What Is Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) affects the hand and arm, characterised by symptoms such as numbness, tingling, and pain. This condition arises due to the compression of the median nerve within the carpal tunnel, which is a narrow passageway located on the palm side of the wrist.
Anatomy of the Carpal Tunnel
The carpal tunnel is made up of wrist bones, known as carpal bones, at the bottom, and a tough band of tissue, known as the transverse carpal ligament, at the top. This tunnel contains the median nerve and the tendons that bend the fingers and thumb.
This nerve provides feeling to the palm side of the thumb and most fingers, and it also controls some thumb movements.
Since the carpal tunnel is so narrow, any swelling or tightness can press on the median nerve, leading to Carpal Tunnel Syndrome.
Causes and Risk Factors of Carpal Tunnel Syndrome
Several factors can contribute to the compression of the median nerve, including:
Anatomical factors: A smaller carpal tunnel can be a hereditary trait, making some individuals more prone to CTS. Wrist fractures or dislocations in that area can also increase the risk of developing CTS.
Repetitive use of the hand: Engaging in activities that involve frequent, repetitive wrist motion, can aggravate the tendons in the wrist and cause swelling.
Health conditions: Illnesses such as diabetes, rheumatoid arthritis, and thyroid gland imbalances can increase the risk of developing CTS due to their impact on the body’s tissues and the median nerve.
Pregnancy: Hormonal changes during pregnancy can cause swelling in the body, including the carpal tunnel, leading to increased pressure on the median nerve.
Symptoms of Carpal Tunnel Syndrome
The symptoms of CTS typically develop gradually over time.
Numbness, tingling, and pain: These sensations are often felt in the thumb, index, middle, and part of the ring finger. Some individuals may experience a sensation that feels like an electric shock in their fingers.
Weakness: People with CTS may experience weakness in their hands and a tendency to drop objects, due to a decrease in grip strength.
Muscle Atrophy: In severe cases, the muscles at the base of the thumb may waste away. This can lead to noticeable changes in the appearance of the hand and further diminish hand function.
Sensory Changes: Those with advanced CTS may lose the ability to differentiate between hot and cold by touch. This increases the risk of burns or injuries due to the inability to perceive temperature correctly.
These symptoms often appear during the night, as many people sleep with their wrists bent, which can exacerbate the pressure on the median nerve. Moving or shaking the hands upon waking up can help to relieve these symptoms.
Diagnosing Carpal Tunnel Syndrome
Diagnosing CTS involves a medical history review, physical examination, and specific diagnostic tests. The process aims to confirm the presence of CTS and rule out other conditions that may mimic its symptoms.
Medical History Review: The doctor will ask about symptoms, their onset, and any conditions that may contribute to them.
Physical Examination: This examination focuses on the hands, arms, shoulders, and neck to check for other possible causes of nerve pressure and assess signs of CTS.
Nerve Conduction Studies: These tests measure how electrical impulses move through the median nerve.
Electromyography (EMG): An EMG can detect abnormalities in muscle electrical activity and determine if muscle damage has occurred.
X-rays or Ultrasounds: Imaging tests may be used to exclude other causes of wrist pain, like arthritis or fractures, or to view the anatomy of the wrist.
Treatment Options
Treatment is aimed at relieving pressure on the median nerve and alleviating symptoms, with options ranging from non-surgical methods to surgery.
Non-Surgical Treatments
Wrist Splinting: Using a wrist splint at night can keep the wrist in a neutral position, alleviating symptoms of numbness and tingling.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs can offer pain relief but do not directly alleviate nerve compression.
Corticosteroid Injections: Injecting corticosteroids into the carpal tunnel can reduce inflammation and swelling, offering temporary relief from symptoms.
Surgical Treatments
Open Release Surgery: This traditional surgical approach involves making an incision in the wrist to cut the ligament that forms the roof of the carpal tunnel, thereby reducing pressure on the median nerve.
Endoscopic Surgery: Endoscopic surgery uses a tiny camera (endoscope) to guide the surgery through small incisions, allowing for potentially quicker recovery times and less post-operative discomfort.
The choice between non-surgical and surgical treatment options depends on the severity of the condition, the duration of symptoms, and the patient’s overall health status.
Conclusion
Carpal Tunnel Syndrome can significantly impact the quality of life by causing pain, numbness, and weakness in the hand and arm. However, with early diagnosis and appropriate treatment, individuals can manage symptoms effectively and restore normal function.
Ultimately, understanding this condition and its treatment options empowers individuals to make informed decisions about their health and seek timely intervention.
For personalised advice and treatment options for Carpal Tunnel Syndrome, contact Spire Hand & Upper Limb Centre today to schedule a consultation.