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Carpal tunnel syndrome is a painful condition which creates numbness and pain in the patient’s arm and hand. The name ‘carpal tunnel syndrome’ denotes the dysfunction that arises in the carpal tunnel.
Carpal tunnel is a passage in your wrist which is no wider than an inch. This passage is surrounded by carpal bones. Carpal bones are small wrist bones. The function of the carpal tunnel is to shield the median nerve. It provides the ability for the thumbs and fingers to move and bend.
Most often, carpal tunnel syndrome deteriorates with time. Hence, early diagnosis is of paramount importance. The syndrome can be controlled at an early stage with a wrist splint. However, if left untreated, carpal tunnel syndrome can create severe nerve damage where surgery becomes the only solution.
Causes of Carpal Tunnel Syndrome
There can be a multitude of reasons for Carpal Tunnel Syndrome, which are as follow:
- Heredity: Heredity is one of the common factors for this syndrome. This is because some people have genetically smaller carpal tunnel. This causes the syndrome to develop.
- Repetitive Use of Hand: Repeating the same wrist motions over a longer period of time causes swelling. Thus, this creates pressure on the carpal tunnel and the nerve.
- Posture: Moving hands in such a way that creates extra flexion and/or extension upon the nerves can also be one of the reasons.
- Pregnancy: Changes in the hormonal level during pregnancy also makes for a reason.
- Health conditions: Patients with medical conditions like rheumatoid arthritis, diabetes, etc. are more likely to develop carpal tunnel syndrome.
Symptoms of Carpal Tunnel Syndrome
The symptoms of carpal tunnel syndrome are as follow:
- Numbness, pain, a burning sensation and tingling in the region of fingers and thumb.
- Frequent shock-like feeling that stems from the fingers and the thumb.
- Pain or a tingling sensation that travels up towards the shoulder
- Weakness, faintness, and clumsiness in the wrist which makes the activities like buttoning your clothes difficult.
- Frequently dropping things happening because of numbness, loss of grip or loss of proprioception.
Mostly, patients with carpal tunnel syndrome begin experiencing the symptoms gradually. This is usually without any trace of a visible injury. Many patients experience recurring symptoms that come and go. However, as it progresses, the symptoms become more evident and frequent. These symptoms usually persist for a longer course of time.
Diagnosis of Carpal Tunnel Syndrome
The diagnosis of CTS requires a plethora of investigations. It can be as simple as a physical examination. This will be followed by a few tests which will confirm the condition. Or it can involve extensive tests at a higher level.
Below are the various types of tests to diagnose CTS:
- Physical Examination:
This is the most basic approach to diagnosing the condition. During the physical examination, your doctor may take your general health history. He will also ask about all the symptoms you’re experiencing. The doctor will then examine your hand and wrist function by performing a few physical tests.
After the initial check-up, the doctor may prescribe some Electrophysiological tests. These may include:
- Nerve Conduction Studies:
Nerve conduction studies measure the signals that travel across the nerves of your arm. It aims at detecting an ineffective nerve. This test happens to understand the severity of the problem.
- Electromyogram (EMG):
An EMG is a tool which checks the level of the electrical activity in the patient’s muscles. EMG results indicate the presence of nerve or muscle damage.
An ultrasound is a much-known tool which uses high-frequency sound waves to obtain a clear picture of the tissues.
X-rays provide imagery of dense structure such as bones. Some doctors ask patients for an X-ray test of the affected area in case the patient has some other problems like a fracture in wrist or arthritis.
How is Carpal Tunnel Syndrome Treated?
Treatment for carpal tunnel syndrome is of an immediate priority, as this condition gradually degrades unless you finalize your treatment. Read about your options below to slow the progression of it.
- Nonsurgical Treatments:
Early diagnosis will prevent a surgical approach to correct the syndrome. If the diagnosis is unclear, the doctor will suggest any one of the below discussed nonsurgical treatment approaches. This will also be the case when the symptoms are mild.
- Wrist Brace: The first course of action which doctors suggest is wearing a splint. A splint or brace helps in relieving the pressure upon the median nerve. A brace reduces the chances of the patient bending his/her wrist. This reduces the numbness and paves the way for healing.
- Nonsteroidal Anti-inflammatory Drugs (NSAIDs): NSAIDs are medicines like ibuprofen or naproxen. NASIDs help in releasing the pressure and curbing the inflammation.
- Steroid Injection: A steroid injection often helps in providing immediate pain relief, though the effects do fade away. Corticosteroid is one of the most powerful agents used at steroids. Its usage is more apparent in cases of carpal tunnel syndrome.
- Surgical Treatments:
If the nonsurgical approaches fail to provide relief after a duration, your doctor will recommend surgery. There are the following two different ways of carpal tunnel surgery:
- Open Carpal Tunnel Release: In this surgery, your surgeon will make a large cut of around 2 inches from your wrist to your palm.
- Endoscopic Carpal Tunnel Release: This surgery involves two tiny cuts; one opening in the wrist and another cut in the palm. These cuts are smaller (about half-inch on both the places), thus are lesser painful than the previously discussed surgery. In one cut, the surgeon will insert a tiny camera (endoscope) to monitor the procedure while the surgery will be done through the second cut.
Post-Op Care & Recovery
Immediately after the surgery, the nurses will make sure that your hand is elevated above your heart. They will also come for regular exercises. This is to increase the movement of fingers to keep swelling and stiffness at bay.
You can expect some swelling, pain, and stiffness following a few days after the surgery. There may be minor soreness in your surgical wound for a few months. The doctor will make you wear a splint. This is to give your hand the neutral position it requires for healing. You should visit the doctor to make sure the nerves are healing properly.
For most cases, surgery does put an end to all the painful symptoms; however, the recovery will be gradual. You can expect complete healing after a year or so. You may even have to see a therapist if your wrist is experiencing pain and stiffness.
Unfortunately, there still be chances of the syndrome returning. So you need to be aware of the symptoms to take a quicker course of action.