Carpal Tunnel Syndrome
Carpal Tunnel Syndrome (CTS) begins in a subtle fashion—a little tingling sensation in the fingers, numbness upon awakening, or a wrist pain that resolves with computer typing. However, what initially appears to be a minor annoyance will develop into a persistent, tingling issue that interferes with normal functioning. CTS results from the median nerve running through a narrowed tunnel in the wrist—the Carpal Tunnel—where it becomes inflamed or compressed. The median nerve is responsible for controlling the motor and sensory functions of the hand and fingers.
CTS is more than an acquired pain syndrome, but rather a symptom that something is stressing the mechanics of the wrist. It is also the leading nerve disorder in adults who perform repetitive hand tasks. Rest and ergonomic adjustments can help treat CTS if detected early, but if left untreated, permanent damage and loss of function can occur. Familiarity with its signs, etiology, and therapy could be the key to maintaining healthy hands.
Early Warning Signs that Should Not be Ignored
Symptoms and signs of Carpal Tunnel Syndrome can progress insidiously, unrecognized, until they reach the stage when performance in activities of daily living is impaired. The initial symptom is paresthesia or tingling of the fingers, often the thumb, index finger, and middle finger. The symptoms intensify at night or early morning. The patient feels a “pins and needles” sensation. Others feel that their grip is failing or that things are spilling more frequently than previously.
More commonly, pain originates in the dominant hand and interferes with fine motor skills, such as typing, buttoning a shirt, or grasping a pen. If the nerve is chronically pinched and left undiagnosed, symptoms persist for an extended period, and muscle weakness ensues.
Why It Happens
CTS occurs when the soft tissues around the median nerve swell, compressing it. The mild inflammation of the fixed, narrow carpal tunnel results in severe symptoms. The most frequent reason is the repetition of hand movements.
Other causes are wrist injury, arthritis, and other illnesses like diabetes or hypothyroidism. Water retention due to hormonal shifts during pregnancy or menopause can also compress nerves, leading to discomfort. Heredity is also a factor—the Carpal Tunnel is smaller in some people by birth, and therefore, they are predisposed to it.
Benefits
Certain risk factors increase the likelihood:
Repetitive use of the hands: continuous movement of the wrist leads to fatigue, tendon compression, and narrowing of the tunnel.
- Wrist anatomy: In some, a naturally narrowed bone channel or tunnel exists, making them susceptible to it.
- Chronic illness: Diabetes and thyroid disease are more likely to cause nerve damage.
- Inflammatory disorders: Rheumatoid arthritis or another form of arthritis might result in inflammation that presses on the tunnel.
- Sex and age: CTS is more frequent in women, possibly due to the tighter wrist area. It is most frequent between the ages of 30 and 60.
How It's Diagnosed
Diagnosis of CTS is established by careful patient history and clinical testing. A physician will inquire about whether all or just certain fingers are numb, as this would help rule out CTS from other illnesses affecting the nerves.
To establish the diagnosis, electromyography and nerve conduction studies are typically used. These tests measure the electrical activity of nerves and muscles, providing information on the site and extent of the compression. Ultrasound or an MRI scan may be used to rule out other causes of wrist pain or nerve dysfunction.
Treatment Options: Lifestyle Changes to Surgery
Treatment for Carpal Tunnel Syndrome varies with the severity and extent of symptoms. Non-surgical interventions are most effective when implemented early in treatment. These include:
- Wearing a wrist splint to immobilize the wrist in a neutral position.
- Restraint of habitual hand movement or fragmentation frequently.
- Control of anti-inflammatory medication like ibuprofen.
- Application of ice packs externally over the involved area to decrease swelling and alleviate pain.
If symptoms persist, corticosteroid injections are performed to reduce the swelling. Carpal Tunnel release is considered if other non-surgical treatments fail or if nerve damage progresses. It is done by incising the ligament, which compresses the median nerve, thereby decompressing the nerve. Most are ambulatory procedures, and most patients return to their regular activities after the procedure is completed.
In-the-Home Lifestyle Changes That Work
Preventing or slowing the progression of Carpal Tunnel Syndrome typically involves changing habits. Workstation ergonomic adjustments can decrease tension. Stretches involving the hands and wrists can lead to flexibility. For patients with pre-existing medical conditions like diabetes or arthritis, condition control prevents CTS.
Additionally, avoiding activities that require prolonged grip or learning to switch tasks more frequently throughout the day can help decrease repetitive stress on the wrist.
When to Make the First Move Towards Help
You don’t have to wait until the pain becomes so excruciating you can’t stand it anymore to find relief for Carpal Tunnel Syndrome. If you roll over one morning and have numb fingers, discover weakness in your fingers, or can’t do the simple things of daily life as easily as you could before, then it is time to take action. Early diagnosis and treatment are crucial for preventing lasting damage and maintaining healthy hands.
Don't Let the Pain Get the Best of You
Carpal Tunnel Syndrome can significantly impact your daily life, potentially disrupting your work, sleep, and leisure time.
We never dismiss your symptoms; instead, we develop a care plan tailored precisely to your needs. From a straightforward wrist splint to testing and investigating surgical options, our team will guide you through each step with care and expertise.
To schedule an appointment, please call (914) 816-1941 or email us at info@chesterneurology.com
