Carpal tunnel syndrome is a very common nerve condition. According to the American College of Rheumatology, it is estimated that anywhere from four to ten million people suffer from the condition.
Causes
The carpal tunnel is located on the palm side of the wrist. It serves as a passageway for several tendons and the median nerve to supply function to the thumb and all the fingers with the exception if the pinky. Carpal tunnel syndrome can develop when the median nerve becomes compressed.
There are several conditions that can irritate or compress the median nerve. For example, an injury, such as a wrist fracture can lead to swelling and nerve compression. Inflammatory diseases, such as rheumatoid arthritis can also cause compression of the median nerve and lead to the condition.
In the past, carpal tunnel syndrome was thought to be related to overuse and repetitive force placed on the median nerve. Workplace conditions, such as excessive computer use or operating vibrating tools were thought to be causes. But according to University of Maryland Medical Center, recent studies have not established a direct link between and carpal tunnel syndrome and workplace factors.
Symptoms and Natural History
Symptoms of carpal tunnel syndrome include tingling or numbness of the thumb and all the fingers except the pinky. Some people also develop weakness in the hand. Pain in the wrist and the palm may also be present.
In most cases, symptoms start with mild pain in the wrist. Although, the condition commonly affects both hands, it can also be unilateral. As time goes on, symptoms may also include mild intermittent numbness of the fingers. Over the course of several weeks or months symptoms often progress until numbness radiates from the wrist up through the arm.
Eventually, numbness can progress to the point where it interferes with everyday activities. Numbness and hand weakness can lead to dropping things and can prevent someone from feeling hot and cold, which can be dangerous. Pain, weakness and numbness can interfere or prevent participation in everyday activities from cooking to computer use to driving.
Diagnosis
Diagnosis is usually made based on a physical exam, symptom review and possibly additional tests. During an exam, your doctor may press on the nerve to see if it causes symptoms. Finger strength and sensation may also be evaluated. A nerve conduction study may also be recommended to determine if nerve impulses are slowed through the carpal tunnel.
Self-Help Treatment for Carpal Tunnel Syndrome
Self-help treatments for carpal tunnel syndrome may include over the counter pain relievers, such as ibuprofen and aspirin. Although pain relievers do not cure the condition, they may help decrease discomfort. Wearing a wrist splint during certain activities, such as sports, prevents the wrist from moving and may help decrease symptoms.
Standard Clinical Treatments for Carpel Tunnel Syndrome
If self-helps treatments don’t help, standard clinical treatments may be needed. Steroid injections can help decrease inflammation and compression of the median nerve. Surgery may also be an option. During the procedure, the carpal ligament is released from the median nerve, which relieves pressure on the nerve. The surgery may be performed using various techniques including open surgery, mini-open or through an endoscopic approach.
Sources
National Institute of Neurological disorders and Stroke. Carpel Tunnel Syndrome Fact Sheet. http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm
American College of Rheumatology. Carpel Tunnel Syndrome. http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Carpal-Tunnel-Syndrome
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