What Is Carpal Tunnel Syndrome? Symptoms, Diagnosis and Treatment
Around our wrist is a band of fibrous tissue that lends support for the joint between the hand and the forearm. The small space between this band and the wrist bone is what is referred to as the carpal tunnel. An important nerve passes through this tunnel, the median nerve, which connects to the thumb and fingers of the hand. The condition called carpal tunnel syndrome specifically refers to irritation of the median nerve.
Carpal tunnel syndrome is usually caused by tendon inflammation due to repetitive actions, such as long hours of typing. However, the condition may also be brought about by obesity, pregnancy, arthritis, trauma, and any other condition that causes undue pressure on the median nerve passing through the carpal tunnel. In rare cases, substances accumulate around the carpal tunnel due to diseases such as amyloidosis and leukemia.
The first symptoms of carpal tunnel syndrome are feelings of numbness and a tingling sensation on the thumb and first three fingers. The symptoms are usually more acutely felt while sleeping at night, especially for people who sleep with flexed wrists, and among those who experience water retention around the wrist when the hand lies flat for a prolonged time.
The condition may either be temporary and resolve on its own, or become chronic. In chronic cases, the patient usually experiences cramping, a burning sensation or weakness in the hand. The pain can radiate up to the forearm. It can potentially lead to muscle atrophy between the thumb and the palm.
Diagnosis of carpal tunnel syndrome includes ruling out other conditions with similar symptoms, such as conditions involving the neck, shoulder, elbow, and reflexes. To do this, an electromyogram is conducted on the muscles of the arms. A nerve conduction velocity test may also be performed to find out if electric impulses are traveling at a normal rate down the median nerve. A physician may also try to reproduce the symptoms of the condition by bending the wrist forward. X-rays of the wrists may be taken to find out if there are any abnormalities in the wrist bones.
There are varied treatment modalities for carpal tunnel syndrome. The choice of treatment would largely depend on how severe the particular condition is, and on whether there are underlying causes. Usually, the initial approach is to give the wrist sustained rest. A splint may be used to make sure that the wrist is not moved. Ice is applied if there are symptoms of swelling. For cases due to repetitive actions, the patient is advised to change his activities. Ergonomic devices for typing are recommended.
Medications for reducing the symptoms include non-steroidal anti-inflammatory drugs and corticosteroids. The side effects of these medications are usually minimal if given for a short period of time only. Vitamin B6 or pyridoxine has been positively correlated to relief of some symptoms.
In cases where there is a pronounced risk for permanent nerve and muscle damage, surgery may be the last resort. The band of tissue around the wrist is severed to lessen the pressure on the median nerve. Patients usually undergo post-surgical exercise rehabilitation after this procedure.