Carpal Tunnel Syndrome – Causes, Symptoms and Treatment

Carpal tunnel syndrome is a musculoskeletal condition that causes numbness, pain, and tingling in the wrist and hand. It occurs due to the increased pressure on the median nerve, which is located on the palm side of the hand. This nerve is responsible for providing sensation to the index finger, middle finger, thumb, and half of the ring finger. It usually does not affect the small finger (the pinky).

The syndrome was first recognized in the mid-1800s, and its first surgery took place in the 1930s. This condition has been treated by orthopedic surgeons for more than 40 years. 

What is the Carpal Tunnel? 

Basically, the carpal tunnel is a narrow canal in the wrist. This tunnel allows the median nerve and tendons to connect the forearm and hand, just like a tunnel you could travel through by car. The tunnel includes the following parts:

• Carpal Bones – These bones create the sides and bottom of the tunnel. They make a semi-circle in the wrist. 
• Ligament – This is responsible for holding the tunnel together as it is a strong tissue. 

The median nerve and tendons are located inside the tunnel. 

• Median Nerve – The median nerve boosts the strength of the thumb as well as the index finger. It provides sensation to all the fingers in the hand except the pinky finger. 
• Tendons – These make up a connection between the forearm and bones in hand. Tendons are the rope-like structures that allow the thumb and fingers to bend. 

Causes of Carpal Tunnel Syndrome 

The increased pressure on the median nerve and wrist causes pain in the carpal tunnel. Inflammation can cause swelling. The most common cause of this irritation is an underlying medical condition that causes swelling in the wrist and sometimes reduced blood flow. 

Some of the most common causes of carpal tunnel syndrome include:

• Thyroid dysfunction 
• Diabetes 
• High blood pressure 
• Fluid retention due to menopause or pregnancy 
• Fractures to the wrist
• Autoimmune disorders like rheumatoid arthritis 

The syndrome condition can worsen if the wrist is overstretched repeatedly. Repeated motion of the wrist leads to compression of the median nerve. It is maybe due to:

• Any repeated movement that overstretches your wrist, such as typing or playing the piano
• Positioning of your wrists while using a keyboard or mouse 
• Prolonged exposure to vibrations from using power tools or hand tools. 

Risk Factor for Carpal Tunnel Syndrome 

The carpal tunnel syndrome is diagnosed three times more in women than men. It is most frequently diagnosed in individuals ranging from age 30 to 60. Certain conditions increase the chances of having this syndrome, such as high blood pressure, diabetes, and arthritis. 

Lifestyle factors that increase the chances of this syndrome are high salt intake, smoking, high body mass index, and sedentary lifestyle. 

Following are the jobs that involve repetitive wrist movement:

• Keyboarding occupations 
• Manufacturing 
• Construction work
• Assembly occupations 

Individuals with these professions are more likely to develop carpal tunnel syndrome. 

Symptoms of Carpal Tunnel Syndrome

The signs are typically discovered along the nerve route due to median nerve compression. Your hand can frequently “fall asleep” and drop objects. Some common symptoms are: 

• Pain and burning that travels up your arm 
• Tingling, numbness, and pain in the first three fingers and thumb of your hand. 
• Weakness in the muscles of the hand 
• Wrist pain at night that interferes with sleep 

Treatments for Carpal Tunnel Syndrome 

The treatment for this syndrome includes both surgical and non-surgical options. If it’s diagnosed early, non-surgical is the best option. However, with severe pain, surgery is required to treat Carpal Tunnel Syndrome. 

Non-Surgical Treatments 

• Nonsteroidal Anti-inflammatory Drugs – Medications like Ibuprofen may relieve the pain for a short time. 
• Wrist Splinting – Nighttime wrist splinting can decrease symptoms drastically, especially for pregnant females. 
• Corticosteroids – A corticosteroid injection relieves inflammation, pain, and swelling, which will lead to reduced compression on the median nerve. 

Surgical Treatments 

• Open Surgery – It includes an incision in the palm of your hand, and cuts through the ligament to free the nerve. 
• Endoscopic Surgery – In this type of treatment, a telescope-like device with a tiny camera attached is used. It is known as an endoscope. Surgeons cut the ligament through one or two small incisions in your wrist or hand. 

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