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Carpal tunnel syndrome: Treatment, symptoms, advice and help

About carpal tunnel syndrome

Carpal tunnel syndrome refers to crisis in the ‘carpal tunnel’ area of wrist resulting in dysfunction of median nerve which carries information between brain and fingers. Carpal tunnel is a small hollow space in the wrist which is enclosed by inflexible coverings (carpal bones and ligament) on all four sides. This space carries significance since it comprises of median nerve and several flexor tendons passing from the forearm to the hand.

Any factor which causes narrowing of the carpal tunnel may compress the median nerve, resulting in sensory and muscular symptoms. This disorder is termed as carpal tunnel syndrome.

Carpal tunnel syndrome: Incidence, age and sex

The incidence of carpal tunnel syndrome is not quite uncommon in the general population. It can occur in any age group; however it is more common in middle aged adults and elderly people.

Signs and symptoms of carpal tunnel syndrome: Diagnosis

The clinical features include sensation of tingling and numbness in the thumb, the forefinger, the middle finger and part? of ring finger of the affected hand. Some individuals may also experience weakness and pain, especially in the muscles of the hand, resulting in weaker grip. This pain is usually worse at night and may be relieved on shaking the hand. The pain may also aggravate with certain movements like typing, writing or driving.

It is advisable to consult a bone specialist when one encounters such clinical features for further evaluation. A detailed history, including occupational history and personal history of diseases may help in diagnosing the syndrome. Moreover some physical tests like Phalen’s test and Tinet’s test may be conducted to elicit signs of carpal tunnel syndrome. Nerve conduction study may be done in few individuals in whom the diagnosis is confusing and not clear.

Causes and prevention of carpal tunnel syndrome

Carpal tunnel syndrome results from repeated or constant flexion movement of the wrist joint as in typing, playing string instruments or holding racket in sports like tennis, badminton, etc. Dislocation at wrist joint or wrist fracture (colle’s fracture) may also result in narrowing of the carpal tunnel, thereby compressing the median nerve. Repeated stress of wrist may inflame the muscle tendons resulting in their swelling, which in turn may pinch upon median nerve and cause its functional impairment.

Certain conditions like hypothyroidism, arthritis, diabetes and pregnancy may also predispose to carpal tunnel syndrome. Appropriate wrist exercises, especially in individuals who are at a higher risk, may help in preventing this syndrome.

Carpal tunnel syndrome: Complications

In most of the cases, carpal tunnel syndrome is reversible with early and effective management. But in exceptional individuals, it may not resolve and eventually result in complete loss of sensation in the fingers or irreversible weakness of the thumb muscles.

Carpal tunnel syndrome: Treatment

The treatment of carpal tunnel syndrome includes anti-inflammatory and analgesic medications which help in alleviating swelling and pain. Injecting steroid drugs into the wrist joint may provide temporary relief from the symptoms. Splinting the wrist in normal resting position may help in stabilising the carpal tunnel and providing rest to the wrist joint.

Surgical intervention in which the carpal tunnel is opened and pressure over the nerve is released, may be considered in individuals who are resistant to conservative measures. Moreover, it is essential to evaluate the underlying cause of carpal tunnel syndrome, if any, and manage it effectively to prevent any episodes in future.