Carpal tunnel syndrome is a type of entrapment neuropathy (nerve damage or dysfunction) in which a peripheral nerve is pressed or squeezed.
Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed at the wrist. This can cause pain, numbness, and weakness in the fingers, hands, and wrists, and occasionally the arms.
If carpal tunnel syndrome is not treated, it can lead to complications such as:
- Nerve damage that can lead to permanent impairment and disability
- Chronic wrist and hand pain
- Hand weakness and decreased grip strength
- This can make it difficult to perform daily tasks such as buttoning clothing or even driving
Carpal tunnel syndrome usually doesn’t go away on its own without at least rest and some conservative intervention. Treatments for carpal tunnel syndrome include:
- Resting the hand and wrist
- Avoiding activities that may provoke symptoms
- Wrist splints to keep hands in a neutral position
- Ice
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen (Advil, Motrin) for pain relief
- Steroid shots or pills (such as prednisone) to help control inflammation and swelling
- Anesthetic injections (lidocaine)
- Yoga, which may help reduce pain and improve grip strength
- Carpal bone mobilization
- A physical or occupational therapist moves the bones in the wrist around in a special way
- There is limited evidence on the effectiveness of this treatment
- Alternative therapies
- These may help some people but their effectiveness has not been proven
- Acupuncture
- Chiropractic
- These may help some people but their effectiveness has not been proven
- Surgery
- Cutting the ligament that stretches across the wrist to form the tunnel
What Are Symptoms of Carpal Tunnel Syndrome?
Symptoms of carpal tunnel syndrome include:
- Burning or tingling sensations in the thumb and the index, middle, and ring fingers
- Symptoms are usually worse at night
- Symptoms often affect both hands, but one hand might be worse
- Pain in the thumb and the index, middle, and ring fingers
- Pain and tingling may extend to the whole hand or up to the wrist and forearm
- Stiff fingers
- Shock-like sensations
- Hand weakness/difficulty grasping items
- Inability to make a fist
- Itchy palms
- Fingers feel swollen even though little or no swelling is apparent
- Changes in hand temperature (colder or warmer)
- Changes in skin color of the affected hand
- Inability to determine between hot and cold by touch (in severe cases)
- Pain and tingling that extends past the elbow to the shoulder (rare)
What Causes Carpal Tunnel Syndrome?
Carpal tunnel syndrome is caused by increased pressure on the median nerve and tendons in the carpal tunnel. Factors that can contribute to this increased pressure include:
- Trauma or injury to the wrist that causes swelling, such as a sprain or fracture
- Mechanical problems in the wrist joint
- Repeated use of vibrating hand tools
- Rheumatoid arthritis
- Underactive thyroid gland
- Overactive pituitary gland
- Fluid retention during pregnancy or menopause
- A cyst or tumor developing in the canal
Risk factors associated with developing carpal tunnel syndrome include:
- Workplace factors
- Repetitive hand and wrist use
- Sustained wrist or palm pressure
- Prolonged wrist extension and flexion
- Forceful hand and wrist use
- Working with vibrating tools
- Use of hands in cold temperatures
- Obesity
- Rheumatoid arthritis
- Osteoarthritis of the hand
- Diabetes
- Being female
- Pregnancy
- Connective tissue diseases
- Low thyroid hormone (hypothyroidism)
- Preexisting median mononeuropathy
- Genetic predisposition
- Aromatase inhibitor use
How Is Carpal Tunnel Syndrome Diagnosed?
Carpal tunnel syndrome is usually diagnosed with a history and physical exam, in which a doctor may tap on or press on the wrist, or ask you to hold your hands in ways that can make carpal tunnel syndrome symptoms worse.
Tests that may be used to help diagnose carpal tunnel syndrome include:
- Nerve conduction studies
- Electromyography (EMG)
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https://www.uptodate.com/contents/carpal-tunnel-syndrome-etiology-and-epidemiology?search=Carpal%20Tunnel%20Syndrome&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2#H5
https://www.medscape.com/answers/327330-84904/what-are-the-complications-of-carpal-tunnel-syndrome-cts