Carpal tunnel syndrome (CTS) is a common condition affecting the median nerve, which runs from the forearm to the hand as it passes through a narrow tunnel in the wrist. The carpal tunnel is a narrow passageway (tunnel) of bones and ligaments on the palm side of your wrist. It houses the median nerve and nine tendons that control the movement of the thumb, forefinger, middle finger, and half the ring finger. When the carpal tunnel becomes too narrow due to inflamed tendons or a wrist injury, the median nerve can get squashed, pinched, or damaged. This, in turn, may lead to carpal tunnel syndrome. CTS affects your fingers, wrist, and arm, causing pain, numbness, tingling, weakness, and difficulty gripping. Symptoms are often worse at night or first thing in the morning. CTS is a progressive condition that can worsen without proper care.
Causes of Carpal tunnel syndrome
Some risk factors increase the chances of getting carpal tunnel syndrome. For example, women are more likely than men to experience carpal tunnel syndrome. It is more likely to occur with aging.
The most common causes of carpal tunnel syndrome include:
- Repetitive hand and wrist movements: Activities that involve repetitive motions of the hand and wrist, such as using a keyboard and computer mouse, playing musical instruments and video games, or assembly line work, can contribute to the development of CTS.
- Frequent, repetitive, grasping movements with the hands: Sports, construction work, gardening, or other physical activities.
- Hand and wrist position: Prolonged or awkward hand and wrist positioning, such as bending the wrist excessively or keeping it in a flexed or extended position for long periods, can increase the risk of CTS.
- Certain medical conditions can increase the likelihood of developing carpal tunnel syndrome:
- Joint or bone disease (arthritis, osteoarthritis, or rheumatoid arthritis)
- Hormonal or metabolic changes (menopause, pregnancy, or thyroid imbalance)
- Changes in blood sugar levels (may be seen with type 2 diabetes)
- Other conditions or injuries of the wrist (strain, sprain, dislocation, break, or swelling and inflammation)
- Family history of CTS: A smaller carpal tunnel can run in families.
Symptoms of CTS
Symptoms often start mildly before increasing in intensity. They can begin to worsen during the night. The symptoms of carpal tunnel syndrome typically include:
- Numbness or tingling: You may experience numbness, a burning feeling or a pins-and-needles sensation in your thumb, index finger, middle finger, and half of the ring finger. The little finger is usually unaffected.
- Hand weakness: Weakness in the hand and a tendency to drop objects may occur due to the compression of the median nerve.
- Pain or discomfort: You may feel pain, a dull ache or discomfort in the hand, wrist, and forearm. The pain can sometimes radiate up the arm towards the shoulder.
Treatment options for CTS
For mild symptoms
- Rest and activity modification: Taking breaks from repetitive activities and avoiding movements that worsen symptoms can help alleviate the condition.
- Wrist splinting: Wearing a splint or brace to keep the wrist from moving can help relieve pressure on the median nerve and reduce symptoms, particularly at night
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help reduce pain and inflammation associated with CTS.
- Corticosteroid injections: In some cases, a corticosteroid injection into the carpal tunnel may be recommended to relieve symptoms.
- Physical therapy: Stretching and strengthening exercises, as well as ultrasound or low-level laser therapy, may be prescribed by a physiotherapist to improve symptoms and prevent further deterioration.
For advanced symptoms
Surgery to widen carpal tunnel may be recommended if symptoms have become severe, other treatments have failed, and you’ve lost finger dexterity and hand strength. The most common surgical procedure for CTS is carpal tunnel release, which involves cutting the carpal ligament to enlarge the carpal tunnel and relieve pressure on the median nerve. This can be done either as open or endoscopic surgery. Surgical release of the carpal tunnel ligament is one of the most effective treatments. Intercare Day Hospitals specialises in Orthopaedic Surgery.
Recovery from carpal tunnel surgery is different for each person. Recovery may take longer if your nerve has been compressed for a long time. You will be encouraged to move your fingers and wrist a few days after surgery to help prevent stiffness. You may need to adjust your work or home activities while you recover.
If you suspect you have carpal tunnel syndrome or are experiencing symptoms, it’s advisable to consult with a healthcare professional for an accurate diagnosis and appropriate treatment options.