Carpal Tunnel Syndrome - Symptom, Treatment And Causes

Carpal tunnel syndrome is a condition that causes numbness or tingling in the hands and arms besides other symptoms. Carpal tunnel is basically a narrow passage on the palm side of the wrist. This condition is caused when a nerve in the carpel tunnel is compressed. Since this median nerve runs up through the hands to the forearm, it affects the arms as well. Not only does it cause nerve pain, but also results in limited functionality of the thumb.

To prevent this syndrome, one needs to understand its causes. We have discussed some of the primary causes below:

1. Issues with the thyroid hormone: Hypothyroidism, an imbalance or lack of thyroid hormones in the body, can create problems that lead to issues with the overall musculoskeletal system. An over-active pituitary gland can also cause issues that affect mobility and motor skills. This can lead to or exacerbate the carpal tunnel syndrome.
2. Arthritis: Arthritis causes swelling and inflammation of joints and tendons, which tend to increase the symptoms of carpal tunnel. Eventually, arthritis can also lead to compression of the median nerve and other structures in the wrist, thereby leading to carpal tunnel syndrome.
3. Pregnancy or menopause: During pregnancy as well as menopause, women experience tingling or numbness in their hands, which is believed to be caused by carpal tunnel. Experts say that when a fluid called oedema builds up in the tissues around the wrists and other parts of the body, it puts a pressure on the median nerve, leading to pain.
4. Work pressure: Experts believe that behaviours can increase the risk of carpal tunnel. The other instances which cause this syndrome include physical labour, using mechanical tools and repeated stress to the wrist. However, various studies suggest that there isn’t any direct association between using a computer and carpal tunnel syndrome. It may just cause different forms of hand pain.
5. Imbalance of body fluids: Fluid retention in the body increases the pressure within the carpal tunnel, which irritates the median nerve. This is common during pregnancy and menopause as discussed earlier.
6. Obesity: One of the significant risk factors for this syndrome is being obese. So be careful about gaining excess weight.
7. Other conditions: Certain conditions like hormonal imbalance, diabetes and kidney failure may increase the chances of carpal tunnel syndrome. It also occurs in people who usually have narrow carpel tunnels. In some cases, it is inherited and is passed from one generation to the next.
8. Inflammatory conditions: Illnesses that end up in inflammation, such as rheumatoid arthritis, can affect the lining around the tendons in the wrist and put pressure on the median nerve.
9. Fractures: A fracture in the wrist can cause narrowing of the carpal tunnel and irritate the nerve.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Also known as Median Nerve Compression, Carpal Tunnel Syndrome is characterized by a sensation of tingling and numbness in the hands or the arm caused due to a strained nerve of the wrist. This condition occurs due to stress which affects the functioning of the part of median nerve, situated along the wrist.

Various Causes of Carpal Tunnel Syndrome:
Constant movement of the hands in activities such as typing on the computer
Pregnancy
Arthritis

Various Symptoms of Carpal Tunnel Syndrome:
The symptoms of this syndrome start to show up when there is excessive pressure build up in the median nerve of the wrist. You may experience-

1. A sensation of numbness
2. A sensation akin to the pain experienced when needles are inserted into the skin
3. Pain (mostly at night)

The build- up of pressure can occur due to a number of reasons. They are

1. Painful injury
2. Fracture
3. Tenosynovitis (a condition that affects the tendons along the sides of the thumb)
4. The compression of the nerve may develop anywhere, and not necessarily the wrist only.

Diagnosis of Carpal Tunnel Syndrome:
Doctors base their diagnosis of the condition on the symptoms and certain tests. These include-

1. Phalen’s test (a test that is carried out to determine any pain or numbness in the fingers within one minute of this activity)
2. Wrist flexion/median nerve compression test
3. Tinel’s test (a test that is used to diagnose irritated nerves)
4. Few nerve enlargements may be revealed by an ultrasound, X-Ray, MRI scan, CT scans etc. The doctor generally recommends any of the above tests to determine carpal tunnel syndrome.

Important measures that help treat the condition are

1. Getting ample rest
2. Educating yourself on the various symptoms
3. Knowing certain activities or movements that trigger symptoms
4. Attending physiotherapy sessions
5. Physiotherapy as an important form of treatment for Carpal tunnel syndrome
6. Extensibility of muscle as well as soft tissue
7. Strengthening the forearms and the ability to grip things and pinch too
8. Maintaining posture and performing hand agility exercises can improve the hand movement
9. Mobilization of the Carpal bone and stretching of the flexor retinaculum (a fibrous band near one’s wrist) so as to widen the carpal tunnel
10. Gliding training for nerves/ tendons for unrestricted motion
11. Endurance training for strengthening the upper limb as well as the wrist

In case you have a concern or query you can always consult an expert & get answers to your questions!

The carpal tunnel is the passageway for the median nerve to pass through on the inner side of your hand, when your palms are facing down. For example, while typing, there is a lot of movement of the fingers and this puts a lot of pressure on this tunnel. In fact, people who are involved in a lot of typing are one of the most prone people for carpal tunnel syndrome (CTS). Other causes would include trauma, fractures, etc., where the tunnel is injured.

Conventional measures to treat CTS included a combination of exercise and pain killers in mild to moderate cases. In moderate (sometimes) to severe cases, surgery was also done. However, with advancements in medical technology, endoscopic surgical procedure is gaining popularity.

What is done?
In endoscopic surgery, a small incision is made in the wrist or one each in the palm and the wrist. Through this, a flexible tube with a camera and minute cutting tools are inserted into the wrist. Another ligament known as transverse carpal ligament is cut. This reduces the pressure on the median nerve, which provides relief from the CTS symptoms.

