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Carpal Tunnel Syndrome: Symptoms, Causes, Treatment

Last Updated: Jul 06, 2023

Carpal Tunnel Syndrome

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Among the most common types of hand conditions, Carpal Tunnel Syndrome is a disorder in which the median nerve, which passes through the wrist, is put under pressure. This nerve is in charge of producing the sensory and motor functions of all fingers apart from the little finger.

The median nerve passes through a passage in the wrist called the carpal tunnel with the transverse carpal ligament on top. If the nerve is irritated or compressed, it causes a feeling of pain, numbness, and tingling in the hand, wrist, and forearm.

Carpal Tunnel Syndrome Symptoms

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The symptoms of Carpal Tunnel Syndrome appear slowly over time, mostly without any former injury.Carpal Tunnel Syndrome symptoms may be inconsistent in the beginning, but over a period of time may be more frequent or persist for longer. Symptoms of Carpal Tunnel Syndrome may include the following:

  • Sensations of tingling, aching, burning, or numbness in the thumb or the three middle fingers that may spread to the forearm.
  • Experiencing sudden shock-like sensations in the fingers.
  • Weakness, specifically in the hand, may make performing fine movements or even gripping objects tough.

Most often, symptoms of Carpal Tunnel Syndrome are more intense at night. Often at times during sleep, our wrists stay fixed in unnatural positions, which may compress the median nerve for a prolonged period of time, causing the symptoms to intensify. As the condition worsens, symptoms become more constant and frequent, with the muscles at the base of the thumb experiencing atrophy.

Carpal Tunnel Syndrome Causes

The Carpal Tunnel is an opening in the wrist which leads to the hand and has the median nerve running through it.Carpal Tunnel Syndrome is caused when the median nerve is squeezed as this nerve provides sensory signals and motor functions to the palm side of all fingers except the little finger.

Compression of the median nerve can be caused by numerous factors, which may not directly cause the condition but rather increase the risk of it. The following may be contributing factors.

  • Repetitive and frequent movements, such as working with vibrating tools or using a keyboard, over a prolonged period of time might aggravate already existing nerve injury or put a strain on the median nerve.
  • Women have smaller carpal tunnels as compared to men, which is why the condition is generally more common among women.
  • Anatomical factors, such as injuries like dislocation or fractures in the wrist, or arthritis, may deform the bones in the wrist, altering the size of the carpal tunnel in the process.
  • Inflammatory conditions, such as rheumatoid arthritis, may affect the lining around the wrists' tendons and compress the median nerve.
  • Diabetes or other chronic illnesses similar to it may increase the chances of nerve damage.
  • Hormonal changes in the body often cause swelling, which may compress the median nerve.

How can you prevent Carpal Tunnel Syndrome?

Despite scientific and medical advancements, Carpal Tunnel Syndrome can be difficult to prevent in the long run. Among the most common hand conditions, Carpal Tunnel Syndrome is known to worsen if not treated. Though there are no proven strategies to help prevent symptoms of carpal tunnel syndrome, here are a few do’s and don'ts to follow to help with prevention.

Do

  • Keep your wrists straight, even while sleeping.
  • Take frequent, short rest breaks to stretch your hands and wrists.
  • Stretching before and after activities.
  • Improving our overall posture while working so as to not put unnecessary stress directly on the wrists.

Don’t

  • Avoid working with cold hands and try keeping your hands warm.
  • Avoid flexing your wrists and straining them in stagnant positions for long periods of time.
  • Practice keeping a loose, but comfortable grip. Repetitive and strong grasping puts pressure on the wrist.
  • Avoid sleeping in a cramped position with your hands cramped up during the entire time period.
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Carpal Tunnel Syndrome - Diagnosis and Tests

The diagnosis of Carpal Tunnel Syndrome requires a physical examination by a medical professional. The history and pattern of your symptoms are examined before conducting a physical examination. At times, an x-ray may be recommended for the affected hand to accurately center on the diagnosis.

An ultrasound of the affected wrist may also be recommended to determine the severity of the compression of the median nerve.

Your doctor may also recommend electromyography, or a nerve conduction study, to measure electric signals produced in the muscles and identify the damage.

