Carpal Tunnel Syndrome

Overview


Carpal tunnel syndrome is a condition characterized by pain, tingling, and numbness in the hands and arms. Carpal tunnel syndrome is a very common problem that affects the hands of people. This condition occurs when the media nerve – one of the main nerves – is squeezed or compressed while passing through the wrist. The median nerve is responsible for the sensation of the thumb, index and middle fingers. This condition was first identified in the mid-1800s. There are 9 tendons that help bend the fingers and thumb. These tendons are called flexor tendons. Carpal tunnel syndrome occurs when the tunnel becomes narrow and nearby flexor tendons swell. This puts pressure on the median nerve leading to carpal tunnel syndrome.

Facts about carpal tunnel syndrome:

Heredity is the most common factor leading to carpal tunnel syndrome. Small carpal tunnels can run in family inheritance. If your parents have carpal tunnel syndrome, you will probably have it too.
Medical conditions such as thyroid problems, rheumatoid arthritis, diabetes can also cause carpal tunnel syndrome.
The diagnosis of carpal tunnel syndrome is very important. If not treated in time, it can permanently damage the muscles of the hand.
Maintaining a healthy weight can reduce the risk of carpal tunnel syndrome.

 

Signs and symptoms of CTS:


The symptoms are always related to the nerve path and the compression of the median nerve. When the hand loses all of its senses, the hand is considered "falling asleep". Other symptoms include:
Pain and burning sensation that moves from the wrist to the arm
Wrist pain increases when the person is sleeping
Weakness of the muscles of the hand
Numbness and tingling in the thumb and middle finger
A person with TSS may feel the need to shake hands

 

Causes of CTS:


Carpal tunnel pain is due to excessive pressure on the median nerve. The most common cause of CTS is often an underlying condition that results in swelling of the wrist. Sometimes even blocked blood flow can cause pain. Other causes include:
  • Diabetes
  • Thyroid retention
  • Arterial hypertension
  • Autoimmune disorders such as rheumatoid arthritis
  • Fractures or trauma to the wrist
  • Fluid retention during pregnancy or menopause
  • CTS can also be the result of:
  • Constant positioning of your mouse or keyboard wrists for long hours
  • Exposure to vibration resulting from the use of power tools
  • Repeated movement that stretches your wrist too much
 

Who is at risk for CTS?


People with activities or jobs that involve repeated use of the fingers are at higher risk of SCC. Other risk factors include:
  1. Heredity (small carpal tunnels can work as a family)
  2. Alcoholism
  3. Pregnancy
  4. Hemodialysis (a process where blood is filtered)
  5. Arthritic diseases such as rheumatoid arthritis and gout
  6. Hormonal imbalance of the thyroid gland (hypothyroidism)
  7. Fracture and dislocation of the wrist
  8. Deformity of the hand or wrist
  9. Diabetes
  10. A mass (tumor) in the carpal tunnel
  11. Older age
  12. Amyloid deposits (an abnormal protein)
 
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What Causes Carpal Tunnel Syndrome


Carpal Tunnel Syndrome is often caused by underlying conditions that place a strain on the median nerve, compromising the blood supply it delivers to the fingers. These can include existing diseases such as diabetes, which increases the sensitivity of pressure to the median nerve, and hypothyroidism, which can increase the amount of water retained in the arms and wrists.

Many causes of Carpal Tunnel Syndrome aren't disease-based, however, causes can be generated from external stimuli, such as wrist injuries, fractures of the arm bone, and dislocation of one of the carpal bones in the wrist. Pregnancy, because it can cause swelling of the wrists, can also place pressure on the median nerve by narrowing the carpal tunnel.

Many instances of Carpal Tunnel Syndrome are thought to be idiopathic, having no obvious cause. However, even with idiopathic instances, certain activities can aggravate the symptoms of Carpal Tunnel Syndrome. These can include using power tools or working on an assembly line, constantly performing repetitive – and sometimes awkward – motions. Certain people can even be born with an abnormally narrow carpal tunnel, making them predisposed to the syndrome that may accompany it.

While Carpal Tunnel Syndrome can affect all demographics, it is far more common in women than in men. It is also most common in those who are middle aged and post-menopausal. Obesity and tobacco use increases a person's risk.

 

Treatment of Carpal Tunnel Syndrome


Many people with a mild case of Carpal Tunnel Syndrome will find relief simply in adjusting their lifestyle and workstyle habits. While foregoing repetitive wrist activity may not be feasible, particularly when a career is based on repetitive motion, allowing the wrist time to rest while at work and at play can greatly relieve the symptoms of Carpal Tunnel Syndrome. Resting the wrist for great lengths at a time may seem like a reasonable break, but studies have shown that it is more beneficial for those afflicted by Carpal Tunnel Syndrome to take several small breaks, rather than one that is lengthy. Applying cold packs to relieve any swelling of the hands and wrists is also a helpful form of treatment.
For those with a case of Carpal Tunnel Syndrome that is not aided by rest or cold compressions, wrist splinting is an alterative form of treatment. A person, wearing a splint that keeps their hand still while they sleep, may notice that the symptoms of burning, tingling, and pain are greatly relieved. Wrist splinting, however, is usually only helpful for those who have had symptoms of Carpal Tunnel Syndrome for less than a year.

While Carpal Tunnel Syndrome certainly doesn't have a magic pill serving as an antidote in its healing, there are certain medications that can relieve its pain and discomfort. These can include Nonsteroidal anti-inflammatory drugs (or NSAIDs) for those whose condition is brought on by inflammation or Corticosteroids to relieve the pressure on the median nerve, decreasing the pain in the process.
The literal hands-on approach of spinal manipulation and deep friction massage can help manage the swelling that is pressing on the median nerve, causing the symptoms to flare up. Manual stretches of the wrist and tendons, additionally, can help increase the blood flow to the hand.

While the evidence is not conclusive, some speculate that dietary changes may lead to diminishing Carpal Tunnel Syndrome symptoms by arming the body with the nutrients it needs to repair nerve damage and decrease inflammation. By taking something as simple as a multi-vitamin, pressure from the median nerve may be diminished, allowing it to repair itself back to its natural state.
While the above mentioned treatment options are usually limited to being beneficial to those who have mild to moderate cases of Carpal Tunnel Syndrome, for those who have severe cases, surgery may be the best option.

Though there are several approved surgeries for Carpal Tunnel Syndrome, they all involve the same theme of the cutting of the ligament that is pressing on the median nerve. They are also all procedures done on an out patient basis, with a small incision cut in the wrist or the palm and a recovery time of just a few weeks. While not all surgeries are successful in relieving the symptoms, roughly 70 percent of patients who choose surgery report satisfaction with the outcome.

Carpal Tunnel Syndrome can happen for reasons that are understood and for reasons that are unknown. However, practicing self-care can prevent some of the symptoms that arise no matter the underlying cause. From keeping hands warm to improving posture, and from relaxing the grip while performing tasks with the hands to taking frequent breaks, the best chance at preventing Carpal Tunnel Syndrome usually lies with some conscientious effort.

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