What Is the Carpal Tunnel Syndrome?

Carpal tunnel syndrome (CTS), also known as median nerve compression, is a condition that occurs when your median nerve is squeezed or compressed inside the carpal tunnel. This results in pain, tingling, and weakness in the hand and wrists. The median nerve provides sensation to the thumb, index, middle, and half of the ring finger without affecting the small finger.

The condition worsens with time, and if left untreated for an extended period, it might result in permanent hand dysfunction, weakness, and loss of sensation in the fingers. This is why it is essential to get an early diagnosis and treatment as soon as possible. When detected early, some of the following measures can help relieve early symptoms:

• A steroid injection to the carpal tunnel
• Nerve mobility exercises
• A splint is worn during sleep
• Limiting activity that worsens symptoms

To prevent worsening the symptoms and nerve damage, your doctor may recommend surgery to restore mobility, relieve symptoms and restore normal function.

Causes of Carpal Tunnel Syndrome

This condition is caused by excess pressure on your median nerve that leads to inflammation, swelling, and obstruction of blood flow, causing numbness, tingling, and pain in your hand and forearm. Factors that may cause median compression include:

• Repetitive and frequent small hand movements with your hands and wrist, such as playing the piano or typing over a long period.
• Frequent repetitive grasping movements with your hands, like those involved in particular sports or physical activities.
• Pregnancy. Hormonal changes during pregnancy can cause swelling that results in pressure on the nerves.
• Hereditary or family history with carpal tunnel syndrome.
• Health or nerve damage conditions such as hypothyroidism, diabetes, rheumatoid arthritis, and thyroid dysfunction.
• High blood pressure
• Medications such as the use of anastrozole (Arimidex)
• Wrist dislocation or fracture
• Tumors
• Infections

Carpal Tunnel Syndrome Signs and Symptoms

The symptoms are primarily along the nerve path; these include:

• Numbness, tingling, and pain in your thumb and the first three fingers worsen at night.
• Weakness in the hand muscles that results in dropping objects
• Pain and burning going through your arm
• Shock-like feelings in your fingers
• Wrist pain that interferes with sleep during the night

Carpal Tunnel Syndrome Diagnosis

Your health provider may ask you questions about your medical history and conduct various tests such as:

Physical examination
Your doctor will examine your hands, arms, and neck to rule out other conditions like an injury or arthritis. Much focus will be put on your hands and wrist to check signs of tenderness, swelling, warmth, discoloration, and feelings in your fingers.

Carpal Tunnel Diagnostic Tests

Tinel’s sign is a procedure that is used to identify carpal tunnel syndrome by tapping or pressing the median nerve in your wrist with a reflex hammer to see if you feel an electric shock sensation or tingling in your fingers.

Phalen’s Maneuver or wrist-flexion test involves flexing the back of your hands, wrist, and fingers downward for a short period to check if you get numbness or tingling in your fingers.

Two-Point Discrimination Tests are done using a 2-point disk criminatory to touch your skin and fingers to identify and figure out nerve function and compression.

The Nerve Conduction Velocity test is an effective method of checking carpal tunnel syndrome by sending a mild electric current down your median nerve to measure the speed of the electrical signal. A slow speed signal indicates more damage to your median nerve.

Electromyogram measure the tiny electrical discharges produced in muscles and can identify the damage to the muscles controlled by the median nerve.

Your doctor may order imaging tests like:
Ultrasound and MRI will show a swollen or compressed median nerve.

X-ray to check the wrist and exclude other medical conditions like arthritis and fracture.

Carpal Tunnel Syndrome Treatment

Mild to moderate symptoms that come and go in less than ten months can be treated with conservative treatments such as:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) medications such as ibuprofen for inflammation and pain relief.
• Steroid injection relieves symptoms.
• Wear a brace or splint at night to prevent bending your wrist while you sleep.
• Modifying work activities to slow or stop the progression of the disease.
• Changing your activities by not keeping your hand in the same position for an extended period.
• Your doctor may recommend nerve gliding exercises to relieve the median nerve.
• Corticosteroid injection relieves pain and decreases inflammation and swelling.

Surgery is recommended when the condition is severe and nonsurgical options are not relieving your symptoms.

Prevention

You can minimize and ease pressure on your wrist by these methods:

• Take short, frequent breaks to stretch, bend hands and wrist periodically
• Improve your posture to avoid compressing the nerves in other areas of your body.
• Avoid bending your wrist all the way up or down; keep your keyboard at elbow height or slightly lower
• Ensure your computer mouse is comfortable and not strenuous to your wrist.