Five Signs of Carpal Tunnel Syndrome
Carpal tunnel syndrome, or CTS, occurs when the median nerve running along the forearm and into the palm becomes compressed at the wrist. The carpal tunnel is a narrow passageway of bone and ligament that houses the median nerve. There are people that can help you with these symptoms.
Symptoms of CTS tend to begin gradually:
1. Burning or tingling numbness in the palm, thumb and fingers, particularly the index and middle fingers. This is often most noticeable upon awakening, as the hand may be in a flexed position during sleep.
2. Decreased grip strength is another common symptom of CTS, as is trouble with manual tasks like grasping objects.
3. Difficulty differentiating hot and cold sensations may also be present.
4. In chronic, untreated CTS cases, the muscles at the base of the thumb may waste away.
5. The fingers may feel swollen, even though there is no visible swelling present.
What Causes Carpal Tunnel?
Carpal tunnel syndrome is usually less a problem with the median nerve so much as it is a lack of available space for the nerve inside the carpal tunnel. There are a number of factors contributing to the development of CTS, including wrist trauma, an overactive pituitary gland, an underactive thyroid gland, and arthritis.
Women are three times more likely than men to develop CTS. It’s thought that this may be because women have smaller carpal tunnels than men. Diabetics and other people with metabolic disorders also have a higher risk of CTS. CTS rarely affects children. People who perform repetitive tasks with their hands, such as assembly line workers, are also at higher risk for CTS.
CTS Diagnosis and Treatment
Carpal tunnel syndrome is best diagnosed early in order to maximize treatment and avoid long-term damage to the nerves. One test used to find CTS is known as the Tinel test. In this test, the doctor will tap or press on the patient’s median nerve. If tingling occurs in the fingers, it’s likely that CTS is present. Another test is called Phalen’s maneuver. In this test, the patient will press the backs of their hands and fingers together while flexing their wrists as far as possible. If, within 1 to 2 minutes tingling occurs in the fingers, the test is considered positive. Another type of examination that may be performed is called an electrodiagnostic test. Also known as a nerve conduction study, this involves measuring the electrical activity in the nerves and muscles. Finally, ultrasound can display abnormalities in the median nerve’s size.
Treatment options for CTS can involve surgical or non-surgical treatments. One common treatment is having the patient wear a splint at night, in order to keep the wrist aligned in the proper position. Anti-inflammatory drugs can help ease the pain and swelling that often accompany CTS. Corticosteroids can also help relieve pressure on the median nerve (not recommended for diabetics, as this can interfere with insulin levels).
There are two different varieties of surgery for treating CTS. Both involve severing ligaments in the wrist in order to relieve pressure on the median nerve. In an open release surgery, an incision is made in the wrist and then the carpal ligament is cut, enlarging the carpal tunnel. In an endoscopic surgery, a small incision is made in the wrist, and a small camera attached to a tube is inserted into the body. The camera feeds an image of the ligament to the surgeon, who cuts the carpal ligament with a small knife that is inserted through the tube. This type of surgery usually allows for a faster recovery with less discomfort, however it is more complicated as well. Prognosis following surgery is generally positive, and CTS is unlikely to reoccur. Some residual numbness or weakness is relatively common, however.
Research is currently being conducted by the National Institute of Neurological Disorders and Stroke (NINDS) to better combat carpal tunnel syndrome.