study will be arranged. A nerve conduction study involves passing a small electric shock through the median nerve (via electrodes placed on the skin of the hand and wrist) to test the speed that the median nerve transmits impulses through the carpal tunnel.

Treatment for carpal tunnel syndrome

Splinting the wrist may be part of the initial treatment. A splint is usually worn at night to start with, to help to keep the wrist from being bent during sleep. Anti-inflammatory medicines may be used to reduce pain. You should rest from any activities that cause symptoms. If initial measures don't control symptoms, your doctor may suggest corticosteroid injections or a surgery called a surgical release.


 
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