Carpal Tunnel Syndrome
Carpal tunnel syndrome refers to the compression of the median nerve within the wrist that causes pain and dysfunction. The median nerve, along with flexor tendons (connective tissue that attaches muscles to bones), sits inside the carpal tunnel. This nerve provides sensation to the thumb and fingers and helps to move the hand. When the surrounding tissues become inflamed, they squeeze the nerve and tendons tightly within the carpal tunnel. Carpal tunnel syndrome commonly affects women between 30 and 60 years of age. Causes may include wrist injuries like bone fractures, sprains or strains; repetitive movements like typing, sewing, driving, or writing; and inflammation from arthritis. Risk factors that may contribute include certain jobs (computer workers, cashiers, musicians); conditions with hormonal changes (pregnancy, premenstrual syndrome, menopause); and certain disease processes (diabetes, high blood pressure, kidney disease, hypothyroidism, blood disorders and obesity).
Symptoms may include:
- Numbness, tingling and weakness of hand, fingers, palm and wrist
- Severe forearm pain that starts at the wrist and spreads to the shoulder (common at night)
- Stiff and painful joints
- Inability to make a fist and cramps in the hand and fingers
- Decreased sensation or loss of sensation in the hand or fingers
- Inability to perform fine finger movements
What your doctor can do:
- Diagnose the disease by asking about your symptoms, doing a physical exam, and ordering x-rays of the wrist.
- Check your thyroid status with an exam and blood work
- Order tests that evaluate the electrical impulses and conduction of the median nerve.
- Provide a splint to support the wrist and limit movement.
- Prescribe non-steroidal anti-inflammatory medications to reduce the tissue swelling and diuretics to empty excess fluid from body tissues.
- Inject corticosteroid medication into the carpal tunnel space to reduce the inflammation.
- Recommend surgery to release the trapped median nerve.
What you can do:
- Rest your wrist and wear the splints, especially at night.
- Exercise the wrist joint by dangling your arms, shaking the wrist, and rubbing your hand.
- Take the anti-inflammatory medication as directed by your doctor.
- Apply hot or cold compresses to the affected area to reduce discomfort.
- Adjust the height of your chair to your desk, use computer keyboard support pads, and take breaks at least once an hour while performing repetitive tasks.
- Take 50-100 mg a day of vitamin B6 for several weeks. Approximately 50% of those with CTS will improve with B6 therapy
What you can expect:
- Most people improve with conservative treatment or surgery.
- If pregnancy is the cause, the delivery of the baby generally “cures” the condition.
- Some complications may include permanent nerve damage and muscle wasting that leads to numbness, weakness and paralysis of the affected wrist.
Contact your doctor if you develop symptoms of carpal tunnel syndrome or if the symptoms persist for more than 2 weeks.