Carpal tunnel syndrome is a nerve-related condition that causes pain and numbness in the wrist and hand. According to the National Institute of Neurological Disorders and Stroke (NINDS), stroke is three times more common in women than in men. It is primarily seen in adults, especially those who work in assembly-line type jobs. According to NINDS, such workers are three times more likely to develop carpal tunnel syndrome (CTS) than those who do desk jobs. More recently, research has found that the use of devices such as cell phones, game consoles, computers and tablets can also lead to carpal tunnel syndrome in students. According to the findings, published in the online edition of the journal Muscle & Nerve, young people who used electronic devices for an average of nine hours a day reported more wrist and hand pain than their peers who used such devices for fewer hours a day. This increases their risk of developing CTS. [Related: Too Much Technology Linked to Carpal Tunnel Syndrome]
CausesThe carpal tunnel is the passageway in the wrist joint that protects the median nerve (the main nerve in the hand), the flexor tendons that bend the fingers and thumb, and other soft tissues such as ligaments and blood vessels. According to the American Academy of Orthopaedic Surgeons (AAOS), carpal tunnel syndrome is when the tissue around the flexor tendons swells and presses on the median nerve. This pressure squeezes the nerve, causing pain associated with CTS.
Carpal tunnel syndrome can have multiple causes. According to the AAOS, the most likely cause is genetic. Some people have a small carpal tunnel, a trait that is prevalent in families. According to NINDS, other contributing factors include:
Trauma or injury to the wrist that causes swelling, such as a sprain or fracture of the pituitary glandOveractivityHypothyroidismRheumatoid arthritisWork-related stressRepeated use of vibrating hand tools during pregnancyFluid retention or the occurrence of cysts or tumors in menopauseCanalNINDS says there is very little clinical data demonstrating that, in the context of work or leisure activities, hand and repetitive and forceful movements of the wrist can lead to carpal tunnel syndrome. Repetitive motion at work or in sports has been linked to other conditions, such as bursitis and tendonitis. Repetitive activities can also lead to writer's cramp, or muscle spasms in the hand that make holding a pen or pencil difficult, says Dr. Cheryl Lieberman, an orthopedic surgeon of the hand and upper extremities.
SymptomsSymptoms of carpal tunnel syndrome usually begin with numbness or tingling at night and pain in the hand at Houston Methodist Hospital." Typically, patients wake up at night with these symptoms and have to shake their hands to relieve the pain. In an interview with Live Science magazine, Lieberman said these symptoms can progress to numbness, tingling and pain during the day. "Those who are affected by these symptoms should see a doctor." These sensations may occur when an individual is holding an object, such as a book. As the condition worsens, the pain may extend from the wrist all the way to the shoulder or hand." Lieberman says, "When carpal tunnel compression is severe, the patient's hand can begin to feel weak. Sometimes the pain can be misinterpreted as CTS. sprains, arthritis, and other problems can be the real cause of the pain, which makes it important to get a diagnosis from a professional.
Diagnosis and testing
Carpal tunnel syndrome is fairly common, affecting 4 to 10 million Americans, according to the American College of Rheumatology
To diagnose carpal tunnel syndrome, a doctor begins with a physical exam. After checking the feeling and strength in the hands, the doctor may want to perform additional tests to rule out any other conditions. According to John, these tests can include an electromyogram or a nerve conduction velocity test Hopkins.
Electromyography is also known as electromyography or EMG. This test measures the electrical output of a muscle. The doctor inserts a small needle into a specific muscle and this needle detects the electrical activity of the muscle.
A nerve conduction velocity study tests the speed of electrical impulses in a nerve. Two electrodes are placed on the surface of the skin and an electric shock is delivered to the nerve. The speed depends on how long the pulse takes to move between the electrodes. This test is also called an electro-neurography or EneG.
Treatment and medicationsFor people with mild carpal tunnel syndrome, surgery is usually not needed. According to the AAOS, CTS can get worse without some kind of treatment, but it can be stopped if caught early on.
Over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or NSAIDs (e.g., aspirin, ibuprofen, and diclofenac) can reduce the pain caused by inflammation. Doctors can also inject corticosteroids, such as prednisone, into the carpal tunnel to reduce pain.
If the underlying condition leads to carpal tunnel syndrome, treatment of this condition can often reduce carpal tunnel symptoms.
Severe cases may require surgery, but patients can try other treatments first." Dr. Nathan Wei, director of the Arthritis Treatment Center in Frederick, Maryland, told Live Science, "There are minimally invasive treatments, such as a needle-and-thread ultrasound-guided release, that are only available for one night's rest." . Surgical success rates are high, more than 90 percent, according to the Cleveland Clinic,
Surgical options include endoscopic surgery and open surgery, according to the Mayo Clinic. Endoscopic surgery involves making two small incisions in the ligament that compresses the nerve. Open surgery involves cutting the ligament with a large incision to open up the area,
and by itself, exercising the affected area is unlikely to relieve pain and should not replace other treatments, said Dr. Peter C. Amadio of the Mayo Clinic. Lieberman agrees, adding that exercises can even exacerbate symptoms." In particular, she says, "cycling and weight lifting puts pressure on the carpal tunnel and can worsen symptoms." I recommend using a splint at night to keep the wrist in a neutral position, which reduces pressure on the carpal tunnel.
Other forms of therapy, such as yoga, occupational therapy, and ultrasound therapy, can be integrated into a regular wellness program to help patients deal with the symptoms of carpal tunnel syndrome For the Mayo Clinic,
PreventionThere are several ways to reduce the risk of developing carpal tunnel syndrome. Here are some tips from the University of Maryland Medical Center:
Take breaks from activities that strain your wrist, and bend your wrist frequently. Adjust your work area to prevent stress on the joint. People who type as part of their occupation should keep their keyboards at elbow height or lower so their wrists are relaxed as they work. Pay attention to your posture while working. Keep your shoulders back to avoid tension in your neck and shoulder muscles, which can eventually lead to wrist and hand problems. Exercise your joints, which builds muscle and protects the carpal tunnel area from damage. Use appropriate force when performing tasks such as writing or typing. In other words, don't grip a pen tightly or hit the keys on a keyboard. This can put unnecessary stress on your wrists and hands. Using ergonomic tools reduces the stress on your joints.""This article is for informational purposes only and does not provide medical advice."
Additional Resources
Download a PDF with information on carpal tunnel syndrome from the National Institutes of Health.Watch the American Academy of Orthopaedic Surgeons' CTS video. National Institute of Neurological Disorders and Stroke Carpal Tunnel Syndrome Fact Sheet