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Carpal Tunnel Syndrome: Symptoms, Causes & Diagnosis

Conditions
Oct 08, 2021

Carpal Tunnel Syndrome: Symptoms, Causes & Diagnosis

Whether you engage in manual tasks or perform computer tasks on a day-to-day basis, you could be at risk of carpal tunnel syndrome. The incidence of carpal tunnel syndrome has been attributed to the use of computers as well as other repetitive activities, but it can also be caused by several other factors. Luckily, there are treatments available for those who suffer from this medical condition, which will be discussed in this article, along with its symptoms and causes. 

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a common condition characterized by pain, numbness and tingling sensations in the hand caused by median nerve compression. The median nerve runs through the carpal tunnel and controls sensation in most of your fingers as well as muscles used for everyday activities like grasping objects with your thumb and fingers or moving your wrist up and down. The carpal tunnel is a narrow passageway that runs through the wrist and connects the forearm to the hand. It's formed by carpal bones on top, and a ligament called the flexor retinaculum below.

Carpal tunnel syndrome affects millions of people every year and has several causes. It is possible to have carpal tunnel syndrome for months or even years before it produces any noticeable symptoms. Some carpal tunnel sufferers report their first symptoms occurred after a particularly strenuous activity such as moving furniture, playing tennis, or even by merely keeping their hands on the steering wheel for a prolonged period, while others notice no obvious trigger at all. Symptoms usually worsen at night and can be quite painful enough so as to cause insomnia

Symptoms of Carpal Tunnel Syndrome

The carpal tunnel is lined by strong, connective tissue and ligaments that hold joints together. If swelling occurs within the carpal tunnel due to injury or other medical conditions it can lead to carpal tunnel syndrome. The telltale signs of median nerve damage include tingling sensations in the fingers, especially in the thumb, index finger and middle finger. Other carpal tunnel syndrome symptoms include:

  • Pain, either constant or periodic, usually in the hands but also potentially radiating up arms to elbows and shoulders
  • Numbness or tingling sensations specifically in carpal region (wrist) as well as up the forearm towards elbow
  • Loss of grip strength, particularly in those who work with their hands for prolonged periods such as carpenters, musicians, chefs etc.
  • Vague feelings of discomfort in the carpal tunnel area
  • Loss of dexterity and clumsiness in hand
  • Aching or throbbing sensations in arms, shoulders and neck
  • Arthritis-like symptoms such as swelling, redness and pain around affected joints
  • Sensation that bones in fingers are enlarged or swollen

Skin conditions such as eczema and psoriasis around the carpal tunnel region may worsen during carpal tunnel flare-ups. Bone abnormalities such as arthritis deformans (Striker's knee) are often present with carpal tunnel syndrome. Note that a single symptom with no additional complaints when there is a history of trauma, or when medical causes have been ruled out, is carpal tunnel syndrome.

Causes of Carpal Tunnel Syndrome

Carpal tunnel syndrome occurs because the carpal bones' connective tissue and carpal ligament become compressed due to repetitive motions. This causes a kind of "pinching" effect that restricts the flow of blood to the median nerve, which is the major nerve that supplies feeling and movement to the carpal region, as well as lower arm regions such as elbows and fingers.

Besides wrist fracture or nerve injury, there are many other risk factors that increase the likelihood for carpal tunnel syndrome, including genetics and age. Carpal tunnels are more common in people over 50 years of age, while some carpal tunnel symptoms may be an early sign of multiple sclerosis (MS). The following also increases the risk for carpal tunnel syndrome:

  • Certain health issues that cause swelling in your hands or wrists such as rheumatoid arthritis, gout and thyroid disorders
  • Medical procedures such as tissue biopsies, blood transfusions and the placement of intravenous lines
  • An injury to your hand or wrist, especially one that's sustained during a fall
  • Repetitive stress injuries from activities such as typing, writing or using a computer mouse for prolonged periods of time
  • Diabetes
  • Pregnancy
  • Infection in your carpal tunnel that occurs when bacteria from an open wound enters the area
  • Constant exposure to a cold environment
  • Tendon damage due to repetitive movements involving the wrist and hands. This is common in carpenters, plumbers, painters, mechanics, gardeners or others who use vibrating tools.

People who often bend their wrists while performing manual work or sports, including baton twirling, heavy lifting and golf, are also at risk of developing carpal tunnel syndrome. Skiing can also increase risk since it requires constant use of your fingers to grip poles even if done recreationally. 