What are the possible complications of Carpal Tunnel Syndrome?

Complications in regards to Carpal Tunnel Syndrome may appear due to the condition, as well as due to surgery.

Carpal Tunnel Syndrome by itself has the potential to cause irreparable damage to the median nerve, causing permanent disability and impairment, along with chronic pain in the hand and wrist. CTS could also weaken and shrink the muscles at the thumb’s base.

Carpal Tunnel Surgery also causes complications such as hypertrophic scars, wrist joint stiffness, or even gives rise to a benign tumor in branches of the median nerve.

However, complications can be easily avoided by taking the guided help of experienced medical professionals, and at Pristyn Care, we help you connect with medical experts and reduce the risk of complications.

Home Remedies for Carpal Tunnel Syndrome

A common hand condition, Carpal Tunnel Syndrome may be treated at home without any surgery. However, the severity of the condition may vary from moderate to severe, in which case it is best to consult a doctor for conventional treatments. Some methods of home remedy for carpal tunnel syndrome are as follows.

  • Wearing a wrist splint while you sleep to hold the wrist still in place may help rid the sensation of numbness and tingling. This is an ideal remedy to apply in the case of pregnant women as it does not involve the use of any additional medication.
  • Hand therapy methods that are used in occupational and physical therapy may also help relieve symptoms. Yoga stretches may also help reduce pain and better the grip on the affected hand.
  • Methods to relieve symptoms include applying a hot pack to the wrist to reduce pain, applying an ice pack to reduce swelling, adding material for a more comfortable grip to tools you may use for prolonged periods of time, as well as wearing work gloves to protect your wrists and hands.

What to eat in Carpal Tunnel Syndrome

Foods that may be beneficial for carpal tunnel syndrome:

  • Fish oil: Foods rich in omega-3 fatty acids due to their anti-inflammatory properties which may support a reduction in symptoms.
  • Berries, leafy greens, and citrus fruits: All these foods are rich sources of antioxidants that may help reduce inflammation and ease symptoms.
  • Salmon, soybeans, and potatoes: Foods rich in vitamin B6 may or may not directly alleviate Carpal Tunnel Syndrome symptoms but are still recommended by doctors due to their overall positive effect on the health.
  • Liver, tuna, and eggs: Foods rich in vitamin B12 may be beneficial in easing the effects of nerve damage and alleviating pain.
  • Turmeric: Said to possess neuroprotective, antioxidant, and anti-inflammatory properties, Turmeric is said to help ease inflammation and protect the peripheral nerves.

What not to eat in Carpal Tunnel Syndrome

While certain foods may help alleviate symptoms, others may aggravate the same. A few foods to avoid when dealing with Carpal Tunnel Syndrome are:

  • Simple carbohydrates: Overconsumption of simple carbohydrates, like sugary breakfast cereals, white flour, white rice, and most desserts, may cause a rise in the body’s glucose levels which increases inflammation.
  • Salty foods: Salty foods, such as dried meats, potato chips, and specially packaged foods, causes inflammation due to salt’s water-retaining property.
  • Saturated and trans fats: Foods containing trans and saturated fats, such as beef, pork, margarine, and fried and processed foods, are linked with increasing levels of inflammation in the body which strains the median nerve.
  • Alcohol: Alcohol is another substance that increases inflammation in the body. Those who drink excessively over a prolonged period of time are also more at risk to develop Carpal Tunnel Syndrome.

Carpal Tunnel Syndrome Treatment

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There are two approaches to treating carpal tunnel syndrome: non-surgically or surgically. Non-surgical procedures are generally used for less severe symptoms and let you carry on with your everyday routine uninterrupted. In more extreme situations, surgical procedures can be beneficial and produce excellent results.

Even if it happens gradually, carpal tunnel syndrome typically gets worse with time in those who don't receive treatment. It is crucial to have an early evaluation and diagnosis from your doctor because of this. It may be able to halt or limit the disease's course in its early stages.

