The carpal tunnel is a narrow opening on the palm side of the wrist. The median nerve runs through this area, providing sensations to the thumb and fingers. If the nerve becomes compressed, it can cause pain, weakness, tingling and numbness in the hand and arm. If you think you might be at risk of developing the condition (for example, if you use a computer keyboard throughout the day or operate vibrating equipment or if you have certain health conditions like diabetes) talk to your doctor about how you could minimise stress on the hands and wrists, including taking regular breaks and improving your posture.
Causes of Carpal Tunnel Syndrome
The anatomy of the wrist means the median nerve can become compressed as it passes through the carpal tunnel. Certain inflammatory health conditions, such as rheumatoid arthritis which causes swelling, can affect the lining around the tendons which may increase pressure on the nerve. Other chronic illnesses like diabetes can also lead to nerve damage. If you fracture or dislocate your wrist, this may deform the bones and potentially narrow the carpal tunnel. Some people are simply born with a smaller carpal tunnel than others and being overweight may also increase the chances of developing the condition. Some studies suggest that working with vibrating tools or repeated flexing of the wrist may contribute to pressure on the median nerve or exacerbate an existing condition. Fluid retention in the body which occurs during pregnancy and menopause can also lead to Carpal Tunnel Syndrome. Women are more prone to developing the condition than men.
Symptoms of Carpal Tunnel Syndrome
The symptoms of Carpal Tunnel Syndrome may come on gradually. You may notice a tingling sensation or numbness in your hand or fingers. This may be particularly obvious when you make certain movements such as holding your phone or gripping a steering wheel. It can sometimes feel like an electric shock passing through your fingers. Your hands may feel weak and you might find it hard to make a pinching movement. Sometimes the condition may wake you up at night or you might notice the numbness and tingling is worse in the morning.
Diagnosis of Carpal Tunnel Syndrome
Alongside a physical examination to assess the strength of your hand and wrist, you may be referred for an ultrasound scan to determine whether the median nerve is being compressed. In some cases, a nerve conduction study may be used to evaluate the electrical activity in the muscles controlled by the median nerve. If your doctor suspects another possible cause of pain you may be given an X-ray to rule out a fracture or a condition like arthritis. The sooner Carpal Tunnel Syndrome is diagnosed the better as you can amend your everyday activities to avoid exacerbating the problem.
Treatment of Carpal Tunnel Syndrome
In the first instance it is important to rest your hands and wrists to avoid making the symptoms worse. Painkillers, anti-inflammatories and ice packs can all help to control the pain and reduce inflammation in the affected area. Wearing a wrist split while you sleep holds the wrist straight which can make it easier to sleep and prevent early morning numbness and tingling. An injection of corticosteroids into the carpal tunnel can help to reduce the inflammation, thereby relieving pressure on the median nerve. If the condition fails to respond to more conservative treatment, surgery may be required to relieve pressure on the nerve. The procedure is called carpal tunnel release and it involves cutting through the ligament to free the nerve. It may be performed arthroscopically (keyhole surgery) or as conventional open surgery.
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