Causes and Treatment of Carpal Tunnel Syndrome

· 17th June 2015

The carpal tunnel is a narrow passageway made up of bones and ligaments in your wrist. The median nerve runs through it. The median nerve controls sensations and movement of the thumb and first three fingers.

What is Carpal Tunnel Syndrome (CTS)?

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Carpal tunnel syndrome is a condition involving inflammation in the wrist area. The wrist may hurt, and the nerve messages travelling to and from the hand and fingers may be interrupted, creating strange sensations and weakness.

Causes

The symptoms present when someone has CTS are caused by the compression of the median nerve.

Anything that causes crowding, irritation or the compression of the nerve in the carpal tunnel space can lead to CTS. A fractured wrist may heal badly and make the space smaller or irritate the nerve. Rheumatoid arthritis might cause swelling and inflammation, as can repeated movements of the hand and wrist where the hand is below the wrist for long periods of time, like when we use a computer with a keyboard.

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Symptoms

CTS might come on slowly. You might experience tingling or numbness in your thumb or fingers which comes and goes. The first three fingers are usually affected, and these symptoms may occur when you are driving, clutching the steering wheel, phone or newspaper or during the night. The sensations might spread up your arm, too.

You might also feel discomfort, and/or weakness. Do you drop objects unexpectedly or having problems making a pinching movement?

When to consult your GP

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If you have the above symptoms persistently in your wrist and hands, and they interfere with your normal life, go and see your GP. If you leave the condition for too long without receiving treatment, the muscles and nerves could get damaged permanently.

Tests and examinations

The Phalen’s manoeuvre is performed by flexing the wrist very gently as far as it will go, then holding your wrist there. The doctor will wait for symptoms to appear: numbness after 1 minute or less. The sooner you feel numbness, the more advanced the condition is.

The Tinel’s sign is not as sensitive a test, but it’s a great way to detect whether your nerves are irritated or not. To perform it, the doctor will lightly tap on the skin above the flexor retinaculum which may cause pins and needles in this area. The technique specifically targets the median nerve.

The Darkan test, or carpal compression test involves firm pressure to the palm area close to the nerve for around 30 seconds.

Treatment options

Treatment depends on the severity of the symptoms and how long you’ve had it. In some cases, CTS improves after just a few months of treatment. Moving your hand and shaking out your wrists can often alleviate symptoms.

If you CTS is caused by underlying health conditions like rheumatoid arthritis, treating it should improve symptoms.

Medication

You can take non-steroidal anti-inflammatory drugs (NSAIDS), like ibuprofen and to help with fluid retention, but some doctors recommend wrist splints and corticosteroid injections.

Surgery

If other treatments fail, carpal tunnel decompression or release surgery may be performed. You stay awake during the surgery, which may be open surgery or the traditional kind. Keyhole surgery may be used. If you are thinking about surgery, consider the possible complications after surgery, the recovery time and the chances of CTS recurring afterward, which is common.

How to prevent carpal tunnel syndrome – postural recommendations

Hand and wrist exercises may help to reduce the chances of getting CTS, and improving it if you already have it. Isometric stretching exercises can strengthen the muscles and improve circulation to these areas. Give them a try.

Remedies for carpal tunnel syndrome that you can make at home

  • Ice packs wrapped in towels can be left on the site for 10 minutes every hour. This reduces inflammation in the tendons effectively when used consistently.
  • Heat. Heat and cold can be used in conjunction. Try soaking your hands and wrists in hot water for 15 minutes before bed every night. See if it doesn’t improve the situation.
  • Wear a splint at night. This will hold everything in a neutral position, relieving pressure on the median nerve.
  • Buy an arnica ointment, and rub it into your wrists twice daily. This ointment eases aches and pains and is a fantastic anti-inflammatory. Use the opportunity to give the whole area a nice massage, or get your partner, child or a friend to lend you a hand.
  • Take a magnesium supplement. Magnesium is great for nerve function and muscle relaxation.
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