When carpal tunnel syndrome is left untreated, it can cause permanent damage to the nerves and muscles in the hands, which may require surgical procedures.

Treatment of Carpal Tunnel Syndrome

The treatment for carpal tunnel syndrome is usually non-invasive and begins with simply resting the wrist, followed by wearing a carpal tunnel wrist brace to immobilize the carpal bones during sleep. Applying ice packs several times daily for 15 minutes also helps reduce carpal tunnel pain until you receive medical treatment. Chiropractic care can help address wrist pain, while a physical therapy program is highly recommended to reduce pressure on the median nerve resulting from repetitive hand movements, as well as promoting carpal bone mobilization. 

Other treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, oral corticosteroid and steroid injections to reduce inflammation.

However, severe cases of carpal tunnel syndrome are treated by carpal tunnel release surgery in which the carpal ligament is cut; this may lead to deterioration in grip strength due to injury to the tendons. Surgery for carpal tunnel may be recommended if symptoms persist even after other conservative treatments for carpal tunnel methods have been tried, particularly in advanced carpal tunnel cases.

Prevention Methods for Carpal Tunnel Syndrome

People with carpal tunnel syndrome can improve the strength and flexibility of their hands, wrists, fingers or range of motion by performing occupational therapy exercises before symptoms worsen. In addition, health professionals who specialise in the condition may recommend carpal tunnel exercises to help reduce the risk of carpal tunnel syndrome occurring in the first place. Doing the following can also help keep carpal tunnel pain at bay:

  • Changing positions regularly when working on a computer or doing repetitive tasks
  • Avoiding repetitive hand movements to avoid damaging your wrist bones 
  • Strengthening and stretching your wrists, hands and fingers
  • Maintaining good posture and taking frequent breaks while working on a computer
  • Avoiding tight clothing over carpal tunnels, as well as wearing tight rings as these can increase pressure in carpal tunnel area leading to injury
  • Using a chair with good back support and a desk that's high enough so the wrists can rest flat when using a keyboard
  • Wearing wrist splints to keep your hands warm
  • Avoiding downward pressure on nerves in your wrist

As there is no known cure for carpal tunnel syndrome, performing carpal tunnel exercises is considered an effective treatment for the condition. They are especially useful if carpal tunnel syndrome is caused by repetitive work activities, such as typing or playing computer games. Follow these steps to get started:

  • Slowly rotate your wrist forward so you feel a gentle stretch in your forearm.
  • Hold this position for five to 10 seconds while breathing normally before rotating slowly back to starting position.
  • Repeat three times for each hand. You can do this exercise several times daily throughout the day whenever carpal tunnel syndrome symptoms are felt.

Diagnosing Carpal Tunnel Syndrome

In the diagnosis of carpal tunnel syndrome, the medical practitioner will ask you to make a fist with your hand and then measure the tightness of your grip, in addition to performing a complete physical examination and reviewing your medical history. They will also ask you questions about your symptoms, such as whether there is any numbness or tingling sensations, where you feel it exactly (wrist area specifically), when did the symptoms start (how long do they last) etc. 

You may even be asked to maintain your position while an object is dangling from your fingers or while holding a lit matchstick. Tests typically include:

  • Electromyography which monitors muscle response by attaching electrodes on the skin over certain muscles
  • Nerve conduction tests
  • Carpal compression test
  • Magnetic resonance imaging
  • X-rays

If you are at risk of carpal tunnel syndrome, you can consult a physical therapist or an occupational therapist in your area for appropriate treatment, to avoid carpal tunnel syndrome surgery and return to your normal activities. Your lifestyle is linked to the development of carpal tunnel syndrome, so it would be better to examine your daily activities today before your body requests carpal tunnel relief.

FAQs About Carpal Tunnel Syndrome

How long does carpal tunnel usually last?

Moderate carpal tunnel syndrome may last about 3 to 4 months, but when you start dropping objects or you can't get a glass of water anymore, you may be in the advanced stages. A severe case could last for an extended period of time like a year or more.

Can you fix carpal tunnel without surgery?

Yes, definitely! Exercising your wrist joint can help ease the symptoms of carpal tunnel syndrome. Cold compresses, wearing wrist splints at night and corticosteroid injections are other conservative treatment options.

Is carpal tunnel serious?

No, it's not as serious as it sounds. Nearly everyone has experienced carpal tunnel syndrome at some point in their lives. By getting proper treatment, you can get rid of pain and restore normal functions to your hand and wrist.

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