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HomeHealth A-Z Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
The most common cause of carpal tunnel syndrome is repeated motion of the hands, such as the repetitive motions when using a computer.

Carpal Tunnel Syndrome

Definition of Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a condition caused by the compression of the median nerve at the wrist, causing pain, tingling, and numbness in the hand, thumb, and fingers.

Description of Carpal Tunnel Syndrome

Carpal tunnel syndrome, also known as CTS, is a painful medical condition. The condition is one in which the median nerve becomes compressed in the wrist. This compression in the wrist generally causes pain, parethesias, as well as muscle weakness not only in the wrist but in the forearm as well as in the hand. Carpal tunnel syndrome can occur at any age, at any time, though it is most commonly diagnosed during middle age and is more common in women than it is in men. It’s thought that more than 10% of the population is at risk of developing carpal tunnel syndrome.

Carpal tunnel syndrome became well known to doctors as well as patients in the ‘90s because of so many people complaining of pain in the wrist. It’s thought the increased number of individuals that work in offices and the like has made the disease more common, allowing it to become better known to the general public. It’s important to note that all wrist pain is not associated with carpal tunnel syndrome; in fact there are many other diseases that can cause similar pain and problems, which is why many other conditions are often misdiagnosed as carpal tunnel syndrome.

To understand carpal tunnel syndrome you have to understand the anatomy of the wrist. The median nerve passes through what is called the carpal tunnel, which is a canal in the wrist that is surrounded by bone on three sides and by fibrous layers on the fourth side. Not only the nerve passes through this canal, there are also nine different tendons that pass through. What can happen is the median nerve can become compressed if the size of the canal decreases or if the tendons and tissues become swollen for any reason. When someone bends their wrist this causes the size of the canal to decrease and this is often when pain is felt.

Causes and Risk Factors of Carpal Tunnel Syndrome

The most common cause of carpal tunnel syndrome is repeated motion of the hands, such as the repetitive motions when using a computer. Using a computer occasionally is not enough to cause the disease from developing, but using a computer every day for extended periods of time can cause the disease. Those that have a history of the disease in their family are more likely to develop the disease, especially if they have aggravating factors such as using a computer, using sign language, or other repetitive hand motions that can cause stress on the carpal tunnel. While repetitive hand motions are often thought to be the primary cause of the disease, the fact is that a family history of carpal tunnel syndrome is a better indicator that one may develop the disease than increased use of the hands.

Symptoms of Carpal Tunnel Syndrome

The symptoms of carpal tunnel syndrome usually appear gradually, and the intensity of the symptoms usually progresses over time. The first symptoms of carpal tunnel syndrome usually occur while the patient is sleeping and the noticeable symptoms are numbness in the hand, wrist, and forearm. In addition the patient may notice a burning or tingling in the area, especially in the areas of the thumb, the index finger, and the middle finger. The symptoms usually occur at night because of the tendency to sleep with the wrists bent, aggravating the compression of the median nerve.

Next, the symptoms may appear during the day time hours. The first symptoms are usually problems with gripping items, having a hard time making a fist, you may begin dropping items, and you will generally just feel weakness in the hand, wrist, and forearm. The increased tingling and burning sensations are often blamed on problems with circulation or having the arm or hand “fall asleep.” The thing that sets carpal tunnel syndrome apart from simply a hand that falls asleep is that there is pain, gripping problems, and this is in addition to the numbness and burning that become more and more noticeable.

Diagnosis of Carpal Tunnel Syndrome

Diagnosing carpal tunnel syndrome is done by a simple clinical exam. There are a couple basic exams that can be used to diagnose the condition and those are Phalen’s maneuver and the Tinel’s sign. Phalen’s maneuver is easy to perform as all that needs to be done is to flex the wrist as far as possible and then holding the wrist in this position until the symptoms begin to appear. The faster the symptoms begin to appear the more advanced the condition is thought to be.

The Tinel’s sign is a less specific test but is a classic way to diagnose carpal tunnel syndrome. All that needs to be done for this test is to tap on the area over the nerve to see if it will create the pins and needles type feeling that patients experience when they do have carpal tunnel syndrome. This test is often used on conjunction with Phalen’s maneuver for a firm diagnosis.

Treatment of Carpal Tunnel Syndrome

The treatment of carpal tunnel syndrome is not universal because each individual has different needs and different levels of pain associated with the disease. Some of the most common treatments are immobilizing braces that can keep the wrists straight to avoid inflaming or compressing the median nerve. These braces should be worn at night to avoid bending the wrists while sleeping. Many people also find that taking anti-inflammatory medication helps with the pain. For those that don’t find any relief from braces and splints, open hand surgery is often very helpful, though the recovery can be painful and quite lengthy. The treatment options are out there and each patient needs to discuss the best options for them with their doctor.

Prevention of Carpal Tunnel Syndrome

Preventing carpal tunnel syndrome can be as simple as knowing that you have a pre-disposition for the disease and ensuring that you take care of your carpal tunnel. Anyone that is involved in repetitive hand motions should try to take frequent breaks from their work, such as computer use. If you have a hard time breaking away from the computer you can actually buy programs that will remind you that it is time to take a break.

Related Articles

Carpal Tunnel Syndrome, by E. Gene Deune, MD

External Resources

National Institutes of Health

American Association of Neurological Surgeons

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