Have you ever felt a shock-like sensation that moves into your fingers? Or tingling sensation and numbness in your hand? Or weakness in your hand that makes it difficult to hold things? It could be due to Carpal Tunnel Syndrome.
The median nerve runs the length of your arm, goes through a passage in your wrist ( Carpal Tunnel) and ends in your hand. It controls the movement and feeling of your thumb and all your fingers except the little finger. If there is pressure on this nerve, it causes numbness, tingling and weakness in your hand and forearm.
Symptoms
- Burning, tingling, pain or itching numbness in your palm and thumb or your index and middle fingers.
- Tingling sensation that moves up into your arm & all the way into the shoulder.
- Weakness in the hand and trouble holding things.
- Shock-like feeling that spreads in your fingers.
- Intensified pain while doing activities with wrist bent. E.g: driving / reading a book holding it.
- Lack of coordination
- Less grip strength particularly the ability while using the thumb to pinch.
Causes
Often, no particular cause is known but these situations can be linked to it:
- Repetitive wrist movements like typing, driving that are done continually placing hands lower to your wrist level.
- Conditions like obesity, pregnancy, hypothyroidism, Rheumatoid Arthritis, and diabetes
- Women have smaller carpal tunnels so they are three times more likely to get it than men.
- Jobs that involve repetitive usage of arm, hand, or wrist e.g: sewer or knitter, cashier, musician, baker, driver
- Fractures or dislocation of your wrists
- Hereditary reasons
Diagnosis and Tests
Your Orthopaedic Surgeon identifies the condition by fully flexing your wrists with your arms extended and by performing a test called Tinel sign. Further tests to confirm the syndrome include:
Imaging tests: X-rays, ultrasounds, or MRI exams help your Orthopaedic Surgeon to have a detailed look at your bones and tissues.
Nerve conduction study: To measure the signals in the nerves of your hand, your Orthopaedic Surgeon tapes electrodes to your skin.
Electromyogram: Electrical activity will be measured by your Orthopaedic Surgeon by inserting a thin electrode into muscle.
Treatments
Non-surgical:
Icing: Ice your wrist or soak it in an ice bath for 10 minutes every hour for temporary relief
Exercises: Stretching movements and nerve gliding exercises will make you feel comfortable.
Immobilization: Your Orthopaedic Surgeon may suggest you to wear a splint to keep your wrist from moving and to lessen pressure on your nerves.
Medication: To control swelling, your Surgeon may prescribe anti-inflammatory medicines or steroid injections.
Shaking: To get relief from night time pain, gently shake the hand or keep it hanging over the side of the bed to lessen the pressure on the median nerve.
Surgical:
If none of those treatments works, classical surgery – Open Carpal Tunnel Release gives brilliant results. Endoscopic Carpal Tunnel Release System (ECTRS) is another procedure to decrease the menace of an open surgery. This technique is minimally invasive, safe and easy to perform, and gives great results. Lately, a newer and more advanced and incisionless treatment — known as Thread ultrasound-guided Carpal Tunnel Release (TCTR) is also being performed under local anaesthesia.
Prevention
- Minimize repetitive hand movements, avoid flexing and extending your wrists repeatedly.
- To reduce strain on hands and wrists shift between activities.
- Avoid holding an object in the same position for an extended time.
- Place your hands and wrists in a right position while you work.
- Make sure that your forearms are at level with your computer desk and chair if you work in an office.
If Carpal Tunnel Syndrome is not identified or neglected at the initial stages, it can get worse with time. Symptoms may temporarily appear to go way but will return with severity. Consult your Orthopaedic Surgeon to diagnosis the condition and take treatment early to avoid permanent damage to the nerve.