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Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a painful condition of the hand and fingers caused by compression of a major nerve where it passes through a passage made by the carpal bones in the wrist. It may be due to frequent repetitive movements or by fluid retention.

Carpal tunnel syndrome (*) is a condition in which the Median nerve which is very sensitive to pressure and controls muscles that move the thumb and carries information about sensations in some fingers, becomes compressed where it passes through the wrist.

* A syndrome is a group of signs and symptoms that together are characteristic or indicative of a particular disease or disorder.


Symptoms of Carpal Tunnel Syndrome

  • Tingling, numbness and pain in one or both hands.
    Weakness in fine finger movements, such as writing or fastening buttons, become more challenging.
  • These symptoms often occur in the thumb, the index, middle and half of the ring finger. However, the tingling and pain can extend outside this area.
  • Symptoms tend to develop gradually, initially being worse at night or in the morning. Shaking the hand will often relieve the pain and tingling.
  • Any repetitive actions of the hand or wrist can aggravate the symptoms,
  • A wrist that is swollen or inflamed due to arthritis could be the cause of tendon symptoms.

Causes of Carpal Tunnel Syndrome

  • In some cases, there isn’t an apparent reason. However, possible causes can include:
  • Hormonal changes during pregnancy
  • Hypothyroidism active thyroid gland
  • Diabetes
  • Following a wrist fracture of the wrist
  • Arthritic changes in the wrist especially if there is also swelling.

Diagnosis

Is usually made from taking a medical history, a wrist and hand examination and some special nerve tests.

Muscle wasting at the base of the thumb, or altered sensation (usual numbness) in the thumb, index and middle fingers are other signs and symptoms to be explored,

Special tests

  • Tinel’s test: Tapping over the median nerve on the palm side of your wrist
  • Phalen’s test: Bending palm towards the forearm for up to a minute.

Treatments for carpal tunnel syndrome

It is possible that it will settle with conservative treatment. However, some people may require surgery

Simple treatments can often help, including:

  • A ‘resting’ wrist splint, especially useful if symptoms are worse at night.
  • A ‘working’ splint is helpful symptoms if particular activities are aggravating factors, the splint should hold your wrist slightly extended (bent back)
  • A physical therapist (osteopath or physiotherapist) will advise about on a suitable splint for you, along with certain exercises which might help prevent the median nerve becoming stuck to nearby tendons.

Medication

A steroid injection can offer short-term pain relief, and a maximise the opportunity for rehabilitation exercises recommended by a physical therapist


Surgery

In severe compression of the median nerve or if the numbness and pain don’t improve with conservative management or treatments, surgery may be necessary. It’s a simple day-case operation usually conducted under a local anaesthetic; it aims to reduce the pressure on the Median nerve consequently relieving pain. Surgical outcomes are typically favourable, but, as with all surgical treatments, some people will have complications.


Please note:
This is for guidance only, it should not be regarded as a substitute for medical advice, diagnosis or treatment given in person by an appropriately trained health professional