What to know about carpal tunnel syndrome

One of the most common nerve disorders experienced in the hands is carpal tunnel syndrome.  This very treatable condition affects between 4 to10 million Americans with middle- aged and older adults who are more likely to develop the syndrome.  Women are also more likely to be diagnosed with this disorder than men.

What is carpal tunnel syndrome?

The condition of carpal tunnel syndrome is when the tunnel surrounding the tissues inside the bones of the wrist narrows which inflames the tissues and entraps the median nerve.  It is the median nerve that allows feeling in the thumb, index, middle, and ring fingers. 

When ligaments and tendons in the carpal tunnel become swollen or inflamed, they press against the median nerve which then results in certain symptoms associated with carpal tunnel syndrome.

What are the symptoms and who is at risk?

The symptoms of carpal tunnel syndrome can include the following:

·      Swollen feeling in the fingers

·      Hand weakness

·      Numbness or “pins and needles” feeling the fingers

·      Difficulty making a fist or manipulating small objects

·      Pain and/or numbness that is worse at night or interrupts sleep

·      Difficulty gripping objects with the hands or dropping objects

·      Burning or tingling in the thumb, index, and middle fingers, or pain that moves up the arm to the elbow

There are people who are more at risk of developing carpal tunnel syndrome for various reasons.  It could be due to any type of repetitive tasks one does at their job or a hobby or it could be due to various medical conditions. 

People with the following occupations or hobbies are more likely to suffer from carpal tunnel syndrome:

·      Auto mechanics

·      Carpenters

·      People who use computers for many hours

·      Check-out line workers

·      Assembly-line workers

·      Musicians

·      Hobbies such as gardening, needlework, golfing, and boating/rowing

The following medical conditions may increase the risk of carpal tunnel syndrome:

·      Women who are pregnant

·      Being overweight

·      Diabetes

·      Thyroid disease

·      Arthritis

·      An injury to the wrist such as a wrist fracture

How is it diagnosed?

To know for certain if one has carpal tunnel syndrome, a consultation with a physician is necessary. 

A diagnosis of carpal tunnel syndrome is based on the symptoms and distribution of hand numbness.  A physician will complete a medical history along with a clinical exam of the neck, shoulder, elbow, pulses, and reflexes to exclude other conditions that can mimic carpal tunnel syndrome.   The wrist will be examined for swelling, warmth, tenderness, deformity, and discoloration.  One sign of the condition is referred to as Tinel’s sign in which a doctor will tap the front of the wrist to see if it results in tingling of the hand.

The clinical exam will also include performing certain tasks with the hands so as to determine if symptoms one is experiencing are related to carpal tunnel syndrome. 

A nerve conduction velocity test is a diagnostic tool for determining if a person’s symptoms are carpal tunnel syndrome.  This test measures the speed of electrical impulses as they travel down the median nerve.  In carpal tunnel syndrome, the impulse slows as it crosses through the carpal tunnel.  Another diagnostic tool that may be used is an electromyogram (EMG).  This can be performed with the nerve conduction velocity test to exclude or detect other conditions that might mimic carpal tunnel syndrome. 

Treatment for carpal tunnel syndrome

Treating carpal tunnel syndrome depends on the severity of it but the following measure may be suggested by a physician:

·      Occupational therapy to loosen the tendons in the hands and wrists

·      Daily use of a nonsteroidal-anti-inflammatory (NSAID) such as aspirin, ibuprofen, and other nonprescription pain relievers to help reduce pain and inflammation

·      Wearing splints, especially at night, to help immobilize the wrist

·      Resting the hands and wrist for longer periods throughout the day

·      Cortisone injection into the carpal tunnel area can help relieve symptoms for weeks to months at a time

·      A surgery known as carpal tunnel release, may be needed to open the carpal tunnel to relieve the pressure on the median nerve