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 CTS get better on its own, but usually it requires treatment to relieve the symptoms.
What causes Carpal Tunnel Syndrome?
CTS 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.
What are the symptoms of CTS?
The common symptoms of CTS are:
- Tingling in the hand and affected fingers (i.e. thumb, index and middle fingers and half of 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 know to increase the likelihood of developing CTS.
- 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 carpel 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 CTS, 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 you hand and arm to see how effectively your nerves are conducting signals to the brain. You may also be given an 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 CTS treated?
If your CTS symptoms don’t improve by themselves, there are several treatment options.
Naturally, avoiding activities which 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.
Home Remedies for Carpal Tunnel Syndrome
If you have only mild symptoms of Carpal Tunnel Syndrome, your doctor initially may recommend simple strategies to bring you relief. The first one is rest: Take frequent breaks from activity to let your hands recover and reduce swelling. Pay attention to good posture, relax your hands and keep your wrists straight.
To reduce swelling, lie down, and elevate your arm with pillows so that it’s above your heart.
Gently apply ice packs to the wrist for 20 minutes for temporary pain relief.
Use pain relievers
Take over-the-counter anti-inflammatory pain relievers, such as nonprescription NSAIDs (aspirin, ibuprofen or naproxen) to reduce pain and swelling.
Smoking, in addition to hurting the heart and lungs, constricts the tiny blood veins of the hand and lowers blood flow, aggravating Carpal Tunnel Syndrome.
Wear a wrist splint
A splint keeps your wrist and fingers in neutral positions, which can reduce the chances of pain.
Wearing a splint at night provides a good 6 to 8 hours of rest for the wrist, so you wake up pain free. Talk to your doctor about getting a splint and ask how often to wear it.
Be wary of other devices
You’ll hear about a lot of devices that allegedly reduce symptoms of Carpal Tunnel Syndrome—braces, wrist rests, wrist trolleys, fingerless gloves. But the jury is still out on whether these devices truly help.
Talk to your doctor about stretching and strengthening exercises to strengthen the fingers, hands, wrists, forearms, shoulders and neck and improve blood flow.