Carpal tunnel syndrome is a condition that occurs when the median nerve of the wrist becomes pinched or compressed. The result is numbness, weakness and tenderness in the hand and wrist, and sharp or piercing pain that can radiate through the fingers and up the arm.
Symptoms generally progress gradually over the course of several months or even years. Nearly 8 million Americans have carpal tunnel syndrome, and women are up to three times as likely to develop it. Retail cashiers, computer users and those who work in jobs that involve repetitive movements of the fingers and wrist such as assembly line workers are at particular risk for carpal tunnel syndrome.
Causes of Carpal Tunnel Syndrome
The carpal tunnel is a narrow, rigid passageway of ligaments and bones. Inside this passageway is the median nerve, which runs from the forearm to the palm of the hand. When the tissues surrounding the nerve swell or thicken from irritation, the tunnel becomes narrower, and increased pressure is placed on the median nerve. This is what causes the pain and other symptoms of carpal tunnel syndrome.
Several factors generally contribute to the development of this condition. These may include work stress, trauma or injury to the wrist, and medical conditions such as rheumatoid arthritis, diabetes, hypothyroidism and overactive pituitary gland. Heredity is also a large factor, as some people have smaller carpal tunnels.
Carpal Tunnel Syndrome Diagnosis
In diagnosing carpal tunnel syndrome, the doctor takes a medical history that includes a review of all signs and symptoms of the condition. A physical exam tests the feeling in the fingers and grip strength. The doctor may tap or press on the nerve to determine the extent of the pain and other symptoms.
X-rays are not useful in diagnosing carpal tunnel syndrome; however, they may be used to exclude other causes of wrist pain. A nerve conduction study may be used to determine if electrical impulses pass more slowly through the carpal tunnel, as slowing in the median nerve can indicate this condition.
Treatments for Carpal Tunnel Syndrome
Treatment during the early phases of carpal tunnel syndrome can stop the damage from progressing. Initial treatment typically involves resting the affected hand and wrist and avoiding activities that can cause further stress and worsen symptoms. Wearing a brace or splint is recommended in some cases, as it keeps the wrist in a neutral position, which can lessen irritation to the median nerve.
Physical therapy and medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and oral or injectable corticosteroids, can help manage the pain of carpal tunnel syndrome. If symptoms are severe or persist after you have tried other treatments, surgery to relieve the pressure on the nerve may be advised.