Carpal Tunnel Syndome
Carpal tunnel syndrome is caused by pressure on the median nerve. The carpal tunnel is a narrow passageway surrounded by bones and ligaments on the palm side of the hand. When the median nerve is compressed, symptoms can include numbness, tingling, and weakness in the hand and arm.
The anatomy of the wrist, health problems and possibly repetitive hand motions can contribute to carpal tunnel syndrome.
Proper treatment usually relieves the tingling and numbness and restores wrist and hand function.
Carpal tunnel syndrome is caused by pressure on the median nerve. The median nerve runs from the forearm through a passageway in the wrist (carpal tunnel) to the hand.
- Anything that squeezes or irritates the median nerve in the carpal tunnel space may lead to carpal tunnel syndrome. A wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation caused by rheumatoid arthritis.
- Many times, there is no single cause of carpal tunnel syndrome. It may be that a combination of risk factors contributes to the development of the condition.
Carpal tunnel syndrome symptoms usually start gradually and include:
- Tingling or numbness. You may notice tingling and numbness in the fingers or hand. Usually the thumb and index, middle or ring fingers are affected, but not the little finger. You might feel a sensation like an electric shock in these fingers.
- Weakness. You may experience weakness in the hand and drop objects. This may be due to the numbness in the hand or weakness of the thumb’s pinching muscles, which are also controlled by the median nerve.
Treat carpal tunnel syndrome as early as possible after symptoms start. In the early stages, simple things that you can do for yourself may make the problem go away. For example:
- Take more-frequent breaks to rest the hands.
- Avoid activities that make symptoms worse.
- Apply cold packs to reduce swelling.
Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, such as ibuprofen (Advil, Motrin IB, others), may help relieve pain from carpal tunnel syndrome in the short term.
There isn’t evidence, however, that these drugs improve carpal tunnel syndrome.
A splint that holds the wrist still while you sleep can help relieve nighttime symptoms of tingling and numbness. Even though you only wear the splint at night, it can also help prevent daytime symptoms. Nighttime splinting may be a good option if you’re pregnant because it does not involve the use of any medications to be effective.
Surgery may be appropriate if symptoms are severe or don’t respond to other treatments.
The goal of carpal tunnel surgery is to relieve pressure by cutting the ligament pressing on the median nerve.
The surgery may be performed with two different techniques:
Endoscopic surgery. Your surgeon uses a telescope-like device with a tiny camera attached to it (endoscope) to see inside the carpal tunnel. Your surgeon cuts the ligament through one or two small incisions in the hand or wrist. Some surgeons may use ultrasound instead of a telescope to guide the tool that cuts the ligament.
Endoscopic surgery may result in less pain than does open surgery in the first few days or weeks after surgery.
- Open surgery. Your surgeon makes an incision in the palm of the hand over the carpal tunnel and cuts through the ligament to free the nerve.
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