Carpal Tunnel Syndrome

CARPAL TUNNEL SYNDROME pain

Last Updated December 20th, 2021

Overview

Loss of sensory function can occur in a number of ways but the direct cause is usually damage or disturbance to the nerves responsible for sensation in a particular area. This normally occurs as a result of degenerative diseases, injury, infections or nutritional deficiencies. In the case of the median nerve, which is one of the main nerves responsible for sensation in the forearm and hand, one of the most common disturbances occurs in the form of carpal tunnel syndrome (CTS). As it traverses the length of the arm and passes into the hand, the median nerve must travel through a passage in the wrist known as the carpal tunnel.

When, for a variety of possible reasons, space within the carpal tunnel becomes restricted, a pressure is exerted on this crucial nerve and the patient experiences numbness, pain or loss of motor function in the hand. In severe cases, there can be permanent nerve and muscle damage. Surgical treatment, known as ‘carpal tunnel release’ may be recommended in order to remove the obstruction that is responsible for compression of the median nerve.

 

What is carpal tunnel syndrome?

CARPAL TUNNELCarpal tunnel syndrome (CTS) is a kind of peripheral neuropathy or a condition involving impairment in the functioning of a nerve of the peripheral nervous system. CTS affects the median nerve which is one of the major nerves responsible for sensation and motor function in the hand. ‘Carpal tunnel’ is the name given to the narrow passageway in the wrist through which the median nerve and nine flexor tendons must pass. This space is bounded by the carpal bones of the wrist, with a tough band of connective tissue (transverse carpal ligament) forming the roof of the ‘tunnel’.

Sometimes, the transverse ligament or the lining of the tendons swell within this constricted space, pinching or compressing the median nerve. This interrupts the flow of blood supply to the nerve and affects its normal functioning which results in loss of sensory and motor function in the hand.

 

Causes of carpal tunnel syndrome

The median nerve may become trapped or compressed in a number of ways. The biological causes for this are not well understood although it is acknowledged that genetic predisposition is likely to play a role. Other underlying disorders can also be responsible.

  • Injury, such as fracture of the wrist bones or a sprain.
  • Hypertension.
  • Hormonal changes associated with pregnancy or menopause.
  • Having a family history of CTS raises the likelihood of developing this condition. For instance, some families may display a hereditary trait of having narrow wrists.
  • Performing repetitive tasks involving the use of violently vibrating tools such as jackhammers or chainsaws. Any activity that exerts repeated pressures and excessive force on the hands and wrist can lead to CTS over the long term.
  • Maintaining poor wrist posture over extended periods of time.
  • Medical disorders such as rheumatoid arthritis, thyroid dysfunction, and diabetes can also be responsible.
  • An abnormal growth in the carpal tunnel, such as a calcium deposit, cyst or tumor.
  • The risk of developing CTS increases with age.
  • Being overweight or obese can also lead to CTS.
  • Smoking is another risk factor.

 

Symptoms and signs

CARPAL TUNNEL SYNDROME painThe signs of CTS develop slowly and eventually grow in intensity as the condition worsens. Those who suffer from CTS commonly experience the following symptoms which are typical of disturbance to the motor and sensory function:

  • Pain, ranging from mild to severe. It usually occurs in the fingers but may also radiate up into the arm.
  • A burning or itching sensation in the fingers other than the little finger.
  • Numbness or intermittent loss of feeling in the hand.
  • Sharp shockwave like sensations, particularly in the fingers other than the little finger.
  • Inability to maintain firm or precise grip.
  • Weakness in the hand.
  • Inability to detect the difference between hot or cold objects by touch.

 

The two types of carpal tunnel syndrome

There are two main types of carpal tunnel syndrome:

  • Acute CTS: This form is relatively less common. It is generally associated with trauma such as fracture of the distal radius.
  • Chronic CTS: This is encountered more frequently and is generally characterized by a slower onset of symptoms.

 

Possible complications

Initially, the symptoms are intermittent. However, if the pressure constricting the median nerve remains unrelieved, its protective sheath can wear away. This can cause permanent nerve damage. Muscles in the hand, particularly the muscle located at the base of the thumb, can atrophy and shrink noticeably. Thus, permanent loss of muscular and nerve function in the hand is possible in severe cases of CTS.

 

Diagnosing carpal tunnel syndrome

CARPAL TUNNEL SYNDROME splintPhysical examination is the necessary first step in detecting carpal tunnel syndrome. The physician will generally perform what is known as the Tinel test by lightly tapping on the area above the nerve to check for signs of tingling. The patient may also be asked to keep the wrists flexed or bent for some time to check whether this results in numbness or tingling. Thumb grip is also assessed to look for signs of weakness in the muscles at its base.

The median nerve does not service the little finger. Hence, any such symptoms also appearing in that finger would most likely rule out CTS. X-rays help to detect any fractures or ligament injuries that may be responsible. An ultrasound or magnetic resonance imaging (MRI) may also be recommended. Electromyography tests are helpful in assessing muscular responses. Assessing nerve conductivity may also require further test procedures. Compromised nerve or muscle function, combined with other symptoms and a relevant medical history must all be considered in order to make a definite diagnosis.

 

Treatment and prevention

Treatment 

Medication 

  • Splints – Wearing a splint at night is the best way to avoid pain related to carpal tunnel syndrome. These splints hold the patient’s wrist in place and make sure that there is no additional or excessive strain on the median nerve.
  • Nonsteroidal anti-inflammatory drugs – These medications are prescribed to reduce inflammation and pain in the wrist.
  • Corticosteroids – These are injected and not given orally to the patent. These medications help in reducing pain and inflammation.

