Carpal Tunnel Syndrome: Causes, Symptoms, and Treatments

What is carpal tunnel syndrome?

Carpal tunnel syndrome is a condition where you feel weakness, numbness, or pain in your hand and wrist. It’s caused by pressure on the median nerve, which is a nerve that runs from your forearm into the palm through the carpal tunnel.

Bones and ligaments form this tunnel, which houses the median nerve and tendons. The median nerve controls feeling in your thumb, index, middle, and part of your ring fingers, as well as some thumb movements.

When the tissues around the carpal tunnel swell or thicken, they squeeze the median nerve, causing the symptoms of carpal tunnel syndrome.

What are the causes of carpal tunnel syndrome?

Daily activities, hormonal changes, or other health factors may cause carpal tunnel syndrome, which is more common in people over 40.

Women are more likely than men to develop this condition due to hormonal changes during pregnancy or menopause. Here are some common causes of carpal tunnel syndrome, such as:

• Repetitive hand movements:

  • Activities like typing, using tools, or working on an assembly line can strain the wrist, causing swelling that presses on the median nerve.

• Wrist position:

  • Keeping your wrist bent for long periods, like while typing or using a mouse, can increase pressure on the median nerve.

• Underlying health conditions: 

  • Conditions like diabetes, obesity, rheumatoid arthritis, or other autoimmune diseases can increase the risk of carpal tunnel syndrome.

• Injury or trauma: 

  • A wrist fracture or dislocation can narrow the carpal tunnel, potentially compressing the median nerve.

• Hormonal changes: 

  • Pregnancy and menopause could lead to fluid retention, which may cause swelling on the wrist and pressure on the median nerve.

What are the symptoms of carpal tunnel syndrome?

The symptoms of carpal tunnel syndrome usually develop gradually and may vary in severity. These symptoms could occur in the areas controlled by the median nerve, such as the thumb, index, middle, and part of the ring fingers. 

Here are a few common symptoms you might experience, including:

• Numbness or tingling: 

  • These sensations, which are frequently more noticeable at night, include numbness, tingling, or feeling as though needles are poking your fingers or palm.

• Pain: 

  • A dull or aching pain in the wrist, hand, and sometimes extending up the forearm. Which worsens during activities that involve repetitive hand movements.

• Weakness: 

  • Decreased strength or grip of the hand, making it harder to grasp objects or perform tasks like holding a pen or turning a doorknob.

• Hand clumsiness: 

  • Difficulty moving fingers to button a shirt or typing on a keyboard due to weak hand strength and coordination.

• Loss of sensation: 

  • In more severe cases, you may lose the ability to sense touch or differentiate between hot and cold in the affected hand.

If you're experiencing persistent carpal tunnel syndrome symptoms, don’t hesitate to request an appointment with our specialists at Thomson Medical for an accurate diagnosis and tailored treatment plan.

How do I diagnose carpal tunnel syndrome?

To diagnose carpal tunnel syndrome, the doctor will ask what symptoms you experienced and if there are any difficulties manipulating any of your fingers. Following that, doctors could do a few things to help diagnose this condition, such as:

• Physical examination:

  • Tinel’s sign: Tapping gently over the wrist to see if there’s any elicited tingling or pain in the fingers.

  • Phalen’s test (wrist flexion test):   Holding the wrists in a flexed position for about a minute to see if it triggers any carpal tunnel syndrome symptoms.

• Electrodiagnostic test: 

  • Nerve conduction studies (NCS) or electromyography (EMG) may be used to evaluate and observe the median nerve function and to ascertain if there’s any compression on the nerve.

Another scanning method, such as the magnetic resonance imaging (MRI) scan, could reveal if the median nerve is swollen or compressed.

What are the treatment options for carpal tunnel syndrome?

To prevent carpal tunnel syndrome from getting worse or causing complications, it's important to treat this condition early. To treat this condition, our doctors could start with nonsurgical (conservative) treatments, such as:

• Wrist splints: 

  • Wearing a splint, especially at night, helps keep your wrist in a neutral position to ease pressure on the median nerve.

• Physical therapy: 

  • Exercises to stretch and strengthen the muscles and tendons in the wrist and hand.

• Oral anti-inflammatory drugs: 

  • These are pain relievers that can help reduce inflammation.