Non-surgical treatments

A few ways of non-surgical treatment for Carpal Tunnel Syndrome are:

  • Using a brace or splint
  • Modifying your routine/activities
  • Specific wrist exercises
  • Nonsteroidal anti-inflammatory medication
  • Steroidal agents

Surgical treatments

Since non-surgical treatment may only be able to temporarily alleviate symptoms, your doctor may recommend surgery. The two ways to surgically treat Carpal Tunnel Syndrome are:

  1. Open Carpal Tunnel Release
  2. Endoscopic Carpal Tunnel Release

What are the non-surgical treatments for carpal tunnel syndrome?

Carpal Tunnel Syndrome may often be treated in its early stages or if it’s not severe. A few non-surgical treatments include:

  • Brace or splint: You can prevent your wrist from being fixed in uncomfortable positions while you sleep by wearing a brace or splint. Reduced pressure on the carpal tunnel nerve is achieved by maintaining a straight or neutral wrist. Wearing a splint all day long while engaging in activities that make your pain worse may also be beneficial.
  • Changing your activities: If your job or hobby makes your symptoms worse, stopping or altering these activities can help reduce or stop the disease's course. In certain circumstances, this can mean changing your workspace or workstation.
  • Doing specific exercises: Exercises that enable the median nerve to move more freely within the carpal tunnel may be beneficial for certain patients. Your doctor or therapist could suggest a particular set of exercises.
  • Specific medication: Pain and inflammation can be reduced with the aid of anti-inflammatory drugs like ibuprofen and naproxen.
  • Steroid injections: Corticosteroid or cortisone is a powerful anti-drug that is injected into the carpal tunnel to help alleviate severe symptoms or lessen a symptom flare-up.

What are the surgical treatments for carpal tunnel syndrome?

There are two main surgical methods for Carpal Tunnel Syndrome treatment.

Open Carpal Tunnel Surgery

  1. A small incision is made on the palm of the affected hand to help observe the affected area.
  2. The doctor then separates the transverse carpal ligament, increasing the width of the tunnel in this way.
  3. There will be more room in the carpal tunnel and reduced strain on the median nerve after surgery, though the ligament slowly lengthens and regrows.

Endoscopic Carpal Tunnel Surgery

  1. Two small incisions or portals are made to observe the inside of your wrist and hand.
  2. An endoscope, or a miniature camera, is used to observe the tunnel.
  3. A specific knife is then used to sever the transverse carpal ligament.

Carpal Tunnel Syndrome Treatment without surgery

Apart from medicinal and surgical treatment, certain home remedies or self-care tips are also helpful in alleviating the symptoms of Carpal Tunnel Syndrome. Certain exercises and modifications in how you perform your daily routine may help ease and reduce symptoms.

However, untreated, Carpal Tunnel Syndrome is bound to progress and worsen. It is best to consult medical experts and know the risks involved.

What are the self-tips to reduce discomfort in carpal tunnel syndrome?

A few simple self-help tips to ease symptoms of carpal tunnel syndrome are:

  • Taking frequent breaks from repetitive tasks.
  • Stretching hands and wrists to improve blood flow.
  • Relaxing your grip.
  • Avoid activities that flex your hand
  • Keep your hands warm, especially while working.
  • Doing quick wrist exercises intermittently.

Which are the best medicines for Carpal Tunnel Syndrome?

The best medicines for Carpal Tunnel Syndrome treatment are anti-inflammatory antibiotics, such as Aspirin and Ibuprofen. This helps ease pain and reduce inflammation in the affected area.

Carpal Tunnel Syndrome Surgery

Surgery may be advised to stop permanent damage in circumstances when your thumb muscles are constantly fading away and numb for a long time. If non-operative therapies do not provide relief and/or testing shows severe nerve alterations, surgery may also be advised then.

A carpal tunnel release is the name of the surgical treatment used to treat carpal tunnel syndrome. Most surgeons carry out this procedure using any of the two surgical methods, but both aim to reduce the pressure on your median nerve by severing the ligament that forms the tunnel's roof. This widens the tunnel and reduces pressure on the median nerve, allowing for proper blood flow to the nerve and nerve function.

What is the success rate for carpal tunnel syndrome surgery?

