Carpal Tunnel Syndrome

Carpal tunnel syndrome is essentially a compression of nerve in the wrist. Carpal tunnel syndrome happens when pressure builds up from swelling in the tunnel and puts pressure on the nerve.


Causes

Pressure on the nerve can happen in several ways, including:

  • Swelling of the lining of flexor tendons, called tenosynovitis
  • Joint dislocations
  • Fractures
  • Arthritis
  • Fluid retention during pregnancy

The situations listed above can narrow the carpal tunnel or cause swelling in the tunnel. Thyroid conditions, rheumatoid arthritis and diabetes can also be associated with carpal tunnel syndrome. Ultimately, there can be many causes of this condition.


Signs and Symptoms

Symptoms of this condition can include:

  • Pain
  • Numbness
  • Tingling
  • Weak grip
  • Occasional clumsiness
  • Tendency to drop things

The numbness or tingling most often takes place in the thumb, index, middle and ring fingers. The symptoms usually are felt during the night but may also be noticed during daily activities such as driving or reading a newspaper. In severe cases, sensation and strength may be permanently lost.


Diagnosis

A detailed history including medical conditions. An x-ray may be taken to check for arthritis or a fracture. In some cases, laboratory tests may be done. Electrodiagnostic studies are done to confirm the diagnosis and check for other possible nerve problems.


Treatment

Symptoms may often be relieved without surgery. Some treatment options are:

  • Changing patterns of hand use (helps reduce pressure on the nerve)
  • Keeping the wrist splinted in a straight position (helps reduce pressure on the nerve)
  • Wearing wrist splints at night (helps relieve symptoms that interfere with sleep)

When symptoms are severe or do not improve, surgery may be needed to make more room for the nerve. Pressure on the nerve is decreased by cutting the ligament that forms the top of the tunnel on the palm side of the hand .

The numbness and tingling may disappear quickly or slowly. Recovery may take several months. Carpal tunnel symptoms may not completely go away after surgery, especially in severe cases .

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