Carpal Tunnel Syndrome
The carpal tunnel is a narrow tube that protects the main nerve and tendons to the palm-side of your thumb and fingers. Carpal tunnel syndrome occurs when that tube becomes compressed, causing pain, weakness and numbness in the hands or wrist.
What Causes Carpal Tunnel Syndrome?
Carpal tunnel syndrome can be due to a congenital predisposition - the tunnel is smaller than most others - making it more apt to be affected by pressure or injury. Generally, the syndrome is due to trauma to the wrist or hand that causes swelling. The swelling impinges on the tunnel, which in turn clamps down on the nerve. This can be because of:
- Arthritis
- Cyst or tumor in the tunnel.
- Fluid retention because of pregnancy, menopause, diabetes or hypothyroidism
- Sprain or fracture
The most common cause of injury is overuse and repetitive motion, such as typing, sewing or using vibrating tools.
What Are the Symptoms?
- Pain, numbness, burning, itching or tingling in hand and wrist that radiates up the arm
- Pain with increased use of your hand
- Increased pain when sleeping
- Weak grip
- Inability to tell hot from cold by touch
When Should You Seek Medical Advice?
See a health care practitioner when you feel that the discomfort is increasing, and is impeding your ability to function.
How Is Carpal Tunnel Syndrome Evaluated?
Your physician will conduct a physical exam to test each finger for sensation, and the muscles for strength. In the Tinel test, the doctor presses on the wrist nerve to see if it provokes tingling or pain. In the Phalen test, you will be asked to flex your wrists or hold the backs of your hands together to evaluate resultant tingling or pain.
Your doctor may order X-rays or ultrasound tests, which can reveal underlying problems such as diabetes, arthritis, and fractures. A nerve conduction study using electrodiagnostic tests can assess damage to the nerve.
How Is Carpal Tunnel Sydrome Treated?
Nonsurgical
- Initially, rest your hands and wrist for two weeks. (You may need a splint to immobilize them.) Apply ice if there is swelling.
- Take an over-the-counter pain reliever, such as acetaminophen (Tylenol), a nonsteroidal anti-inflammatory drug (NSAID) (Advil, Motrin) or naproxen sodium (Aleve), as directed.
- Diuretics can decrease swelling.
- Corticosteroids can be taken orally or injected to relieve pressure on the nerve. (Don't take without your physician's approval)
- Physical or occupational therapy
- Yoga
Surgical
Carpal tunnel release involves cutting the tissue band squeezing the nerve. This can be done endocscopically, a minimally invasive procedure. Physical therapy is necessary after surgery to rebuild strength.
For more information or to make an appointment please call
1-877-233-WELL (9355).