Carpal tunnel syndrome: What you need to know

Carpal tunnel syndrome is a painful, progressive condition that occurs when the median nerve in the wrist is compressed.

Also known as median nerve entrapment or median nerve compression, it may happen when a nerve swells, the tendons become inflamed, or something causes swelling in the carpal tunnel.

Symptoms include tingling, burning, or itching and numbness in the palm of the hand and the fingers, especially the thumb and index finger.

The National Institute of Neurological Disorders and Stroke (NINDS), describe carpal tunnel syndrome (CTS) as the "most common and widely known of the entrapment neuropathies in which the body's peripheral nerves are compressed or traumatized."

CTS affects between 3 percent and 6 percent of adults in the United States. It normally develops between the ages of 45 and 64 years, and the prevalence increases with age. It can appear in one or both wrists. It is more common in women than in men.

Without treatment, CTS can have a negative impact on a person's quality of life. Eventually, the median nerve can become severely damaged, and there may be permanent numbness in the fingers and permanent weakness in the muscles that are innervated by the median nerve.

It is often linked to computer use, but reports date back to the 1800s. It was familiar to orthopedic surgeons since before the widespread use of computers.

Symptoms

Symptoms tend to develop gradually over time.

The first symptoms often appear during the night, or on waking up in the morning. Patients may feel the need to "shake out" their hands when they wake up. The discomfort may wake them repeatedly during the night.

The three main symptoms associated with CTS are:

• pain
• numbness
• tingling

These symptoms occur in the thumb and the two fingers next to it, as well as half of the ring finger. They may extend to the rest of the hand and into the forearm.

As the condition progresses, symptoms may persist during the day. The person may lose grip strength and find it harder to form a fist or grasp small objects. Opening a bottle of soda, doing up buttons, or typing on a keyboard can become a challenge.

If left untreated, the muscles at the base of the thumb may wither away, and the person may no longer be able to tell hot from cold with the thumb and finger.

Symptoms tend to emerge or get worse after using the affected hand. The sensation of tingling, burning, and pain may worsen if the arm or hand has been in the same position for a long time.

Treatment

Treatment aims to relieve symptoms and slow the progression of CTS by reducing pressure on the median nerve.

People with mild symptoms may find their condition improves without treatment within a few months, especially if they are aged 30 years or under or if CTS occurs during pregnancy.

Self-help tips

The following may help reduce discomfort:

• Resting the hand and wrist: The more rest the hand and wrist get, the greater the chance of relieving the symptoms.
• Cold compress: Placing an ice pack on the wrist may help when the problem flares up, but ice should not be applied ice directly onto the skin.
• Controlling the triggers: If CTS stems from repetitive hand movements, the person should take breaks so the hand and wrist have time to rest and recover.
• Occupational therapy: A therapist can teach a person how to repetitive tasks differently.
• Wrist splints: These keep the wrist in the same position and prevent it from bending. They can be worn during sleep, but also during the day if they do not interfere with daily activities. Wrist splints are available over the counter at pharmacies. A doctor or pharmacist can advise about the best one to choose.

Most patients with mild symptoms who follow these strategies will notice an improvement within 4 weeks.

Source: Medical news Today