The bones that are located in the wrist are called carpals. The carpal tunnel is covered by carpals in the wrist on three sides with transverse carpal ligament on the other side. The central part of the wrist is occupied by the median nerve and flexor tendons. The median nerve travels through the carpal tunnel to the hand and helps in providing sensation to the thumb, index and middle fingers. Any irritation that is caused to the tissue in the carpal tunnel can affect or disturb the median nerve. This compression on the median nerve which causes numbness or tingling to the fingers and the hand is said to be ‘Carpal Tunnel Syndrome’.
- Pain, numbness or tingling or all the three in the hand
- Numbness in the thumb, index, middle and ring fingers
- Weakness in the hand
- Weaker grip to hold objects
- Difficulty in feeling or holding objects
- Deep pain in the hand, arm and extended to elbow
- Loss of sensation in severe cases
No specific causes have been observed for the occurrence of carpal tunnel syndrome. Sometimes flexor tendons tend to swell to an extent that may lead to this syndrome. Joint dislocations, fractures and arthritis may be some of the reasons. Pregnant women might experience swelling in the tunnel and symptoms of carpal syndrome due to fluid retention which might disappear later. People suffering from diabetes are also at the risk of the disease. Consumption of alcohol may also be one of the causes. It is observed that pressure applied on the nerve at work might also increase the intensity of developing this syndrome to a larger extent. Sometimes, stress or other medical conditions like down syndrome, amyloidosis, acromegaly or tumor on the median nerve can also cause CTS. Genetic factors with the same disorder might contribute to the growth of this disease. Computer operators, typists, industry workers and musicians are highly at the risk of acquiring the disease.
To avoid permanent destruction of the median nerve, it is better to attend for an early diagnosis followed by immediate treatment. The initial step for diagnosis would be to observe the movement of the wrist and the sensation of the hand. Nerve disorders are checked with the help of nerve conduction testing. The test analyses the speed of electrical impulses sent into the median nerve of the wrist and any abnormality in the test would lead to other diagnostic tests. Electrodiagnostic test would ensure further confirmation of the disease apart from its symptoms. Electromyography where the electrical movement is observed detects severe conditions of the median nerve. Ultrasound imaging and magnetic resonance imaging of the wrist are also used to diagnose carpel syndrome.
Carpel syndrome at a milder level can be treated with corticosteroid injections and wrist splints. Surgery is also suggested in cases of severity. Allowing the movement of the hand to rest is suggested in most cases which might lessen the intensity of pain. Treatment for hypothyroidism and diabetes would reduce the risk of the disease. To get relieved from the pain anti-inflammatory nonsteroidal drugs like aspirin and ibuprofen might be helpful. Vitamin B6 (pyridoxine) is also prescribed to patients. Low-level laser therapy and acupuncture are also suggested as a part of the treatment.
It is observed that older patients are highly at the risk of experiencing carpel tunnel syndrome. Women are more likely to acquire this syndrome rather than men due to hormonal changes. The syndrome of one wrist has a wider chance of leading to pain of the other wrist. In severe cases numbness and weakness might become stagnant which might spread upwards and reach the shoulder. There is a scope of persistence in pain, numbness and tingling even after a surgery.
Adjusting the position of tools, type machines and key boards would prevent the syndrome to a greater extent. Avoiding stress and pressure on the hand and wrist might help in the prevention of the disease. Lack of proper exercise and obesity might also be some of the reasons to complicate the disease. Forgoing smoking, maintaining good weight and performing simple exercises would prevent the increased risk of the syndrome. Good posture at workplace, avoiding repetitive tasks by giving short breaks in between and reducing hand stress are some of ways of prevention.
Cases with minimum severity of the syndrome can be treated with simple remedies available at home. Wearing a splint on the wrist and putting it to rest can improve the condition in a short time. Increase in period of rest and simple wrist exercises would help as the best remedy for carpel syndrome. Ice application would reduce the pain to a larger extent. However, a conservative approach to the disease, participation in yoga and other exercise programs, making changes in work and recreational activities would considerably reduce stress on the wrist and leaves one free from carpel syndrome.