What is Carpal Tunnel Syndrome and How to Cure it?

What is Carpal Tunnel Syndrome (CTS)?

Carpal tunnel syndrome is a condition in which the median nerve is compressed or pinched in your wrist. The median nerve provides feeling to the first three fingers on each hand (your thumb, index finger, and middle finger). Carpal tunnel syndrome can cause pain, numbness, tingling, and weakness in these areas of the hand.

What Causes Carpal Tunnel Syndrome?

Carpal tunnel syndrome most often comes from prolonged pressure or irritation on the median nerve. Some common activities that can cause carpal tunnel syndrome include: carrying heavy objects, using power tools, typing, playing sports, bending wrists for long periods. Repetitive motions like knitting can be painful, but it's a treatable condition if caught early enough. It may take some time, but carpal tunnel syndrome can be cured. It may go away on its own if you avoid the activities that caused it or reduce how much you do them.

How Common is Carpal Tunnel Syndrome?

A research paper published in American Family Physician Journal estimates that "Carpal tunnel syndrome is the most common entrapment neuropathy, affecting approximately 3 to 6 percent of adults in the general population" at some point in their lifetimes. Carpal tunnel syndrome occurs more commonly in middle age (age 40+). According to one study, female sex hormones may play a role in making carpal tunnel syndrome more common among women than men after puberty. CTS can also be frequently associated with pregnancy and hypothyroidism.

The Signs & Symptoms of Carpal Tunnel Syndrome

Some people with carpal tunnel syndrome don't have any symptoms. If you do, you may experience burning, numbness, and tingling in the first three fingers of your hand, both while resting and especially at night. You can feel a sharp pain that radiates from the wrist up into the mid-arm, numbness or weakness when trying to grip objects, inability to fully open or close your hand because of aching tendons.

How to Diagnose Carpal Tunnel Syndrome

One of the most common ways to diagnose carpal tunnel syndrome is by doing a wrist bending test. To do this test, you will need to flex/bend your wrists in front of you with your wrists touching each other. Hold this position for about 30 to 60 seconds. If you feel your usual numbness and pain in your wrists and fingers, then you may have this syndrome.

Another way to diagnose carpal tunnel syndrome is by checking for weakness and wasting of the hand muscle group that is located closest to your thumb. If you find that you are having difficulty opening jars or turning doorknobs, then this could be a sign of carpal tunnel syndrome.

If still in doubt, your primary care doctor can also send you to a local neurologist for a so-called nerve conduction velocity/electromyography test (EMG/NCV) that will definitively prove or disprove whether or not you have carpal tunnel syndrome.

How to Treat Carpal Tunnel Syndrome

Carpal tunnel syndrome usually gets better with conservative measures like stretching, application of heat and cold packs, anti-inflammatory medication, and splints. However, surgery is sometimes needed to treat this condition, especially if symptoms persist after three to six months of nonsurgical treatment.

If you suspect that you have carpal tunnel syndrome it's important to see your doctor right away. Your doctor will take a medical history and ask about symptoms. Sometimes an x-ray is needed to check for bone spurs or other problems that can cause carpal tunnel syndrome. Once the diagnosis is made, you will be given a splint or brace to wear at night that keeps your wrist in its natural position while allowing a full range of motion during the day. Sometimes anti-inflammatory medications are also prescribed. Carpal tunnel exercises may also be recommended (see below).

If these methods do not relieve pain and other symptoms, your primary care doctor or a pain management doctor might suggest corticosteroid injections into the area around the median nerve which often provides relief for people with carpal tunnel syndrome within one week. Surgery may be needed to make more room for the nerve if conservative measures aren't effective, but it's best to avoid this drastic measure by using conservative treatment first.

Some Noninvasive Options include Carpal Tunnel Exercises:

1. Keep your wrist elevated while resting in bed or at a desk for about 15 minutes per hour by placing pillows or towels under your hand to keep it in an upward position.

2. Stretch the muscles of your arm, shoulder, and neck at least twice a day when you're not experiencing symptoms when they are relaxed. Point your fingers down toward the ground when stretching to reduce pain. Hold each stretch for at least 20 seconds.

3. Try applying ice over the area that is painful, which reduces inflammation and swelling around the median nerve. However, if you have decreased sensation in your hand or arm, you should not apply ice.

4. One of the most common treatments is splinting, which can include wearing a splint at night while you sleep with your affected arm tucked in or putting it in a neutral position. Your doctor may recommend night splints to stretch your affected wrist and hand muscles while you sleep.

5. Work with an occupational therapist on carpal tunnel exercises, which can reduce pain and improve function in your wrist and hand, according to the Mayo Clinic.

6. Your doctor may recommend physical therapy if these options aren't effective. You will also learn different physical therapy exercises to increase strength and flexibility in your hand, wrist, forearm, and shoulder.

Carpal Tunnel Surgery

Carpal tunnel surgery may be an option if you don't get relief from noninvasive methods or symptoms persist for more than six months despite different treatments. Your primary care doctor will evaluate whether the procedure is right for you after considering factors such as the duration of your symptoms, your age, and your overall health. If all conservative measures fail, your PCP will make a referral to a hand surgeon for you.

Carpal tunnel release surgery involves cutting the so-called transverse carpal ligament to relieve pressure on the median nerve within the carpal tunnel. It's a relatively simple and quick procedure that usually takes no more than one hour by an experienced hand surgeon.

Conclusion

Carpal tunnel syndrome is a common condition that can be treated with conservative measures before resorting to surgery. If you've been experiencing pain in your wrist and numbness or tingling in the fingers, it's important to see a doctor as soon as possible for diagnosis and treatment options. I hope this article has helped dispel some of the mystery around carpal tunnel syndrome so that you're better prepared for what may come if symptoms persist after three to six months of nonsurgical treatments.

Please leave a comment below and I will try to reply to it ASAP. Also, for more of my blogs you can click here.

References

LeBlanc KE, Cestia W. Carpal tunnel syndrome. Am Fam Physician. 2011 Apr 15;83(8):952-8. PMID: 21524035.