Carpal Tunnel Syndrome

 

Carpal Tunnel Syndrome

Have you been experiencing a feeling of numbness or tingling in your palm and fingers? Do you feel you are being poked with pins and needles on one hand?

Did you know that this could be the result of a condition known as Carpal Tunnel Syndrome.

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS) is a disorder that causes pain and numbness in the fingers and hands, and sometimes the arms. It happens when the median nerve, a nerve in the wrist gets pinched or squeezed. The median nerve goes through a tunnel in the wrist that is formed by the bones of the wrist and a tough band of tissue called a ligament.

The median nerve receives and carries the signals about this particular sensation and tells the brain what the hand is ‘feeling’. The median nerve receives the aforementioned inputs from;

  • The thumb
  • Index finger
  • Middle finger
  • Certain parts of the ring finger
  • Parts of the palm closest to the thumb

Understanding the Carpal Tunnel – the carpal tunnel is a passage forming beneath the transverse ligament, which extends across the lower palm connecting the bones of the wrist. Take a look at your palm, under the skin on your wrist, is the carpal tunnel.

What causes CTS?

The most common established reason resulting in the development of CTS is pressure exerted on the median nerve. The exact cause of the pinching of the nerve remains unknown, however, there are certain identified risk factors that may lead to it, i.e. when;

  • Tissues in the tunnel get swollen
  • People hold their hands in a position that makes the tunnel smaller

Who is more likely to develop symptoms of CTS?

Anybody can develop the disorder, however, it is rather uncommon in children. Women are three times more likely to develop CTS than men. This could also be because the carpal tunnel in women is smaller than that in men.

People having desk jobs who work on their desktop for long hours, those hold and talk over their phone for a long time are most commonly affected by the disorder. The risk of developing the condition is not confined to people who work desk jobs, industries that include assembly line work also see many people developing the condition. Those who have the habit of keeping the hands below the head or the pillow are also prone to CTS.

Risk Factors for developing CTS;

  • Overweight and obesity
  • Underlying health conditions like diabetes, hyperthyroidism, rheumatoid arthritis etc.
  • Pregnancy sometimes puts women at the risk of developing short-term symptoms.

What are the symptoms of carpal tunnel syndrome?

The symptoms of CTS include pain and a tingling sensation in the thumb and the index, middle, and ring finger. The symptoms often affect both hands, however, one hand might have worse symptoms than the other.

In some cases, the pain and tingling can extend to the entire hand or even up to the wrist and forearm. It is very rare that the sensation extends past the elbow to the shoulder. Symptoms are usually worst at night and can even wake you up from sleep. The symptoms can also flare up when you perform activities that involve bending and unbending of your wrist or raising your arms.

Performing certain activities can also trigger symptoms in people with carpal tunnel syndrome. However, they do not actually cause the condition. Examples include:

  • Sleeping
  • Driving
  • Reading
  • Typing
  • Holding a phone

In many people, the symptoms come and go, but some people eventually have symptoms all the time. They can end up having trouble moving their fingers or controlling their grip.

Is there a test for carpal tunnel syndrome?

The first and the most important thing to do upon experiencing the symptoms is to visit a professional in order to understand the issue. Most often people tend to disregard minor issues such as CTS which ultimately leads to damage of the nerves and muscles. CTS is a rather common disorder that has an estimated prevalence of 1-5%.

A specialist will advise you on certain tests like the electrical test of the nerves, that can show if you have carpal tunnel syndrome and tell the severity of the condition. A specialist will be able to diagnose the condition by learning about your symptoms and performing an examination. During the examination, the Doctor might tap or press on your wrist, or ask you to hold your hands in ways that are known to make symptoms worse.

In case of patients who may require surgery to treat the condition, Doctors usually advise the below tests;

  • Nerve conduction studies– to show whether the median nerve is carrying electrical signals the right way. In people with carpal tunnel syndrome, signals can be slow or weak.
  • Electromyography–also called EMG, can show whether the muscles in the hand and wrist are responding the right way to electrical signals. This test is most useful in checking if there is an underlying condition that could be causing the symptoms.

How is carpal tunnel syndrome treated?

Treatments for CTS are often combined and can include:

  • Wrist splints– Some people feel better if they wear splints at night that keep their hands in a neutral position. A neutral position is one in which the wrist is not bent forward or backward and the fingers are curled naturally towards the palm.
  • Steroid shots or pills– Steroids are a group of medicines that control inflammation and swelling. To treat CTS, Doctors sometimes inject steroids into the carpal tunnel. People who do not want to take an injection can take steroids in the form of a pill, although the pills are less effective than the shot.
  • Other physical treatments– There is some evidence that yoga or a treatment called ‘carpal bone mobilization’ can help people with carpal tunnel syndrome. In carpal bone mobilization, a physical or occupational therapist moves your hand or wrist around in a certain manner, so that the bones in the wrist movement.
  • Surgery– Surgery is recommended for those who have ongoing or severe nerve damage, causing the symptoms. Surgery involves cutting the ligament that stretches across the wrist to form the tunnel. However, women who experience carpal tunnel syndrome during pregnancy usually don’t need surgery. In most cases, the symptoms gradually improve after the baby’s birth.

Can carpal tunnel syndrome be prevented?

It’s unclear whether there is any way to prevent carpal tunnel syndrome. But its good idea to maintain a healthy weight, avoid abnormal postures of the hand for prolonged periods (usage of computer and mobile, keeping the hand below the head while sleeping etc.). If the symptoms are recurrent and disturb your sleep, ensure to seek professional help. Do not ignore any symptoms, it is advisable to save yourself the long-term pain by addressing the issue at an early stage.

 

 

 

 

 

 

 

 

 

 

 

Dr. Vishal Pawar

Specialist Neurologist

Aster Speciality Clinic, International City

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