With any condition, the chances of a high rate of success are higher in its early stages. Surgery for Carpal tunnel Syndrome has a comparatively high success rate of over 80%. The majority of the condition’s symptoms are reduced quickly, but gradually, after the surgery.

How long does it take to recover from Carpal Tunnel Syndrome?

The duration of the recovery period after surgery depends on the intensity of the condition before surgical intervention and other factors. The recovery may take anywhere from several weeks to months. However, most symptoms reduce to quite an extent after surgery. It is crucial to follow proper aftercare guidelines as well after Carpal Tunnel Syndrome surgery.

What is the price of Carpal Tunnel Syndrome treatments in India?

Based on numerous circumstances, including hospitalization costs, medical costs, etc., the typical cost of CTS release surgery is between Rs. 40,000 and Rs. 60,000.

Are the results of the Carpal Tunnel Syndrome treatment permanent?

If you undergo non-surgical treatment options, then the procedures will help bring about temporary relief from the inflammation and the pain. However, if you undergo Carpal Tunnel Release surgery, the condition will be treated effectively, though it might recur. Still, in some cases, patients have gained relief from all symptoms that still persist.

Who is eligible for the Carpal Tunnel Syndrome treatment?

Carpal Tunnel is a common hand condition with very straightforward treatment methods. The median nerve responsible for motor and nerve function in the palm, thumb, and middle three fingers, may get compressed and cause pain, numbness, and tingling. Everyone who suffers from this is eligible for Carpal Tunnel Syndrome treatment.

Who is not eligible for the Carpal Tunnel Syndrome treatment?

In its early stages, Carpal Tunnel Syndrome does not require surgical treatment.

What are the Carpal Tunnel Syndrome post-treatment guidelines?

After a Carpal Tunnel release, here are a few aftercare guidelines to follow.

  • Keep your wrist at an elevated angle for the first 24 hours.
  • Keep moving your fingers to aid recovery.
  • Take medication and painkillers as prescribed.
  • Avoid lifting things weighing more than 1kg for the initial two weeks after the procedure.
  • Slowly accustom yourself to doing heavier tasks gradually from 4 weeks after surgery.

What are the side effects of Carpal Tunnel Syndrome treatments?

There are relatively few side effects and non-surgical treatment is quite safe. If antibiotics are taken incorrectly, various negative effects might occur. Surgical operations may have a few side effects, such as fever, redness or bleeding from the incision, or increased pain around the incision.

Carpal Tunnel Syndrome - Outlook/Prognosis

Surgery will, for the vast majority of patients, reduce carpal tunnel syndrome symptoms. However, recovery could be sluggish, and it might take up to a year to fully recover.

Your recovery may be slowed if you have arthritis or tendinitis, two conditions that also can lead to pain or rigidity in your hand or wrist. Recovery will also take longer in situations of chronic carpal tunnel syndrome that include substantial sensory loss and/or muscular atrophy at the base of the thumb. These patients might not be able to make a full recovery and may have to seek physiotherapy for their hand muscles.

Frequently Asked Questions (FAQs)

What nerve is affected by carpal tunnel syndrome?

The median nerve in the wrist is affected and becomes compressed. It passes through the carpal tunnel and provides motor and sensory functions to the wrist.

How serious is carpal tunnel syndrome?

Carpal Tunnel Syndrome is a common condition that may be treated non-surgically in its early stages. However, it is a progressive condition that worsens over time. It is best to opt for surgical treatment if the condition is severe.

Does carpal tunnel syndrome go away?

After surgical treatment, for many patients, the symptoms of carpal tunnel syndrome have been relieved indefinitely. However, recovery is gradual and takes time anywhere from a few weeks to months.

Can a chiropractor help with carpal tunnel syndrome?

A chiropractor can help temporarily treat the symptoms of carpal tunnel syndrome. It is still best to look into surgical treatment for a more lasting solution.

Is carpal tunnel syndrome dangerous?

In its early stages, no, carpal tunnel syndrome is not dangerous if taken care of and treated. However, as it is a progressive condition, it is best to look out for signs and get diagnosed.

References

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Written ByDr. E. Logesh MSPT (Master of Physical Therapy),BPTh/BPTPhysiotherapy
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