What is Carpal Tunnel?
The Carpal Tunnel is a passageway that is located on the palmar side of your hand at the wrist which contains and protects the median nerve, tendons, and blood vessels that lead to the hands and fingers. The median nerve is a major nerve that supplies innervation to the hand from the thumb through the ring finger. The carpal tunnel is made of several ligaments that join to form a very rigid structure called the flexor retinaculum. When this passageway becomes compressed, it can send pain signals and other symptoms such as tingling and weakness distally into your hand and fingers. Early diagnosis and treatment of Carpal Tunnel Syndrome (CTS) is critical as the longer the nerve is compressed, the more damage it can cause, even leading to permanent damage. Women are much more likely to acquire CTS and it is rarely seen in children.
What Causes Carpal Tunnel?
Anything that can cause compression on this area of the wrist can cause Carpal Tunnel Syndrome. This syndrome is not a result of a problem with the median nerve itself, but rather compression of it. Compression of the flexor retinaculum can be from internal or external factors. These factors may be:
- Repetitive grasping of the hand or bending of the wrist or a frequent use of a vibrating hand tool
- Broken bones in or near the area or other trauma to the wrist which leads to swelling
- Diabetes and other metabolic disorders
- Thickening of the lining of irritated tendons
- Underactive thyroid or other hormone imbalances
- Menopause and pregnancy (both of which affect the way hormones act)
- Rheumatoid Arthritis
- High blood pressure
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What are Signs of Carpal Tunnel?
The symptoms often experienced with a diagnosis of Carpal Tunnel Syndrome are:
- Tingling and numbness in hands and fingers
- Lack of sensation in your thumb, pointer, and middle fingers
- Cramping and muscle spasms in the hands
- Feeling of swollen, immobile fingers, although no visible swelling may be present
- Feeling of needing to “shake-out” the hand upon waking, usually the dominant hand
- Weakness in the hand and frequent dropping of items and difficulty with fine motor movements such as buttoning your shirt
- Electric-shock like feelings
- Bending the wrist and holding it that position for one minute will reproduce symptoms
- In advanced cases, patients are unable to feel the sensation of temperature, and find it difficult to differentiate between hot and cold
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Treatments that can Provide Carpal Tunnel Relief
Treatment for CTS will always be based on how far the condition has progressed. First line treatments will always be conservative measures. These may include:
- NSAIDs (non-steroidal anti-inflammatory drugs)
- Bracing or splinting of the wrist in order to promote proper positioning
- Activity modification
- Steroid injections
- Physical or occupational therapy that can teach you “nerve flossing” techniques to help mobilize the nerve
If conservative measures fail, then surgery may be indicated. The surgery to treat this condition is called a Carpal Tunnel Release. The goal of this surgery is to increase the size of the carpal tunnel and release pressure on the nerve.