Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a hand-and-arm condition that causes numbness, tingling, and other symptoms. Carpal tunnel syndrome is caused by a pinched nerve in your wrist. A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems, and possibly patterns of hand use. Bound by bones and ligaments, the carpal tunnel is a narrow passageway located on the palm side of your wrist. This tunnel protects a main nerve to your hand and the nine tendons that bend your fingers. Compression of the nerve produces the numbness, tingling and, eventually, hand weakness that characterize carpal tunnel syndrome.

Carpal tunnel syndrome usually starts gradually with numbness or tingling in your thumb, index, and middle fingers that comes and goes. This may be associated with discomfort in your wrist and hand. Common carpal tunnel syndrome symptoms include:

Tingling or numbness. You may experience tingling and numbness in your fingers or hand, especially your thumb, index, middle, or ring fingers––but not your little finger. This sensation often occurs while holding a steering wheel, phone, or newspaper––or commonly, when you awake from sleeping. The sensation may extend from your wrist up to your arm. Many people "shake out" their hands to try to relieve their symptoms. As the disorder progresses, the numb feeling may become constant.

Weakness. You may experience weakness in your hand and a tendency to drop objects. This may be due to the numbness in your hand or weakness of the thumb's pinching muscles, which causes carpal tunnel syndrome as a result of compression of the median nerve. The median nerve runs from your forearm through a passageway in your wrist (carpal tunnel) to your hand. It provides sensation to the palm side of your thumb and fingers, with the exception of your little finger. It also provides nerve signals to move the muscles around the base of your thumb (motor function).

In general, anything that crowds, irritates, or compresses the median nerve in the carpal tunnel space can lead to carpal tunnel syndrome. For example, a wrist fracture can narrow the carpal tunnel and irritate the nerve, as can the swelling and inflammation resulting from rheumatoid arthritis. In many cases, no single cause can be identified. It may be that a combination of risk factors contributes to the development of the condition.

Some studies suggest that carpal tunnel syndrome can result from overuse or strain in certain job tasks that require a combination of repetitive, forceful, and awkward or stressed motions of your hands and wrists. Examples of these include using power tools {such as chippers, grinders, chain saws, or jackhammers} and heavy assembly line work, such as takes place in a meatpacking plant. Using computers or driving while squeezing the wheel also causes it.

Although repetitive computer use is commonly assumed to cause carpal tunnel syndrome, the scientific evidence for this association isn't definitive.

Although it's not clear which activities can cause carpal tunnel syndrome, if your work or hobbies are hand-intensive involving a combination of awkward, repetitive wrist or finger motions, forceful pinching or gripping, and working with vibrating tools, you may be at higher risk of developing the condition.

Your sex. Women are three times more likely than men to develop carpal tunnel syndrome. The incidence in women peaks after menopause, and the risk of carpal tunnel syndrome also increases in men during middle age.

Heredity. You may be significantly more likely to develop carpal tunnel syndrome if close relatives have had the condition. Inherited physical characteristics, such as the shape of your wrist, may make you more susceptible.

Certain health conditions. Conditions including some thyroid problems, diabetes, obesity and rheumatoid arthritis can increase your risk. Women who are pregnant, taking oral contraceptives, or going through menopause also are at increased risk, most likely due to hormonal changes. Fluid retention may be a cause of carpal tunnel syndrome during pregnancy. Fortunately, carpal tunnel syndrome related to pregnancy almost always improves after childbirth. People who smoke cigarettes may experience worse symptoms and slower recovery from carpal tunnel syndrome than nonsmokers do. This is because smoking constricts the small blood vessels of the hand and reduces blood flow to the hand.

Typically, there are three types of treatment for carpal tunnel.  The first is a wrist support that is worn at night coupled with a regime of aspirin, naproxen, or Tylenol taken on a regular basis.  The second round includes shots with cortisone and, as a last resort, surgery. 

Despite the negative news, there are exercises that can strengthen and reverse carpal tunnel.  Flexion and extension can be done with the opposite wrist or a light weight or band.  Squeezing can be done with a dead tennis ball, stress toy, or just a person’s own fist.

Despite what has been told in the past, there is a lot you can do for carpal tunnel.  Most treatments with just over-the-counter pain relievers and exercises can reverse or eliminate the pain all together.