Could It Be Carpal Tunnel Syndrome?
Carpal tunnel syndrome (CTS) is a common cause of hand numbness and pain. The carpal tunnel is a narrow passage that traverses from the wrist deep in to the palm of the hand. The symptoms result from compression of a nerve (median nerve) that lies within the carpal tunnel. When the nerve gets compressed. there is numbness or tingling of the thumb, index finger, middle finger and part of the ring finger. One may also experience weakness and pain in the hand, wrist, or forearm.
The symptoms usually me and go in the beginning stages but as the severity increases, numbness or tingling may be more constant and often more common at night. People report feeling clumsy and often drop objects more frequently and have trouble gripping objects like a phone, pencil, newspaper. steering wheel etc.
Causes
Certain conditions can increase risks of developing CTS, including diabetes, rheumatoid arthritis, pregnancy, trauma and thyroid imbalance, amongst others. CTS is also more common in women and in older individuals. There can be hereditary or anatomic factors at play as well and some people naturally have a smaller, tighter carpal tunnel.
The symptoms of carpal tunnel syndrome usually come and go in the beginning stages, but as the severity increases, numbness or tingling may be more constant
In many cases, a clear cut cause of carpal tunnel syndrome is not always identified.
Manual labour requiring a forceful grip or usage of vibrational construction equipment may also contribute to CTS. Some experts have suggested that other workplace factors involving repetitive movements or computer usage can also contribute to the development of this ailment.
The scientific evidence available is conflicting and as yet, there is no definitive correlation between these factors. While not conclusively proven, it is widely believed that activity involving the hands that require repetition and force, especially for prolonged periods of time and certain positions like wrist bending (flexion), could contribute to CTS.
Evaluation
Anyone with recurrent pain, numbness, tingling, or weakness in the hand should consult a physician for evaluation. The doctor will likely ask more detailed questions about the symptoms experienced and perform a physical examination. If the symptoms are suggestive of CTS, the doctor may order tests such as an
x-ray to rule out other causes of wrist pain and/or a nerve conduction study which can determine if there is any nerve compression.
Treatment For CTS
Non-Operative Treatments
It carpal tunnel syndrome is treated early, especially in the case of mild symptoms, certain non-operative treatments can be really effective and may also reverse symptoms. Some of the treatments include:
Wrist Bracing: Wearing a wrist brace can help hold the wrist still in a non-aggravating position. It can especially be used at night.
Non-Steroidal Anti-inflammatory Medication: Taking anti- inflammatory medication may help decrease any inflammation irritating the carpal tunnel.
Corticosteroids: A steroid injection administered directly in to the carpal tunnel can help decrease inflammation and swelling.
Physiotherapy And Yoga: Stretching exercises, balance and posture enhancements may help control symptoms.
Lifestyle Adjustments: Take periodic breaks and stretch during work or repetitive activities, assure ergonomic workspace, avoid hand positions which aggravate symptoms and maintain a good posture.
Operative Treatment
With continued symptoms despite efforts at non-operative treatment, the doctor may recommend surgery. Surgery involves releasing a ligament within the carpal tunnel which presses on the nerve. This enlarges the carpal tunnel, creating more room within the carpal tunnel thereby decreasing pressure on the nerve.
Anyone with recurrent pain, numbness, tingling, or weakness in the hand should consult a physician for evaluation
The surgeon may make an open’ incision in the palm to release the tissue or possibly even use a camera to assist, if an endoscopic method is utilized. Surgery may be recommended sooner in more severe cases. However, recovery may take a few weeks to several months for more complete healing. Surgery usually affords reliable outcomes and symptom management but more severe CTS cases may take longer to heal and residual symptoms could still remain.
Although carpal tunnel syndrome can create a nuisance with activities of daily living, fortunately treatment methods remain quite effective for symptom relief and restoring hand and wrist function.