Carpal tunnel syndrome is the compression of the median nerve that passes into the hand of an individual. The median nerve is then located on the palm side of the hand (also called the carpal tunnel). The median nerve provides a sensation which is giving the ability to feel the thumb, index finger, long finger, and part of the ring finger. Afterward, it supplies the impulse to the muscle heading to the thumb. Carpal tunnel syndrome can occur in either both of the hands. The carpal tunnel normally is a narrow canal or tube located inside the wrist. Similarly to a tunnel, you can travel by car, this part of the wrist allows the median nerve and tendons to be able to connect the hand and forearm. The parts of this tunnel include carpal bones, ligaments, median nerve, and tendons. The carpal bones make up the bottom and sides of the tunnel. They are soon formed in a semi-circle. The ligament is a powerful tissue that is capable of holding the tunnel together. As to the median nerve, this provides feeling to most of the fingers in the hand. It also adds strength to the base of the thumb and index finger. Finally, the tendons connect muscles inside the forearm to the bones in the hand. They allow the fingers and thumb to bend.
Symptoms of carpal tunnel syndrome usually begin slowly and may occur at any time. Early symptoms include:
- Numbness at night.
- Tingling and/or pain in the fingers (especially the thumb, index, and middle fingers).
As a matter of fact, due to some patients sleeping with their wrists curled, nighttime symptoms are much more common and can wake people from sleep. These nighttime symptoms are often the very first reported symptoms. Shaking the hands helps relieve symptoms in the beginning stage of the condition.
Common daytime symptoms may include the following:
- Tingling in the fingers.
- Decreased feeling located in the fingers.
- Difficulty using any of the two hands during small activities, like handling small objects, grasping a steering wheel to drive, holding a book to read, writing, using a computer keyboard.
As carpal tunnel syndrome can worsen, symptoms become more constant. These types of symptoms include weakness in the hand, inability to perform tasks that may require delicate motions, and dropping objects. In a more severe condition, however, the muscles at the base of the thumb visibly shrink in size. Unfortunately, if this condition is left untreated after its early stages, the muscles at the base of the thumb can wither away, and the person may no longer be able to tell hot from cold with the thumb and the finger. No matter which symptoms tend to emerge or worsen after using the affected hand, the sensation of tingling, burning, and pain can worsen if the arm or hand has been in the same position for a long period of time.
Who Gets Carpal Tunnel Syndrome?
Carpal tunnel syndrome affects between 3% and 6% of adults within the population. It usually develops between the ages of 45-64 years, and the prevalence increases with age. It can appear in one or both wrists; while despite the parts in the wrist, it is more common in women than in men. People who are at risk of developing carpal tunnel syndrome are those who perform activities or jobs that involve repetitive finger use. Motions that can place people at risk of experiencing carpal tunnel syndrome include high-force (hammering), long-term use, extreme wrist motions, and vibration. Many other factors may also contribute to the development of carpal tunnel syndrome. These factors include heredity, pregnancy, hemodialysis, wrist fracture and/or dislocation, hand or wrist deformity, arthritic diseases, hormone imbalance, diabetes, alcoholism, a tumor inside the carpal tunnel, and an abnormal protein.
How Does It Affect You?
While carpal tunnel syndrome is a common condition, it has a different set of symptoms from many other sources of hand pain. There are actually several similar conditions that cause hand pain. These symptom complications include:
- De Quervain’s tendinosis – A condition where swelling (inflammation) affects the wrist and base of the thumb. In this condition, the patient will feel pain when you make a fist and shaking someone’s hand.
- Trigger finger – This condition causes soreness at the very base of the finger or thumb. Trigger finger also causes pain, locking (or catching), and stiffness when bending the fingers and thumb.
- Arthritis – This is the main term for many conditions that can cause stiffness and swelling in the joints. Arthritis can impact many joints in the human body and ranges from small amounts of discomfort to breaking down the joint over a period of time.
Carpal tunnel syndrome can be highly difficult to prevent. The condition can be caused by so many different activities in a person’s daily life that prevention can be extremely challenging. Workstation changes, proper seating, and wrist placement can help decrease some factors that can lead to the development of carpal tunnel syndrome. Other preventative methods include sleeping with your wrists held straight, keeping your wrists straight when using tools, avoiding flexing (curling) and extending your wrists repeatedly, decreasing repetitive grasping with the affected wrist in a flexed position, taking frequent rest breaks from activities, and monitoring and properly treating medical conditions linked to carpal tunnel syndrome.
