Carpal Tunnel Syndrome Causes and Treatments
Carpal tunnel syndrome is a disorder in which the median nerve at the end of the wrist is compressed, which can cause numbness, tingling or muscle atrophy in the fingers and hands. It is also called median nerve dysfunction, and is most common in people whose jobs or daily activities require repetitive motions of the wrist and hand, such as typing or playing the piano. If the wrist is positioned poorly, the median nerve is unable to travel to the hand.
Carpal tunnel syndrome is caused by the exertion of pressure on the median nerve directly above where it passes through the wrist. The median nerve is the sensation supply for the thumb side of the palms, to the thumb, the index finger, middle finger and the ring finger, as well as a large part of the hand.
Because of this, carpal tunnel syndrome does not directly affect the wrists, but the hands. It is commonly misconstrued as an issue of the wrist because the median nerve travels through the carpal bones in the wrist and the elastic membrane that holds the bones together, which is called the carpal tunnel. The tunnel is quite inflexible, so when pressure is applied it causes extreme pain in the areas to which the nerve supplies sensory input.
Most people with carpal tunnel syndrome are between the ages of thirty and sixty, and women are five times as likely to develop it as men. The development of carpal syndrome often occurs during pregnancy, premenstrual syndrome and menopause because of the heightened changes in hormones and fluid retention.
Trauma to this area is normally caused by repetitive movement of the wrists, which engages swelling of the tissues and carpal tunnel syndrome. High-risk activities include sports that use the hands, sewing, typing, instruments (such as the piano or violin), driving, assembly line work, painting, writing and the consistent use of hand tools, especially ones that vibrate.
Most diagnoses of carpal tunnel syndrome occur after a patient reports his or her symptoms. It is rarely discovered through surgery or via any other means because it is difficult to diagnose. Common symptoms include weakness in the hands, numbness or tingling in the hands, sharp jolts of pain that extend to the elbow, impaired coordination in the hands, a weak or feeble grip and atrophy of any muscle in the hands.
A doctor will examine the wrists and hands physically first to determine points of weakness and strength of grip. He might also tap the median nerve at the wrist to see if the patient experiences pain directly afterwards. Another physical sign is when bending the wrist all the way forward (called Phalen’s test) causes weakness or a strong tingling sensation.
Initially, the patient will be advised to wear night splints on the wrists for several weeks to several months. If this doesn’t work, the patient may have to wear the splints during the day, adding hot and cold compresses alternately.
In some cases, alteration of the patient’s daily life may be necessary. For typists, the keyboard should be positioned in a way so that the wrists are not bent at an angle while typing. Patients might also need to wear a splint or cast while working in order to keep the wrists from bending unnecessarily.
An anti-inflammatory medication might be prescribed and the carpal tunnel may need to be injected with corticosteroids, which may result in dramatic relief of the most debilitating symptoms.
