Carpal Tunnel Syndrome
What is Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is a common condition that occurs when the median nerve, which runs from the forearm through a narrow passageway in the wrist called the carpal tunnel, becomes compressed or pinched. This compression can cause pain, numbness, tingling, and weakness in the hand and fingers.
The carpal tunnel is a rigid structure made up of bones and ligaments at the base of the hand. When tissues surrounding the flexor tendons swell, they can press against the median nerve, causing the characteristic symptoms of carpal tunnel syndrome. This condition is more common in women and typically affects people between the ages of 30 and 60.
Symptoms of Carpal Tunnel Syndrome
Carpal tunnel syndrome symptoms usually develop gradually and may vary in severity. The symptoms often affect the thumb, index, middle, and ring fingers, as these are innervated by the median nerve.
Primary Symptoms
Associated Symptoms
Symptom Progression
Early Stage
Mild tingling and numbness in fingers, especially at night or upon waking. Symptoms may be relieved by shaking the hands.
Moderate Stage
Persistent numbness and tingling during daily activities. Grip strength may begin to weaken, making it difficult to hold objects.
Severe Stage
Constant numbness, severe weakness, and muscle atrophy in the thumb area. Daily tasks become increasingly difficult.
Causes and Risk Factors
Primary Causes
- Repetitive Hand Motions: Prolonged repetitive flexing and extending of the hands and wrists
- Anatomical Factors: Smaller carpal tunnel size or wrist fractures that alter the space
- Nerve Compression: Swelling and inflammation that reduces tunnel space
- Fluid Retention: Pregnancy or menopause-related fluid changes
Risk Factors
- Gender: Women are 3 times more likely to develop CTS
- Age: Most common between ages 30-60
- Medical Conditions: Diabetes, thyroid disorders, rheumatoid arthritis
- Pregnancy: Hormonal changes and fluid retention
- Occupation: Jobs requiring repetitive wrist motions
- Heredity: Genetic predisposition to smaller carpal tunnel
Diagnosis
Diagnosing carpal tunnel syndrome involves a comprehensive evaluation by a healthcare provider, typically including:
Physical Examination
- Tinel's Sign: Tapping over the median nerve at the wrist
- Phalen's Test: Holding wrists in flexed position for 60 seconds
- Grip Strength Testing: Measuring hand strength and dexterity
- Sensory Testing: Checking sensation in fingers
Advanced Testing
- Nerve Conduction Studies: Measuring electrical activity of median nerve
- Electromyography (EMG): Testing muscle electrical activity
- Ultrasound: Imaging the median nerve and surrounding tissues
- MRI: Detailed imaging when other causes are suspected
Treatment Options
Treatment for carpal tunnel syndrome depends on the severity of symptoms and how long they've been present. Early treatment often prevents the need for surgery.
Conservative Treatment
Medical Interventions
Treatment Timeline
Immediate (0-2 weeks)
Rest, splinting, anti-inflammatory medications
Short-term (2-6 weeks)
Physical therapy, ergonomic modifications, possible corticosteroid injection
Long-term (6+ weeks)
Continued conservative management or surgical consultation if symptoms persist
Prevention
While not all cases of carpal tunnel syndrome can be prevented, several strategies can reduce your risk:
Workplace Ergonomics
- Use ergonomic keyboards and mouse pads with wrist support
- Maintain proper wrist position while typing
- Take regular breaks from repetitive activities
- Adjust workstation height and positioning
Daily Habits
- Perform wrist stretching exercises regularly
- Avoid sleeping on your hands
- Use tools with larger, padded grips when possible
- Maintain a healthy weight
- Manage underlying health conditions
Prognosis and Outlook
The prognosis for carpal tunnel syndrome is generally good, especially when diagnosed and treated early:
Conservative Treatment
Up to 80% of mild to moderate cases improve with non-surgical treatment. Symptoms may resolve completely with proper management and lifestyle modifications.
Surgical Treatment
Carpal tunnel release surgery has a success rate of 85-95%. Most patients experience significant improvement in symptoms, though recovery may take several months.
Long-term Outlook
With appropriate treatment, most people can return to normal activities. However, severe cases with prolonged nerve compression may have permanent nerve damage.
When to Seek Medical Attention
Seek Immediate Care If:
- Sudden, severe loss of hand function
- Complete numbness in the hand
- Signs of infection after injury
Schedule an Appointment If:
- Persistent numbness or tingling lasting more than 2 weeks
- Difficulty gripping objects or weakness in the hand
- Symptoms interfere with sleep or daily activities
- Progressive worsening of symptoms
Medical Disclaimer
This information is for educational purposes only and should not replace professional medical advice. Always consult with a qualified healthcare provider for proper diagnosis and treatment of carpal tunnel syndrome or any other medical condition.