One of the most common hand diseases that occurs due to pressure on the nerve (known as the median nerve) in the carpal tunnel of the wrist is called carpal tunnel syndrome. However, a narrow passageway surrounded by ligaments and bones on the palm side of the hand is called carpal tunnel. People with this syndrome usually experience the following symptoms such as numbness, weakness, and tingling that happens in the thumb and fingers. There are some factors that contribute to this condition. For example, wrist anatomy, certain health problems, and repetitive hand movements.
However, there are some treatments that may lessen numbness and tingling and restore hand function.
Symptoms
The symptoms caused by this condition usually begin gradually. For example:
- Numbness and tingling – These symptoms may occur in the fingers or the entire hand. However, it mostly affects the thumb, index, middle, and ring fingers. When they occur, you may feel a mild electric shock in the fingers listed above. In most cases, numbness and tingling of the fingers happen when you hold a steering wheel, phone, or newspaper. Sometimes, these feelings may spread to the arm.
- Weakness – Some people with this syndrome may experience weakness in the hand, which makes them drop objects. It is thought to occur due to numbness or weakness of the thumb’s muscles, also controlled by the median nerve.
If any of the carpal tunnel syndrome occurs, do not hesitate to visit a doctor for diagnosis and treatment.
Causes
The main cause of this condition is pressure on the median nerve.
However, this nerve begins in the forearm and goes through a passageway in the hand known as carpal tunnel. This nerve is responsible for sensations that we feel in the palm side, thumb, and fingers, except the little finger. Furthermore, the median nerve is also responsible for signals to move the muscles around the thumb (this movement is called motor function).
Anything that causes irritation or pressure on the median nerve may lead to carpal tunnel syndrome. For instance, a fracture of the wrist may narrow the carpal tunnel and cause irritation to the median nerve. However, carpal tunnel syndrome may occur due to certain health conditions that cause inflammation such as rheumatoid arthritis and others.
In most cases, this condition occurs due to multiple factors, or the cause cannot be identified.
Risk Factors
Physicians have determined some factors that may elevate your risk of developing carpal tunnel syndrome. Some of them do not directly cause the condition but may cause irritation to the median nerve. Check some of them below:
- Anatomical factors – The space between the carpal tunnel may become altered even due to a wrist fracture or dislocation. Furthermore, small bone changes or arthritis may cause problems with carpal tunnel and irritate the median nerve. Some people have this pathway narrowed, which may irritate this nerve.
- Sex – This syndrome happens more commonly in women than men because the carpal tunnel is smaller. Some females develop carpal tunnel syndrome due to hormone effects on the tendons in the carpal tunnel.
- Nerve conditions – There are some conditions that cause damage to multiple nerves (including the median nerve). For example, diabetes, autoimmune conditions, and others.
- Inflammatory conditions – These include rheumatoid arthritis, gout, and others that cause inflammation.
- Medications – Certain medicines are linked with carpal tunnel syndrome. For example, Anastrozole (a medicine used to treat breast cancer), oral anticoagulants, fluoroquinolone antibiotics, aromatase inhibitors, and beta-blockers.
- Obesity – Excessive body weight may increase the risk of carpal tunnel syndrome.
- Body fluid changes – Fluid buildup in the body may put extra pressure on the carpal tunnel and irritate the median nerve. It usually occurs during menopause or pregnancy. However, in most cases, the condition gets better right after pregnancy.
- Some diseases – There are some conditions that may cause damage to the carpal tunnel or irritate the median nerve. Examples include thyroid disorders, kidney failure, lymphedema, and others.
Workplace Factors
Those who work with vibrating tools or on an assembly line may put extra pressure on the carpal tunnel due to movements that require flexing the wrist. Furthermore, such work may worsen existing nerve damage. In any case, there is no research about these factors and carpal tunnel syndrome.
How to Prevent Carpal Tunnel Syndrome?
While there are no sure ways to prevent this syndrome, you may consider the following tips that will help to reduce stress on the hands and wrists as well. For example:
- Decrease the force and relax the grip – For instance, if you are working in places that involve a cash register or keyboard, try to hit the keys softly.
- Take frequent breaks – It is advised to bend and stretch the hands and wrists periodically, especially if you use tools or equipment that vibrates or requires a great amount of force.
- Improve posture – Sometimes, a wrong posture may cause irritation to the median nerve.
- Make sure that your computer mouse is comfortable and does not put extra pressure on the carpal tunnel.
- Keep the hands warm – Those who work or stay in cold environments for long periods may develop hand pain and stiffness. As a result, it puts extra pressure on the wrists, tendons, and hands.
