In most cases of carpal tunnel syndrome the cause is unknown. The fingers and palmar face next to the thumb may be painful and you may feel tingling and numb. Doctors base the diagnosis on an exam and, if necessary, on the outcome of nerve function tests. Symptoms can usually be alleviated with the use of painkillers, splints or sometimes injection of a corticosteroid or surgery.
Carpal tunnel syndrome is the painful compression (pinching) of the median nerve as it passes through the carpal tunnel at the wrist.
What is Carpal Tunnel Syndrome?
"Carpal Tunnel Syndrome is a condition caused by compression of a nerve where it passes through the wrist into the hand and characterized especially by weakness, pain, and disturbances of sensation in the hand and fingers."
At the base of the palm, just above the carpal bones of the wrist, is a "sleeve" or “tunnel” where the tendons and nerves from the arm pass through to the hand and fingers.
The nerve that passes through this narrow tunnel is called the Median Nerve. The tunnel between the forearm and hand is called “The Carpal Tunnel”.
Diagnosis of Carpal Tunnel
A medical exam sometimes a nerve conduction test The diagnosis of carpal tunnel syndrome is mainly made by examination of the affected hand and wrist. A doctor may conduct nerve conduction studies to make sure that the problem corresponds to carpal tunnel syndrome, especially if surgery is being considered.
The symptoms are strange sensations, numbness, tingling and pain in the first three fingers and half of the ring finger, on the thumb side of the hand. In some cases the whole hand is affected. In some cases, there is also pain and a burning or tingling sensation in the forearm. People often wake up at night with a burning sensation or throbbing pain with numbness and tingling due to the position of the hand. The person may shake the hand to try to regain the normal sensation. Over time, the muscles of the hand in the dorsal part may weaken and retract due to lack of use (atrophy).
Carpal tunnel syndrome results from compression (pinching) of the median nerve. Compression may be caused by swelling of adjacent tissue or within the tunnel or by bands of fibrous tissue forming on the palmar surface of the wrist.
Pregnant women and people with diabetes, hypoactive thyroid gland, certain forms of amyloidosis or rheumatoid arthritis have an increased risk of developing carpal tunnel syndrome. Also at risk are those whose professional activities require repetitive effort movements with their wrists extended, such as using a screwdriver. Another potential (but controversial) factor is the use of the computer keyboard when not properly positioned. Prolonged exposure to vibration (eg when using certain power tools) has also been thought to cause carpal tunnel syndrome. However, most cases develop for unknown causes.
- A splint
- Treatment of underlying disorders
- Injections of a corticosteroid (Sometimes)
- Surgery (Sometimes)
Sometimes avoiding positions that overstretch the wrist or put extra pressure on the median nerve and adjusting the angle of the computer keyboard offer some relief. Often, wearing wrist splints to keep the hand in a neutral position (especially at night) and taking light painkillers are helpful measures.
Corticosteroid injections into the carpal tunnel usually provide lasting relief.
If the pain is severe or if the muscle atrophies or weakens, surgery is the best way to relieve pressure on the median nerve. A surgeon can cut the fibrous bands that put pressure on the nerve.