Carpal Tunnel Syndrome (CTS) Causes, Symptoms and Treatment

Carpal tunnel syndrome (CTS) is a common cause of hand numbness and pain. The carpal tunnel is a narrow passage that traverses from the wrist deep in to the palm of the hand. The symptoms result from compression of a nerve (median nerve) that lies within the carpal tunnel. When the nerve gets compressed, there is numbness or tingling of the thumb, index finger, middle finger and part of the ring finger. One may also experience weakness and pain in the hand, wrist, or forearm. The symptoms usually come and go in the beginning stages but as the severity increases, numbness or tingling may be more constant and often more common at night. People report feeling clumsy and often drop objects more frequently and have trouble gripping objects like a phone, pencil, newspaper, steering wheel etc.

Causes: Certain condition can increase risks of developing CTS, including diabetes, rheumatoid arthritis, pregnancy, trauma and thyroid imbalance, amongst others CTS is also more common in women and in older individuals. There can be hereditary or anatomic factors at play as well and some people naturally have a smaller, tighter carpal tunnel. In many cases, a clear cut cause of carpal tunnel syndrome is not always identified. Manual labour requiring a forceful grip or usage of vibrational construction equipment may also contribute to CTS. Some experts have suggested that other workplace factors involving repetitive movements or computer usage can also contribute to the development of this ailment. The scientific evidence available is conflicting and as yet, there is no definitive correlation between these it is widely believed that activity involving the hands that require repetition and force, especially for prolonged periods of time and certain positions like wrist bending (flexion), could contribute to CTS.

Evaluation: Anyone with recurrent pain, numbness, tingling, or weakness in the hand should consult a physician for evaluation. The doctor will likely ask more detailed questions about the symptoms experienced and perform a physical examination. If the symptoms are suggestive of CTS, the doctor may order tests such as an x-ray to rule out other causes of wrist pain and or a nerve conduction study which can determine if there is any nerve compression.

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome Treatment:

Non-Operative treatments: If carpal tunnel syndrome is treated early, especially in the case of mild symptoms, certain non-operative treatments can be really effective and may also reverse symptoms. Some of the treatments include:

1. Wrist Bracing: Wearing a wrist brace can help hold the wrist still in a non-aggravating position. It can especially be used at night.

2. Non-Steroidal Anti-Inflammatory Medication: Taking anti-inglammatory medication may help decrease any inflammation irritating the carpal tunnel.

3. Corticosteroids: A steroid injection administered directly in to the carpal tunnel can help decrease inflammation and swelling.

4. Physiotherapy And Yoga: Stretching exercises, balance and posture enhancements may help control symptoms.

5. Lifestyle Adjustments: Take periodic breaks and stretch during work or repetitive activities, assure ergonomic workspace, avoid hand position which aggravate symptoms and maintain a good posture.

Operative Treatment: With continued symptoms despite efforts at non-operative treatment, the doctors may recommend surgery. Surgery involves releasing a ligament within the carpal tunnel which presses on the nerve. This enlarges the carpal tunnel, creating more room within the carpal tunnel thereby decreasing pressure on the nerve. The surgeon may make an ‘open’ incision in the palm to release the tissue or possibly even use a camera to assist, if an endoscopic method is utilized. Surgery may be recommended sooner in more severe cases.

However, recovery may take a few weeks to several months for more complete healing. Surgery usually affords reliable outcomes and symptom management but more severe CTS cases may take longer to heal and residual symptoms could still remain. Although carpal tunnel syndrome can create a nuisance with activities of daily living, fortunately treatment methods remain quite effective for symptom relief and restoring hand and wrist function.

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