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Carpal Tunnel Syndrome – Test, Exercises, Pictures, Symptoms, Causes, Treatment

Updated on October 20, 2013

Carpal tunnel syndrome refers to an arm and hand condition that is progressively painful and caused due to a pinched nerve in the wrist. Varied factors such as presence of certain health issues, the wrist anatomy and patterns of hand usage can contribute towards development of carpal tunnel syndrome.

The carpal tunnel is a slim tube-like structure that is about the size of the thumb and is enclosed by ligaments and bones. It is situated on the palm or upper side of the wrist. The tunnel guards 9 tendons that help bend the fingers, as well as the main nerve of the hand. When the nerve is squeezed, it results in pain, numbness and ultimately weakness of the hand associated with carpal tunnel syndrome.

Most individuals affected by carpal tunnel syndrome can alleviate the numbness and pain via medications and other treatment options that restore normalcy of hand and wrist use.

Symptoms of carpal tunnel syndrome

Carpal tunnel syndrome usually commences slowly with a dull ache in the wrist that can radiate to the forearm or hand. Some of the common signs and symptoms of carpal tunnel syndrome are listed below:

  • The hand or fingers may experience numbness or tingling, particularly the index finger and thumb or ring and middle fingers but not the little finger. Patients will typically experience this abnormal feeling after waking up or when holding a phone, steering wheel or newspaper. Lots of affected individuals tend to forcefully shake their hands to ease the symptoms. The progression of the condition may lead to continuous numbness.

  • The hands may experience weakness resulting in increased tendency to drop items

  • The pain may extend from the wrist down to the palm or fingers or up the arm to the shoulders. This is more so after repetitive or vigorous use of the hands. The pain normally affects the palm or inner side of the forearm.

Causes of carpal tunnel syndrome

Carpal tunnel syndrome is caused due to compression or squeezing of the median nerve. This nerve passes from the forearm via the carpal passageway to the hand. It offers feeling on the palm side of the fingers and thumb, excluding the little finger. It is also responsible for transmission of nerve signals that help move the muscles near the thumb base.

Typically, carpal tunnel syndrome can be caused by anything that irritates, crowds, or narrows the median nerve in the carpal passageway. For example, inflammation and swelling associated with rheumatoid arthritis or a wrist fracture can constrict the carpal space and irritate the median nerve.

In most instances, no singular cause for carpal tunnel syndrome can be determined. Often a combination of varied factors eventually result in the carpal anomaly. Some of the risk factors that increase the susceptibility of developing carpal tunnel syndrome are as follows:

  • The presence of certain nerve-damaging conditions like alcoholism or diabetes can aggravate and damage the nerves, including the median nerve.

  • A wrist fracture or any other kind of accident that dislocates or alters the carpal space can exert pressure on the median nerve, increasing the risk to carpal tunnel syndrome

  • Infections and other inflammatory conditions like rheumatoid arthritis can adversely affect the wrist tendons, thereby creating additional pressure on the median nerve.

  • Women have smaller carpal tunnels than men and hence at greater risk to the syndrome. It may also be noted that women affected by the condition have comparatively smaller carpal space than other non-affected women.

  • Jobs that require repetitive or prolonged use of the wrist, or involves use of vibrating machinery, may cause external pressure on the median nerve or aggravate an existing case of nerve damage, thereby increasing the risk to carpal tunnel syndrome.

  • Menopause, pregnancy, thyroid abnormalities, obesity, kidney failure and other such conditions that alter the fluid composition in the body can result in elevated pressure in the carpal passageway, thereby aggravating the median nerve.

Diagnosis of carpal tunnel syndrome (Tests)

The doctor may carry out a number of tests and diagnostic procedures to ascertain the presence of carpal tunnel syndrome. Some of the tests are listed below:

  • A physical examination to test the muscle strength in the hands as well as the sensations in the fingers. The abnormal symptoms may be recreated by putting pressure on the median nerve via squeezing or tapping the nerve or bending the wrist.

  • The pattern of symptoms may be studied. If the little finger also experiences problems then carpal tunnel syndrome can be ruled out. The timing of the symptoms such as when holding items, etc. is also verified.

  • An electromyogram, x-rays of the wrist and a nerve conduction study may also be ordered by the doctor.

If the symptoms and diagnostic tests point to the presence of some other condition, then the doctor will direct the patient to a specific specialist for further tests.

Treatment of carpal tunnel syndrome

Mild cases of carpal tunnel syndrome can be alleviated by application of ice packs to decrease swelling and resting of the hands. If the syndrome persists, then the doctor will recommend the following treatment options:

  • Non-surgical therapies

    • Intake of non-steroidal anti-inflammatory drugs to ease pain

    • Wrist splitting so as to keep the wrist still during sleep and thus reduce nocturnal numbness and tingling.

    • Treating the underlying causes of carpal tunnel syndrome can help eliminate the condition

    • Corticosteroid injections directly administered into the carpal tunnel so as to alleviate the pain.

  • Surgery

    • If carpal tunnel syndrome is not resolved via non-surgical means, then surgery is recommended. It can be either an open surgery or an endoscopic surgery. Surgery involves release of pressure on median nerve by cutting the ligament that is exerting the pressure. The ligament will grow back during the healing process. Such newly formed tissue will offer greater carpal space for the nerve.

Exercises for carpal tunnel syndrome

  • Stretch the fingers and wrist as if they were in a hand-stand stance. Hold for five seconds.

  • Relax the fingers and wrists.

  • Create a tight fist with both hands and then bend the wrists downwards. Hold for five seconds.

  • Relax

  • Repeat the above exercises for up to ten times. Later, let the arms hang loosely on the side and shake them for a few seconds.

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