Treatment targets to relieve symptoms and reduce the progression of carpal tunnel syndrome by decreasing pressure on the median nerves. Patients 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 the syndrome occurs during pregnancy. For 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 onto the affected wrist can help when the problem flares up, although, ice should not be applied directly onto the skin.
- Controlling the triggers – If carpal tunnel syndrome stems from repetitive hand movements, the patient should take breaks so the hand and wrist have the time to rest and recover.
- Occupational therapy – A therapist can teach a patient how to repetitive tasks in a variety of ways.
- Wrist splints – These keep the wrist in the same position and help prevent it from bending. They can be worn during sleep, but also during the day if they do not interfere with any daily activities. Wrist splints are available over the counter at pharmacies. A doctor or pharmacist can advise about the best wrist splints to choose.
Most patients with mild symptoms who follow these types of strategies will then notice an improvement within 4 weeks.
Self-tests for carpal tunnel syndrome include tapping the wrist lightly to see if this produces a tingling sensation or numbness in the fingers. Another test is to flex the wrist or hold it above the head for a minute. If there is pain, numbness, or tingling, it may mean that carpal tunnel syndrome is currently in development. However, these self-tests are not conclusive. A primary care physician can normally diagnose carpal tunnel syndrome after asking about symptoms and examining the hand and wrist for any signs of weakness inside the muscles from around the thumb. They will also assess how well the person can use the hand and wrist.
A number of diagnostic tests can indicate if a person is likely to have carpal tunnel syndrome:
Tinel’s test, or Tinel’s sign – The doctor taps the median nerve at the wrist lightly to see whether the patient feels the numbness or tingling in one or more fingers.
Phalen’s test for wrist-flexion – The patient presses the back of the hands against each other so that the wrist is bent. If tingling or numbness occurs within one minute, there may be damage to the median nerve.
Nerve conduction study – Electrodes are placed on the hand and wrist. Small electric shocks are then applied. The test measures how quickly the nerves transmit the impulses to the muscles.
Electromyography – A fine needle is inserted into the muscle. Electrical activity on a screen may reveal whether there is any median nerve damage, and if so, how severe it currently is.
Blood tests – Blood tests can detect an underlying condition that can be related to carpal tunnel syndrome, including hypothyroidism, rheumatoid, arthritis, or diabetes.
Imaging scans – An x-ray can show whether there is a fracture or some other disorder, such as rheumatoid arthritis. An ultrasound scan can identify the structure of the median nerve. Studies have discovered that MRI scans are not useful in diagnosing carpal tunnel syndrome.
The doctor may recommend corticosteroid injections to help reduce inflammation. These are normally applied by injection, which then heads directly into the carpal tunnel. Tablets are available, although, they are usually less effective. At first, the pain may increase, but it should begin to reduce after 2 days.
If the response is positive, but symptoms tend to return after a few months, another dose may be recommended. However, continued use of corticosteroids is not advisable, as there can be long-term risk effects.
Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, may help relieve short-term pain. These can only help if the carpal tunnel syndrome is due to an underlying inflammatory condition, rather than repetitive use.
Alternative & Homeopathic Treatments
If you experience mild carpal tunnel syndrome, you may be able to ease your symptoms with lifestyle changes and medication. Here are 7 home remedies for carpal tunnel relief:
- Take breaks from repetitive activities – Whether you are typing, playing guitar, or using a hand drill, try setting a timer beforehand for 15 minutes. When it goes off, stop what you’re doing and wiggle your fingers. Stretch your hands and move your wrists to help improve blood flow to these areas.
- Wear splints on your wrists – Keeping your wrists straight can help relieve the pressure on your median nerve. Symptoms are more common at night, so wearing a splint in the evening may help relieve your symptoms before they start. If in case you have issues with repetitive tasks while at work, you can also wear wrist splints during the day.
- Lighten up – If you ever find yourself straining or forcing tasks such as writing, typing, or using a cash register, relax your grip or reduce the force you are using. Try using a soft-grip pen or tapping keys more lightly.
- Mind your flexion – Avoid activities that make your wrists flex to the extreme in either direction. Try to keep your wrists neutral as much as possible.
- Stay warm – Keeping your hands warm can help with pain and stiffness. Consider wearing a fingerless glove or keeping hand warmers nearby.
- Stretch it out – You can do quick wrist exercises while you’re standing in line at a store or sitting on a chair either at home or at work. For example, make a fist and then slide your fingers until they are straight again. Repeat this method 5 to 10 times. This can help relieve any pressure on your affected wrist.