What to expect as benefits?
The intention behind the surgery remains the same in both traditional and endoscopic procedures. The pressure on the median nerve is released, restoring movement and reducing pain in the joints. In addition, the endoscopic procedure has the following benefits.

1. Less invasive: Needless to say, there are only one or two small incisions done for this procedure, so less surrounding tissue is damaged.
2. Same day surgery: No hospitalization is required, and unless required, the patient can return home on the same day of surgery.
3. Reduced recovery time: The recovery period is usually substantially less compared to the traditional surgical approach.
4. Back to work: Depending on which is your dominant hand, you would be able to return to your regular work earlier than with regular surgery. If your non-dominant hand is involved, a day or two of rest is required. If your dominant hand was involved, give it up to four weeks for complete recovery.
5. Reduced chances of nerve injury: The area of operation has many nerves and blood vessels, and endoscopic surgery reduces the chances of damaging adjacent nerves.
6. Anesthesia: This is done under local anesthesia. Therefore, complications arising out of general anesthesia are completely avoided.

Indications
While these sound promising, your doctor will decide if you are a candidate for endoscopic procedure depending on the following:

• Nonsurgical treatment including exercise and pain killers have not provided relief, even after several months.
• Severe symptoms including those of nerve damage, like loss of sensation, altered coordination, etc., is affecting your normal daily routine.
• Person requiring bilateral surgery like severe trauma, wheelchair dependent, etc.

In case you have a concern or query you can always consult an expert & get answers to your questions!

If you suffer from rheumatoid arthritis, you may be at a high risk of developing Carpal tunnel syndrome. This is a very painful condition in which the hands and wrists are affected. The Carpal tunnel refers to a structure which is formed by the bones present in the wrist and the surrounding connective tissues, through which the nerves and tendons controlling the thumb movement pass. Carpal tunnel syndrome occurs when the connective tissues get swollen because of inflammation and the nerves passing through the tunnel are crowded and squeezed.

Ways to get relief from Carpal tunnel syndrome:

Here are some common ways by which a patient with Rheumatoid arthritis can get relief from any discomfort caused due to Carpal tunnel syndrome:

1. Get your Rheumatoid arthritis treated. Carpal tunnel syndrome is commonly caused because of an underlying sickness such as rheumatoid arthritis. Medicines such as disease modifying anti-rheumatic drugs are used to manage the condition and for reducing inflammation which causes carpal tunnel syndrome.
2. Getting enough rest is also very important. You must avoid using that hand or wrist, which has been affected for some weeks. This will allow the inflamed tissue to heal. 
3. You may wear a wrist splinter. A splint is suggested for resting your wrist therefore, it is kept in a neutral position. It can be worn during the day or when you are sleeping.
4. You can take prescribed non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief. These also help in reducing the swelling of tissues within the carpal tunnel.
5. A Cortisone shot may also be effective for easing the carpal tunnel syndrome. These steroid injections are given directly into the carpal tunnel. You will be able to get temporary relief from pain.
6. A set of Carpal tunnel exercises have been developed by doctors. These are designed for stretching the wrists and for keeping them limber. You must perform these exercises on a regular basis for best results. Yoga is also effective for easing carpal tunnel syndrome. Performing regular yoga will help you to improve your wrist pain. The upper joints of the body are strengthened. 
7. Take breaks at work on a regular basis. By changing your position and taking short breaks, your Carpal tunnel symptoms are bound to improve. This is more essential for people who do a job where great stress is placed on the wrists. If you are into typing, you need to take breaks and stretch your wrists.

There are several alternative therapies for easing carpal tunnel syndrome, which  are being studied and researched on. They include the likes of acupuncture, chiropractic care, magnets, botox treatments and vitamin B6 supplements. If you wish to discuss any specific problem, you can consult a pain management specialist.

The human hand has multiple bones, tendons, ligaments and muscles which in unison help us to grip things and manipulate other objects to do our work. Within the wrist lies a narrow passageway on the palm side which houses the main nerve for movement of the nine tendons. These tendons help us to move our fingers individually and grip things or accomplish any task we want with our hands.

What is carpal tunnel syndrome?
Carpal tunnel syndrome is a condition where this nerve gets pinched due to a variety of factors and may have adverse effects. Some of the symptoms include tingling, numbness and pain with movements of the arm.

Causes of Carpal Tunnel Syndrome:
The nerve within the wrist which is known as the median nerve can be pinched due to a variety of factors:

1. Movements where the wrists are always higher and in an angle: Repetitive movements of the wrists where the hands are always at a lower angle, can increase the chances of carpal tunnel syndrome. This is usually a workplace related problem and thus be caused by bad hand posture.
2. Medical Conditions: There are certain medical conditions that may also trigger the onset of carpal tunnel syndrome such as diabetes, thyroid, menopause and other problems.
3. Pregnancy: Pregnancy has also known to cause carpal tunnel disorder as it can alter the balance of fluids within your body. However, other factors could also put your fluids in imbalance and cause problems with the median nerve.
4. Conditions that may cause inflammation: Certain conditions such as rheumatoid arthritis can cause the inflammation within the joints which might lead to the median nerve being pinched which in turn might lead to carpal tunnel syndrome.

Some Preventive Measures from Carpal Tunnel Syndrome:

1. Breaks from repetitive work: It is important for your wrists to have a break when you are doing repetitive tasks that might cause carpal tunnel syndrome. Relax and stretch your muscles within the break time
2. Wear wrist splints: These are support devices which can help correct problems for repetitive actions throughout the day while you are sleeping.
3. Take pain reliever if you start having chronic pains: If your wrist pain is not letting you functions normally, take a pain reliever such as ibuprofen or aspirin and go to a doctor as soon as possible for a more thorough treatment.