• Injections of corticosteroid: 

  • These medications aim to reduce inflammation and swelling around the median nerve.

If conservative treatments don’t improve your condition or if carpal tunnel becomes worse, doctors may suggest carpal tunnel surgery. This surgery (carpal tunnel release surgery) relieves pressure on the nerve by cutting the ligament and pressing it. 

This procedure can be done through traditional open surgery or a minimally invasive endoscopic approach.

How to prevent carpal tunnel syndrome?

It’s difficult to prevent carpal tunnel syndrome entirely, especially if a health condition or activity you can’t avoid causes it. But there are steps you can take to lower your risk of having carpal tunnel syndrome.

Here are some things you could do to reduce the risk of carpal tunnel syndrome, such as:

• Ergonomic adjustments: 

  • Set up your workstation so that your wrist stays neutral (not bent) when typing or using a mouse.

• Frequent breaks:

  • Taking a break from repetitive tasks to stretch and move your hands and wrists.

• Hand and wrist exercises: 

  • Regular stretching and strengthening exercises can help maintain flexibility and reduce strain.

• Good hand positioning: 

  • Try to avoid positions that cause excessive wrist bending or strain.

When do I need to see a doctor for carpal tunnel syndrome?

If you experience symptoms such as persistent numbness, tingling, or pain in the hand or wrist, it’s important to consult a doctor. Early diagnosis and treatment can help prevent more severe symptoms and complications, such as permanent nerve damage.

What are the possible complications of carpal tunnel syndrome?

Left untreated, carpal tunnel syndrome can lead to a variety of complications that affect hand function and your quality of life. These complications are generally related to ongoing compression of the median nerve and its effect on the hand's function.

Here are complications that could happen because of carpal tunnel syndrome, including:

• Nerve damage: 

  • Prolonged pressure on the median nerve can cause damage, which causes weakness, difficulty with everyday tasks like gripping objects or buttoning a shirt, and permanent sensory loss in severe cases. 

• Muscle weakness: 

  • Without proper treatment, the muscles at the base of the thumb (thenar muscles) may become weak leading to reduced grip strength and finger coordination.

• Chronic pain: 

  • Unrelieved pain from carpal tunnel syndrome can become chronic and spread from the wrist into the forearm, elbow, and even the shoulder. This pain could disrupt sleep and cause a decline in quality of life.

  • People with underlying health conditions such as diabetes, rheumatoid arthritis, or obesity could experience further swelling and compression in the carpal tunnel, making carpal tunnel syndrome more difficult to manage.

• Anxiety: 

  • The difficulty in performing daily tasks or working normally could cause the patient to suffer from anxiety.

Complications could also happen after a carpal tunnel syndrome surgery, such as infection, scarring, or damaging other nerves and structures around the carpal tunnel. Although these complications after surgery are relatively rare.

To help in the treatment, you can also do exercise on the wrist and hand to relieve the symptoms, particularly in the early stages or as part of a comprehensive treatment plan. Specific exercises can help stretch and strengthen the muscles and tendons around the carpal tunnel, reduce pressure on the median nerve, and improve overall wrist flexibility. 

By understanding the causes, symptoms, risk factors, and treatment options for carpal tunnel syndrome, you can take proactive steps to protect joint health and improve your quality of life. 

FAQ

How to check if you have carpal tunnel?

Whilst checking for carpal tunnel syndrome typically involves looking out for specific symptoms, it's important to note that a proper medical diagnosis is essential.

Common signs include numbness or tingling in your thumb, index, and middle fingers, weakness in your hand grip, and pain that may extend from your wrist up to your arm.

However, as these symptoms can be similar to other conditions, consulting a specialist at Thomson Medical will ensure an accurate diagnosis through proper clinical examination and testing.

How serious is a carpal tunnel syndrome?

Carpal tunnel syndrome (CTS) is not a life-threatening condition, but it can lead to significant complications if left untreated. Early intervention is crucial to prevent further injury and disruption of hand function, which could effect your quality of life.

Can carpal tunnel syndrome recur after surgery?

Although surgery is generally effective in relieving pressure on the median nerve, recurrence of symptoms can occur. Especially if the post-surgery rehabilitation isn’t done properly and no lifestyle changes from the patient.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Book an appointment with Thomson Medical today.