Surgery 

  • Endoscopy – Here the surgeon uses an endoscope (a tube with a camera in the front) to see the condition of the median nerve.
  • Open surgery – Here, the surgeon will make an incision in the patient’s palm and cut through the ligament, reaching the median nerve and relieving the compression on the nerve.

Prevention 

  • Avoid putting a strain on your wrists.
  • Take breaks, this helps in giving your wrists some rest.
  • Do mild exercises, to help relieve the soreness in your wrists.
  • Do not expose your hands to extreme temperature; make sure to keep them warm.

 

Dos and Don'ts

Dos
  • Go for check-ups if you have the slightest pain in your wrist, this could be an indication that your condition is getting worse.
  • Go for regular physiotherapy, this helps in treating the condition.
  • Give the affected hand rest, straining the affected hand can cause more pain and aggravate the symptoms.
Don'ts
  • Take any pain in your arms lightly; it can lead to severe problems.
  • Indulge in any strenuous activities, this can cause more problems along with CTS such as muscle tear, tendon tear etc.
  • Forget to put a splint on your wrist before going to sleep, as you can move your wrist in to a position that can cause you more pain in the morning.

 

 

 

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Lipoprotein (A) Test Lipoprotein (A) test is used to measure and monitor the levels of LDL(Low-Density Lipoprotein) in the bloodstream in…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
PREGNANCY
Pregnancy During pregnancy, the body undergoes a number of biological and physical changes to accommodate and provide for the…
Vitamin b12
Vitamin B12 Test Vitamin b12 is an essential nutrient required for healthy functioning of the nervous system and also development of…
Gua sha: Scraping away layers of pain with this ancient healing tool Gua sha is an ancient oriental healing method which focuses on scraping the body with specific tools to…
Helicobacter pylori IGA
Helicobacter Pylori – IgA Test The H.pylori IgA test is a blood test used to identify the level of IgA antigen in the…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
Threatened abortion
A few facts about threatened abortion A threatened miscarriage indicates an early pregnancy loss. Look out for symptoms like bleeding, vaginal discharge, and pain.
blood ketone test
Blood Ketone (D3HB) Test The Blood Ketone Test measures and monitors the levels of ketone in the blood which is usually performed…
Astaxanthin: Why experts believe it could be 550x more potent than vitamin E! What is astaxanthin and why is this new supplement on the block touted as the most powerful antioxidant…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
amylase test
Amylase Test Amylase test is done by checking the level of this protein in the blood sample and also in…
tonometry
Tonometry Tonometry uses a device called tonometer to measure the pressure inside the eye. This pressure is depends upon…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
piles
Best treatment for piles in Bangalore All you need to know about piles and piles treatment in Bangalore - the types of treatment available,…
Is bronchitis contagious? And how to prevent this infection? It is acute bronchitis that is contagious which means you can contract it from another person or you…
fitness routine fun
10 fantastic ways to make your fitness routine more fun! Are you too bored to exercise? Do you avoid gym cause it's too monotonous? Looking for fun and…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
creatinine
Creatinine Test The level of creatinine in the blood is a significant indicator of the health of your kidneys. This…
Carb Cycling: Weighing the pros vs the cons of this diet routine Completely discarding carbs from your life will do you more harm than good. Read more about carb cycling,…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
immunoglobulin M
Immunoglobulin M Test Immunoglobulin M is the largest and the first produced antibody which helps in the prevention or fighting of…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
Exercises or diet? Find out the healthiest way to gain weight Tired of being called skinny all the time? Looking for healthy ways to beef up? Why not try…
labiaplasty
Labiaplasty Labiaplasty is a surgical procedure to modify the labia minora and the labia majora. Learn about who can…
kidney stones
Kidney stones Kidney stones are solid substances made up of crystals. They can be of various sizes. Treatment depend on…
castor oil hair
Castor oil : A vitamin-rich oil for shiny locks and healthy bowels Castor oil bestows unlimited benefits, whether you use it for your hair or skin. But did you know…
stress depressed anxiety
Are you depressed or just stressed? Know when to see a doctor Why are some people more anxious than others? Is being depressed the same as feeling sad? Have you…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
colposcopy
Colposcopy Colposcopy is a simple, quick and non- invasive diagnostic tool to look closely inside the vulva, vagina, and…
free testosterone test
Free testosterone Free Testosterone Test measures and monitors the level of the free testosterone in the blood. Less than 4%…
toxo gondii igm test
Toxo Gondii-IgM Test The toxo gondii IgM test is a blood test that tells the presence or absence of toxoplasmosis IgM…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
Crossfit with rope
CrossFit: Now get the perfectly sculpted body with this explosive gym routine CrossFit is a fitness regimen that makes use of high-intensity exercises in a shorter period to achieve muscle…
Is it possible to achieve full body detox with Master Cleanse? Master cleanse is a diet consisting of a lemonade based beverage, a salt water drink and a herbal…
Bloodtestalbumin
Albumin Test Albumin test or blood serum test is a liver function test that measures the amount of the protein…
Hymenoplasty
Hymenoplasty Read on to find out all about hymenoplasty, the procedure, post-surgery care, the risks, and the benefits.
eating disorder anorexia
Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Goji berry: A traditional Chinese berry that packs the best of antioxidants Goji berry is an ancient berry that is considered to be power-packed with nutrients and antioxidants. Which means…

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