Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome (CTS) is a medical condition that occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed at the wrist. This condition leads to symptoms such as pain, numbness, and tingling in the hand and arm.

Anatomy and Pathophysiology

The carpal tunnel is a narrow passageway located on the palm side of the wrist. It is bounded by bones and ligaments. The median nerve, along with several tendons, passes through this tunnel. When the tunnel becomes narrowed or when tissues surrounding the flexor tendons swell, they can press on the median nerve, causing the symptoms of Carpal Tunnel Syndrome.

Median Nerve

The median nerve is responsible for sensation in the thumb, index finger, middle finger, and part of the ring finger. It also controls some of the muscles at the base of the thumb.

Causes

Several factors can contribute to the development of Carpal Tunnel Syndrome:

• Repetitive Hand Use: Activities that involve repetitive wrist movements can aggravate the tendons in the wrist, leading to swelling.
• Wrist Anatomy: Some individuals have a smaller carpal tunnel, which can predispose them to CTS.
• Health Conditions: Conditions such as diabetes, rheumatoid arthritis, and thyroid gland imbalance can increase the risk of CTS.
• Pregnancy: Hormonal changes during pregnancy can cause swelling, which may lead to CTS.

Symptoms

The symptoms of Carpal Tunnel Syndrome usually start gradually and include:

• Tingling or numbness in the fingers or hand, especially the thumb, index, middle, and ring fingers.
• Pain or discomfort in the wrist and palm.
• Weakness in the hand and a tendency to drop objects.

Diagnosis

Diagnosis of Carpal Tunnel Syndrome is based on the patient's history, physical examination, and sometimes additional tests such as:

• Nerve Conduction Studies: These tests measure the electrical impulses in the median nerve and the speed at which they travel.
• Electromyography (EMG): This test measures the electrical activity in muscles.
• Ultrasound or MRI: Imaging tests can help visualize the structure of the carpal tunnel.

Treatment

Treatment for Carpal Tunnel Syndrome depends on the severity of the condition and may include:

• Wrist Splinting: Wearing a splint at night can help relieve symptoms.
• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): These can help reduce pain and inflammation.
• Corticosteroid Injections: These can reduce inflammation and swelling.
• Surgery: In severe cases, a procedure called carpal tunnel release may be performed to relieve pressure on the median nerve.

Prevention

Preventive measures for Carpal Tunnel Syndrome include:

• Taking frequent breaks from repetitive tasks.
• Performing stretching exercises.
• Maintaining a neutral wrist position.
• Using ergonomic tools and equipment.

Also see

• Median nerve
• Repetitive strain injury
• Peripheral neuropathy
• Rheumatoid arthritis