According to the American College of Rheumatology, nearly 10 million Americans have been diagnosed and treated for pain occurring due to carpal tunnel syndrome in one or both of their wrists. Carpal tunnel syndrome (CTS) is a condition of the carpal tunnel, which plays home to the median nerve that assists in controlling the hand.
Comprised of ligament and bone, it is possible for the carpal tunnel to become damaged or inflamed, compressing the median nerve which will adversely affect the function of the hand. Median nerve compression from CTS produces symptoms pain in the wrist, but also may cause weakness or numbness in the hand.
Patients with a sudden onset feeling of tingling or numbness in their palm, or an itching feeling between the palm and wrist, might potentially be experiencing the effects of CTS.
What are the causes of Carpal Tunnel Syndrome?
The most common cause behind the development of CTS is when the carpal muscles suffer a strain or are damaged. CTS may also arise when a patient’s carpal tunnel has a near constant amount of pressure placed on it. In many cases, CTS is a culmination of effects between separate contributing factors that can each affect the hand and wrist.
Patients who perform repetitive tasks with their hands are at increased risk of straining the carpal muscles. It is possible for certain patients to be more susceptible to the effects of carpal tunnel syndrome, or to be more likely to develop it, due to a congenital narrowing of the carpal tunnel.
CTS may also be the result of a direct injury to the wrist that causes the carpal tunnel to begin affecting the median nerve. Inflammation from arthritic swelling may also compress the median nerve.
What are the symptoms of Carpal Tunnel Syndrome?
The effects of carpal tunnel syndrome are gradual, meaning that patients may not notice the early indicators and instead write them off as minor annoyances. Only in the later stages, when pain has become debilitating, do patients commonly decide to seek treatment. The most prevalent symptoms are numbness in the palm, spreading to the fingers and occurring first in the middle and index fingers. Patients may also experience weakness with lifting cups, writing or other tasks.
Patients with near-constant tenderness at the knuckle of the thumb may be experiencing the early stages of muscular decay. Other symptoms of CTS include tenderness and swelling in the wrist, and a gradual loss of function in the hand.
How is Carpal Tunnel Syndrome diagnosed?
Early diagnosis is critical in preventing the long-term debilitating effects of CTS. For many patients, the first step will be for the physician to eliminate the chance that any other condition is producing the symptoms. After this, the hand and wrist will be carefully examined in search for areas of swelling, discoloration, tenderness, and warmth. Functional loss of the hand is also a strong indicator in the presence of CTS.
There are a number of condition-specific tests that have been developed to examine for CTS, with a neurography test being a frequently used tool (Neurography for diagnosing carpal tunnel syndrome, 2013).
What are the treatment options for Carpal Tunnel Syndrome?
The available treatments will differ based on how far the symptoms of CTS have progressed. Minor symptoms may be treated with conservative methods, with a secondary goal of preventing further damage from occurring. These include warm or cold compresses on the hand, and medication for both pain and inflammation.
Patients with moderate symptoms may be eligible to attend physical therapy to strengthen the hand and wrist to prevent further damage. Carpal tunnel bracing may also be very effective.
One highly effective form of therapy that has only recently began to be used as treatment is massage therapy combined with trigger point injections into the wrist. Carpal tunnel steroid injections may provide relief for three to six months.