Carpal Tunnel Syndrome is a condition that affects the hands, causing tingling, pain, and sometimes difficulties with movement. It generally develops over a period of time and can last for just a few weeks or continue for many months. Sometimes carpal tunnel syndrome gets better on its own, but usually, it requires treatment to relieve the symptoms.
What causes Carpal Tunnel Syndrome?
Carpal tunnel syndrome is caused when the median nerve, which runs through the inner wrist, is damaged or becomes compressed. This nerve runs through a sheath known as the ‘carpal tunnel’, hence the name of the condition.
The median nerve controls the movement of the thumb, index and middle finger, and half of the ring finger. It also conducts nerve sensations (e.g sense of touch, hot and cold), from the hand to the brain. When the carpal tunnel is compressed or damaged it puts pressure on the median nerve which affects its function.
What are the symptoms of carpal tunnel syndrome?
The common symptoms of carpal tunnel syndrome are:
- Tingling in the hand and affected fingers (i.e. thumb, index and middle fingers and half of the ring finger)
- Numbness in the hand
- A throbbing ache in the hand which may extend to the arm
- Weakness in the thumb which can lead to muscle wasting
- Reduced sensitivity to touch
Other less common symptoms include dry skin, swelling, and a change in color of the affected hand. Pain, numbness, and weakness can also cause problems with dexterity, so patients may drop things easily and have difficulty with fiddly tasks like doing buttons up, threading a needle, and so on.
These symptoms might affect one or both hands – generally, CTS starts slowly in one hand and then begins to affect the other hand in time. People often say their symptoms are worse during the night.
What can increase the risk of developing CTS?
Several factors are known to increase the likelihood of developing carpal tunnel syndrome.
- Genetics may play a part in CTS – about a quarter of patients who develop it have a family history of the condition
- Injury – an injury such as a broken or sprained wrist can cause swelling in the carpal tunnel which puts pressure on the median nerve
- Physical characteristics – people with a narrow carpal tunnel and those with cysts or other physical conditions may be at greater risk
- Pregnancy – swelling of the wrists may cause CTS
- Repetitive actions – some repetitive tasks, such as playing a musical instrument, assembly line duties, and activities with continuous vibration, can all make CTS worse. However, typing is NOT a contributory factor in CTS
- Underlying health conditions – these include: diabetes, under-active thyroid, rheumatoid arthritis, obesity
How is Carpal Tunnel Syndrome diagnosed?
If you suspect you have carpal tunnel syndrome, you should make an appointment with your family doctor first. Your GP will carry out a physical examination, which may include things like flexing your wrists to see if this provokes your symptoms, and they could refer you for hospital tests if they feel it’s necessary.
These additional tests can include a nerve conduction test, where electrodes are placed on your hand and arm to see how effectively your nerves are conducting signals to the brain. You may also be given electromyography, in which fine needles are inserted in your skin and your muscles stimulated electronically to measure their response.
An X-ray or ultrasound scan might also be needed to check on any physical problems such as fractures, arthritis, growths, or cysts.
How is Carpal Tunnel Syndrome treated?
If your carpal tunnel syndrome symptoms don’t improve by themselves, there are several treatment options.
Naturally, avoiding activities that trigger your symptoms is recommended, although sometimes this is difficult to put into practice e.g. if it’s part of your job. Therapy such as massage and stretching exercises have also been shown to help, so doing these regularly may ease the problems.
Wrist splints that hold your wrist in a neutral position can often bring relief. Corticosteroids can reduce the inflammation and these can be taken orally or injected directly into your wrist. Surgery is also an option when the roof of the carpal tunnel is cut to relieve pressure on the median nerve. This is done as a day procedure, often via keyhole surgery, under local anesthetic.