CARPAL TUNNEL SYNDROME

The carpal tunnel is the passageway in the wrist and which consists of:

  • 8 Carpal Bonesand
  • Transverse Carpal Ligament

It is through this narrow tunnel, the median nerve and the tendons that connect the fingers to the muscles of the forearm pass through.

The median nerve is responsible for the following:

  • Sensation in palm side of the thumb, index, middle finger, and the inside half of the ring finger.
  • Innervates, muscles in the forearm that allows grasping objects with the forefinger and the thumb.

Carpal Tunnel syndrome occurs when the median nerve is compressed due to pressure put on the nerve by swelling of the nerve itself, surrounding tendons, or a combination of factors which may increase pressure

There are many possible causes of carpal tunnel syndrome but most cases are idopathic or have unknown cause.

Some possible causes include:

  • Any condition that puts pressure on the wrist
  • Excessive, repetitive hand and wrist movements
  • Congenital predisposition (narrow carpal tunnel)

Early detection of carpal tunnel syndrome makes treatment easier and recovery can be achieved in only a few months. If left untreated it may become a chronic disease.

Symptoms often include:

  • Burning, tingling, or itching numbness in the palm of the hand and thumb, index and middle fingers; may usually run up the center of the forearm, possibly up until as high as the shoulder.
  • Fingers “falling asleep” is a common complaint.

DIAGNOSIS

  • Special Tests (May aid in diagnosis but not definitive)
  • Tinel’s Maneuver
    • A positive test is a tingling sensation in the fingers when being tapped on the palm side of the wrist where carpal tunnel is located
  • Phalen’s Maneuver
    • A positive test is when symptoms are elicited by flexing the wrist fully with the elbows bent for approximately 60 seconds
  • Electromyogram and nerve conduction studies may be performed to assess the extent of nerve damage

 

RECOMMENDED MEDICATIONS

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Pain relief and inflammation reduction
  • Corticosteroids
    • May be an alternative option when NSAIDs are not effective. Consult your doctor for more information

What to think about

  • Medications should be used in conjunction with other measures
    • ice, rest, and splints
  • Surgical intervention may be needed should conservatives measures fail

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