Carpal Tunnel Syndrome: Signs, Causes, and How to Treat It

Carpal Tunnel Syndrome is the most common condition of the hands and wrists, causing pain, tingling sensation, and weakness. The carpal tunnel is a space in the bone of the wrist that allows the passage of various nerves and blood vessels. Any pressure or swelling on one side of the tunnel causes extra pressure on the median nerve, the primary sensation in the hands and wrist. This leads to the development of pressure on the nerve, producing carpal tunnel symptoms.  

Causes:

Carpal tunnel syndrome is caused by swelling or irritation of the wrist that damages or presses the tissues passing through the carpal tunnel. This multifactorial condition produces stress and presses on the median nerve that performs the hand's motor functions, leading to carpal tunnel symptoms.  

• Wrist fractures or diseases like arthritis affect the tunnel, leading to pressure on the median nerve.  
• The female gender is more susceptible to carpal tunnel symptoms due to narrow tunnel space and hormonal factors.
• Long-term diseases like diabetes, Rheumatoid arthritis, gout, and thyroid disorders increase the risk of nerve damage, leading to carpal tunnel syndrome symptoms.  
• Specific medications used to treat breast cancer also increase the risk of carpal tunnel syndrome symptoms.  
• Fluid retention conditions like pregnancy and menopause cause pressure on the nerves, leading to carpal tunnel symptoms.  
• Workplace factors where repetitive hand movements are needed or have increased use of vibrating tools also increase the risk of carpal tunnel syndrome.

Symptoms:

Carpal Tunnel symptoms develop slowly. Initially, they present with mild symptoms but gradually worsen over time. The carpal tunnel symptoms are predominantly noticed at night, causing difficulty in sleeping. As the symptoms worsen, daytime pain is also noticed. The carpal tunnel symptoms Include the following:

• Hand and wrist numbness like pinpricking  
• The hand may be so numb that it may feel like it is asleep
• Pain in the wrist and hands that starts from inside the hand and not from superficial areas.  
• Pain is sharp, burning stab, or constant ache.  
• Tingling sensation
• Fingertip numbing  
• Difficulty in holding the objects, weakness
• Inability to perform precise movements  

Treatment:

After a physical examination, specific tests, including X-ray, ultrasound, electromyography tests, and nerve conduction studies, are recommended to help diagnose the condition.  

Early treatment helps achieve better results. Simple lifestyle modifications, such as, taking frequent breaks, stretching exercises, and applying cold packs, help relieve the symptoms.  

Carpal tunnel syndrome is managed by nonsurgical options like  

• Wrist splinting to keep the wrist still and relieve nighttime and daytime symptoms of tingling and numbness.  
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen help to relieve pain from carpal tunnel syndrome in the short term.
• Corticosteroids are also prescribed to relieve pain. Ultrasound-guided injections are also given to control swelling and treat carpal tunnel symptoms.  
• Physical therapy helps strengthen the wrist muscles and increase flexibility.  

Surgical options are preferred for severe symptoms which cannot be controlled by routine management. Surgery creates more space in the tunnel so that the irritation and pressure of the nerve are reduced. These are done by:

• Open surgery in the palm relieves symptoms and frees the nerve.  
• Endoscopic surgery reduces symptoms and relieves pressure. A small endoscope camera views the carpal tunnel's contents and reduces the pressure.  
• Ultrasound-guided surgery is similar to endoscopic surgery, except that ultrasound waves identify the nerves, tendons, and ligaments.  

Carpal tunnel syndrome is a common health condition that can be difficult to prevent. Depending on the cause, it can be treated accordingly to control the symptoms.