Carpal Tunnel Syndrome
Carpal tunnel syndrome (CTS) is a medical condition involving squeezing or compression of the median nerve in the carpal tunnel on the palm side of the hand.
The median nerve is one of the major nerves of the hand. Excessive strain or pressure on it causes symptoms such as numbness, tingling, pain, and weakness in the hand. It can occur in both hands and genetics is considered the main risk factor for this disease.
Carpal tunnel syndrome deteriorates with time in many patients. If left unchecked, the normal movements of the hand and fingers can disappear, involving loss of sensation and weakness. Women are more prone to getting this syndrome than men.
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Carpal Tunnel Syndrome symptoms
The symptoms of carpal tunnel syndrome are as follows-
- Electric shock sensations on the thumb, index, middle, and ring fingers every now and then.
- Burning, tingling, numbness, and pain sensations are observed in digits 1-4, including the thumb, index, middle, and ring fingers.These symptoms usually cause sleep problems.
- Tingling and pain sensations that may move up the forearm on the way to the shoulder
- Feelings of clumsiness and weakness in the hands, make it difficult to perform fine finger movements like writing, using a computer keyboard, or holding a book. Weakness is prominent in the thumb.
- Having less grip when holding things makes them drop easily from the hands.
Most often, the symptoms of carpal tunnel can begin slowly, without any injury. Initially, many individuals experience symptoms that come and go. After a prolonged period, the condition intensifies, and symptoms are seen more regularly or may be able to stay for an extended period of time.
The symptoms of tunnel syndrome at night are common. They may cause sleep problems, as many people sleep with their wrists bent. The symptoms are commonly seen during the daytime when holding anything for a long time (resulting in less grip to hold things) for example, during driving, writing, using a phone, or reading a book.
The causes of carpal tunnel syndrome
The compression of the median nerve causes carpal tunnel syndrome as it passes through the carpal tunnel. Its symptoms induce a feeling of numbness and tingling in the fingers.
Carpal tunnel syndrome can be triggered by any activity that irritates or presses the median nerve in the carpal tunnel passageway of the hand.
Risks factors
- Continuous and small movements with the hands. For example - typing or using a keyboard.
- Wrist fracture, rheumatoid arthritis, or dislocation. The swelling, bleeding, and deformity caused by the fracture compress the median nerve.
- Certain physical activities and sports cause frequent hand movements.
- Changes in hormones and metabolic disorders such as menopause, pregnancy, or thyroid problems.
- Abnormal blood sugar levels, often seen in type 2 diabetes.
- Wrist injuries include swelling, bruising, and sprains.
- Genetic factors
When to see a doctor?
Consult your orthopaedic hand specialist if you notice symptoms of carpal tunnel and if you find it difficult to perform your normal daily activities or experience sleep problems. If not treated on time, it can lead to permanent nerve injury and muscle damage.
Consult our orthopedic doctors for more information and adequate treatment for carpal tunnel syndrome.
Carpal tunnel syndrome diagnosis
Tinel’s sign:
This test is done to check for nerve problems. To check for Tinel’s sign, the doctor lightly taps over the median nerve at the wrist to see if it gives rise to a tingling or "pins and needles" type of sensation in the fingers.
Wrist flexion test (or Phalen test):
In this test, the doctor asks the patient to keep both elbows on the table, and keep both forearms vertical. The patient has to stretch both wrists at 90 degrees for sixty seconds. The test is positive when there is pain in one finger connected with the median nerve.
X-rays:
The doctor will recommend an X-rays test of the wrist area if the wrist motion is limited, or if there is the presence of arthritis or injury.
Electrophysiological tests:
This test is performed to check how well the median nerve is functioning and to find out whether there is too much pressure on the nerve.
This test includes -
- Nerve conduction studies (NCS)
- Electromyogram (EMG)
Ultrasound or USG scan:
USG scan makes use of high-frequency sound waves to generate pictures of carpal bones and the surrounding tissues. This test helps to evaluate the condition of the wrist and also the intensity of the median nerve compression.
Magnetic resonance imaging (MRI) scans:
MRI scan is used to monitor the condition of the wrist (the carpal bones) and also the intensity of the syndrome. This scan is preferred only in a few cases.
Treatment
The following are some examples of nonsurgical treatments -
Carpal tunnel splints:
The wrist splints for carpal tunnel assist in keeping the wrist in a straight position because it decreases pressure on the median nerve and does not aggravate the symptoms.
Nonsteroidal anti-inflammatory drugs (NSAIDs):
These medicines help to relieve pain and inflammation.
Nerve gliding exercises:
The physiotherapist will make the patient do these exercises to facilitate wrist movements and speed up recovery.
Corticosteroids:
The doctor may use an anti-inflammatory agent that can be injected into the carpal tunnel to reduce the pain and inflammation.
Surgical Treatment For Carpal Tunnel Syndrome
If nonsurgical methods fail to relieve the syndrome's symptoms or give only temporary relief, then surgery will be needed to treat carpal tunnel syndrome.
The surgical procedure used to treat the syndrome is known as carpal tunnel release.
There are two different techniques to perform this operation, but both aim to decrease pressure on the median nerve by separating the ligament at the top of the tunnel (transverse carpal ligament). By cutting the ligament, the tunnel size widens and reduces strain on the median nerve. It facilitates proper blood circulation to the nerve and improves nerve function.
The two surgical procedures are:
- Open carpal tunnel release
- Endoscopic carpal tunnel release
Dos and Don’ts
Carpal tunnel syndrome (CTS) is a painful condition of the wrist due to strain on the median nerve. Its symptoms include inflammation, pain, swelling, and limited hand movements. Risk factors can be continuous hand movements leading to strain, trauma, and hormonal changes.
| Do’s | Don’ts |
| Use resting splint to keep wrist in functional position | Overuse your wrists or hands to perform physical activities. |
| Avoid strain on the wrist. | Sleep without wearing cts splints |
| Apply cold packs to reduce swelling. | Put pressure on the affected part of the wrist. |
| Take breaks to give rest to your hands. | Smoke and consume excess alcohol for quick recovery |
| Practice exercises suggested by your physiotherapist. | Avoid taking OTC anti-inflammatory drugs. |
Follow the do’s and don’ts for carpal tunnel syndrome for a fast healing process and recovery. Its treatment includes wearing splints for carpal tunnel and doing hand exercises recommended by the physical therapist.
Carpal Tunnel Syndrome Care at Medicover
At Medicover Hospitals, we have the most trusted team of orthopaedic doctors working together to provide excellent healthcare services to our patients. Our team adopts a multidimensional approach for treating carpal tunnel syndrome and its related complications with the active participation of medical experts from different specialties. We provide world-class healthcare services at affordable costs in all our departments to offer our patients high-quality treatment outcomes and satisfactory experiences.
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