Carpal Tunnel Syndrome

Carpal tunnel syndrome of wrist is a condition that affects the hand and the arm of a person. It is a caused primarily by compression to the median nerve. The median nerve is a nerve that runs on the inner side of the wrist (palm side) through a tunnel that is surrounded by the carpals (bones that form the wrist) and ligaments. This nerve supplies all the fingers except the small finger and ring finger.

What are the Causes?

The pinching of median nerve can be caused by various factors like-

• Fracture of the wrist
• Inflammation or swelling in the wrist area
• Blood flow stoppage
• Diseases like diabetes and hypertension can cause this syndrome.
• During pregnancy when the fluid is retained within various body parts

You can be at an increased risk of developing this condition if:

• You indulge in activities that cause the over-extension of your wrist like in case of typing
• You overuse any vibrating tool or gadget for prolonged duration
• You are gripping the mouse or a keyboard in an improper way causing the wrist to get fatigued more often.
• You are a female because females have smaller space within the carpal tunnel thereby increasing the chances of compression.

How do I understand that I have it?

The usual symptoms that you might observe are-

• Tingling sensation– During the initial phase, you might just observe a tingling sensation in your thumb and first three fingers and extending towards the arm. This may progress to a condition when you find your arm going numb.
• Pain– Since there is median nerve compression; you may have pain in the areas that are supplied by the nerve. The pain may increase at night while you fall asleep.
• Weakness– This is quite dangerous and, at times, embarrassing. Things might just fall from your hand because you may lose the capacity to hold them tight as your grasp needs the coordination of all your fingers and your thumb which have become numb.

If you find these symptoms bothering you persistently, you need to go to your physician for medical assistance. Early diagnosis can prevent extensive and irreversible nerve damage.

What are the tests conducted by the doctor?

1. History– Firstly, your doctor will ask the details about your symptoms like the time when it started, the severity and questions alike.
2. Examination– Now your doctor will check your wrist and arm for any swelling or other deformity. He will also tap your wrist to check how you respond.
3. Xray– This may be required to rule out other factors of pain like fracture.
4. Electromyography– This test is conducted to check the electrical activity in muscles.
5. Nerve conduction test– This test is to check if the propagation of nerve impulses slow down inside the carpal tunnel or not.

What are the treatment options available?

Orthopedists try to treat this syndrome non-invasively. The usual non-surgical treatment modalities are-

• Wrist splint– This holds the wrist so that the nerve does not get compressed while you are asleep.
• NSAIDS– Ibuprofen is good for pain relief in the arm.
• Injectable corticosteroids– They provide instant relief when injected to the affected area as they relieve pain and reduce inflammation.

Surgically, it can be treated by incising the bands inside the carpal tunnel that put pressure on the nerve. This is done in severe cases only.

Simple preventive measures are-

• Avoid over exertion.
• Take breaks when you work on a computer or any other vibrating tool.
• Stretch your fingers and wrist in between work so that the nerve impingement is avoided.
• Do not sleep on your hand.

If you have been told that you have carpal tunnel syndrome or you would like to have your hand evaluated, contact our nationally renowned specialists at Orthopedic Surgery San Diego today for an appointment.