Carpal Tunnel Syndrome

Carpal tunnel syndrome is a medical condition that causes compression of the median nerve in the wrist. The median nerve and several tendons (the flexor tendons that allow us to flex our fingers and wrist) reach from arm to hand through a small space called the carpal tunnel. The median nerve controls sensation on the palm side of the thumb, index finger, middle finger, and half of the ring finger.

        Compression of the median nerve can cause numbness, tingling, and weakness in the wrist and hand. Carpal tunnel can create a sensation of electric shock in the thumb, index and middle finger. Pain may also be felt from the arm to the shoulder or between the elbow and wrist.

       Carpal tunnel patients may complain to their doctors about pain that can wake them up at night. Because many people sleep with their wrists bent, this can cause compression of the median nerve, which causes pain at night. Carpal tunnel symptoms can also occur during the day, especially when holding things in their hands (such as a phone, book, tools, or driving) and can often be relieved by “shaking” or moving the hands. These carpal tunnel symptoms may gradually become constant over time and cause additional problems, such as dropping things more often. In severe cases, the muscles at the base of the thumb weaken.

                         Carpal Tunnel Risk Factors:

     If carpal tunnel pain is not treated, carpal tunnel syndrome can damage the median nerve and the muscles it innervates. There are several factors that can play a role in getting carpal tunnel syndrome.

      Women are more prone to carpal tunnel syndrome because their carpal tunnels are usually smaller than men.

      Chronic diseases such as diabetes and alcoholism increase your risk of median nerve damage. Inflammatory conditions such as rheumatoid arthritis or infections can also cause inflammation in the carpal tunnel area, causing pressure on the median nerve.

       Pregnancy, obesity, menopause, and thyroid conditions can increase the pressure on your median nerves due to the increased pressure from fluid retention. This increases your risk of carpal tunnel syndrome. Generally, carpal tunnel syndrome in pregnancy usually resolves after the baby is born.

        Work factors may also play a role in median nerve irritation and damage. Long-term work on the computer can be given as an example. Individuals who frequently work with vibrating tools or who have repetitive wrist stretching during their work may also be at risk of developing carpal tunnel syndrome.

                                               Test

        To diagnose whether you have carpal tunnel syndrome, your doctor will do a physical exam and question your health and daily routine, as well as recent activities that may have caused the pain in your wrist. Some tests, such as blood tests and nerve testing, may be done by your carpal tunnel clinic doctor to see if your median nerve is working properly and to check for any health issues that may be contributing to your symptoms.

                             Carpal Tunnel Pain Management and Treatment Options

      If your carpal tunnel pain symptoms are mild, you can treat carpal tunnel syndrome at home. For carpal tunnel pain management, try avoiding activities that cause numbness and pain, and rest your wrist between activities. Ice your wrist for 10-15 minutes every hour or two. Wearing a wrist splint at night and, if possible, during the day will help keep your wrist in a neutral position and take pressure off your median nerve.

       For more advanced symptoms, the patient can be relieved by administering a carpal tunnel steroid injection with ultrasound. After the patient’s arm is placed in the supine position and the wrists are rested on a hard flat surface, the fingers are kept half closed. After the necessary antiseptic cleaning has been achieved at the injection site, first ultrasound examination is performed to exclude space-occupying lesions or anatomical variants. Next, the bony structures that limit the carpal tunnel proximally (pisiform, scaphoid) and distally (trapezia and hamate) are examined. The median nerve is identified after ultrasound has identified the transverse carpal ligament as an arched hyperechoic stripe. The procedure is terminated by injecting a mixture of 1% lidocaine and 40 mg triamcinolone near the median nerve.