Diagnosis
Physicians usually diagnose this condition by asking some questions about your symptoms and medical history. However, they may perform some tests to confirm the condition and rule out other diseases that may cause similar symptoms. Check below for some tests:
- History of symptoms – The pattern of the symptoms of carpal tunnel syndrome is important in diagnosis. For instance, the symptoms often happen while holding a phone, a newspaper, or gripping a steering wheel.
- A physical examination – During this procedure, doctors will test the feeling in the fingers and hand muscle strength.
- X-ray – This test is used to get detailed images of the hand and wrist to rule out other causes of the pain including fractures, arthritis, and others.
- Ultrasound – This test uses sound waves to get pictures of the wrists. These images may show the nerve that is compromised.
- Electromyography – This test involves a small needle electrode that is inserted into muscles to check the electrical activity when they contract and rest. Electromyography can identify damage to the muscles that are controlled by the nerve from the carpal tunnel.
- Nerve conduction study – This test can diagnose carpal tunnel syndrome and exclude other conditions that cause similar symptoms. It involves a small shock that is passed through the median nerve. If these impulses are slowed in the carpal tunnel, it means you have this condition.
Treatment
Generally, it is advised to treat the condition as soon as the symptoms appear because, in the early stages, you can easily lessen the symptoms by using the following tips. For example, take frequent breaks to rest the hands, do not engage in activities that may worsen the symptoms, and use cold packs to decrease inflammation.
When the disease advances, physicians usually recommend wrist splinting, medications, and surgery.
Therapies and Medicines
The following treatments are effective in people with early carpal tunnel syndrome and mild symptoms. For example:
- Wrist splinting – This treatment may lessen the numbness and tingling during sleep as well as daytime symptoms. It is an effective option for pregnant people because you do not need to take any medications.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – These include Ibuprofen, Naproxen sodium, Acetaminophen, and others. These medicines are used to reduce pain caused by this syndrome.
- Corticosteroids – This category of medicines is used to relieve pain and reduce inflammation and pressure on the median nerve. In most cases, doctors will inject a corticosteroid medicine (such as Cortisone) into the carpal tunnel.
People who experience this syndrome due to other health conditions (such as rheumatoid arthritis) require additional treatment for the underlying condition.
Surgery
This treatment option is recommended for people who do not respond to other treatments (such as therapies and medicines) and whose symptoms are severe. Check below for some surgeries used to treat carpal tunnel syndrome:
- Endoscopic surgery – During this procedure, surgeons use an endoscope to see inside the carpal tunnel. Thereafter, they will cut the ligament through one or two small incisions in the wrist or hand.
- Open surgery – During this surgery, doctors make a cut (an incision) in the hand palm over the carpal tunnel. Thereafter, surgeons cut through the ligament to free the nerve.
- Ultrasound-guided surgery – This treatment option is very similar to endoscopic surgery. The only difference is that the surgeons use ultrasound to see the nerve when cutting the ligament.
Home Remedies
If you cannot visit a doctor, the following tips may help temporarily relieve the symptoms. Examples include:
- Take frequent breaks from activities that require repeated movements
- Try to get and maintain a healthy weight
- Use over-the-counter (OTC) pain relievers, including Aspirin, Acetaminophen, Ibuprofen, and others
- Avoid sleeping on the hands
However, if pain, numbness, or weakness continue to occur, it is advised to visit a doctor.
Frequently Asked Questions
What are the causes of carpal tunnel syndrome?
- Thyroid disorders
- Autoimmune conditions (such as rheumatoid arthritis)
- Wrist or hand trauma
- Pregnancy
- Repetitive movements of the hand and wrist
What conditions are usually mistaken for carpal tunnel syndrome?
Sometimes, physicians may misdiagnose or mistake multiple conditions for carpal tunnel syndrome. Examples include:
- Tendonitis
- Arthritis (including rheumatoid arthritis, osteoarthritis, and others)
- Pinched nerves (also known as cervical radiculopathy)
- Ulnar neuropathy
- Thoracic outlet syndrome
What happens if carpal tunnel syndrome is not treated?
Those who ignore the symptoms and do not treat the condition may experience permanent damage to the median nerve and hand dysfunction. Check below for some symptoms of untreated carpal tunnel syndrome:
- Prolonged weakness in the thumb and fingers
- Loss of coordination in the fingers
- Difficulty performing daily tasks and moving the thumb
- Loss of motor skills
Ask your healthcare provider if you have additional questions.
