Carpal tunnel syndrome

Carpal tunnel syndrome is a medical condition in which a compression in the median nerves is caused by work activities such as typing, playing that involves wrist movements, driving and sewing-like activities. Anatomically, the carpal tunnel is a narrow passage in the wrist bones and the median nerve is present inside this carpal tunnel. In case of extreme wrist movement without rest, the strain can cause compression in the median nerve which can cause carpal tunnel syndrome. With some of the lifestyle and work place modifications, carpal tunnel syndrome can be prevented easily. The carpal tunnel syndrome is also called entrapment neuropathy.

Causes of Carpal Tunnel Syndrome

The exact underlying neuropathology of the carpal tunnel syndrome is still unknown. But compression of the median nerve in the carpel tunnel is believed to be the cause of carpal tunnel syndrome. In some cases, irritated or inflamed tendonic ligaments can cause the symptoms of carpal tunnel syndrome. The activities that need extreme wrist movements such as playing tennis and shuttle cork, sewing, driving and typing can increase the incidence of this disorder.

Symptoms

• Numbness or tingling, pain-like sensation in the fingers, particularly in the thumb.
• Burning sensations
• Loss of grip strength
• Numbness
• Pain radiating to the other parts such as the elbow
• In the long-term, there will be muscle wasting (i.e.) abnormal loss of muscles in the affected area

Diagnosis

• Electrophysiological tests such as EMG
• Nerve Conduction velocity
• X-ray of the wrist
• Phalen’s test of the wrist
• Medical examinations and clinical correlation of the symptoms

Treatment Options

The treatment options are medications such as NSAIDS and corticosteroid injections in the affected area with supportive therapies such as wearing splints, hot and cold compression in the affected area. Surgical interventions are opted, if ligaments are involved. If the cause of this disorder is ligament compression on the median nerve, surgery is needed.

Prevention 

You can prevent the incidence of carpal tunnel syndrome by avoiding or reducing the number of wrist movements and the actions and by avoiding some of the sports activities that involve numerous wrist movements. Alternatively, you can use the wrist guards and supportive tools that are ergonomically designed to reduce the risk of wrist injury. Some of the commonly available Ergonomic aids such as split keyboards, keyboard trays, typing pads for computers and wrist braces while playing sports such as tennis and shuttle cork may be used to improve wrist posture. While using a computer or a typewriter, try to take frequent breaks and stop all the wrist moving activities immediately, if you experience tingling or pain. Avoiding sleep positions such as laying head on the wrist. 

Prognosis

The symptoms often improve with proper medical treatment and rest. But in more than 50% of the carpal tunnel syndrome patients’ surgical intervention is required. The recovery from this disorder and the surgical trauma may take some months but there will a complete cure. Hence the prognosis is usually good.

When to see a doctor

If you experience, numbness, pain or an abnormal loss of muscles/tissues from your fingers or if the symptoms get worsen, even after you took the medications, you need to consult a doctor right away.