This article has been compiled by Vaibhavi Kodnani, a content writer at Proactive For Her. https://www.linkedin.com/in/vaibhavi-kodnani-09016a9b/
What is the carpal tunnel?
Carpal tunnel is a narrow passageway, situated at the base of the palm side of the hand. It comprises the median nerve and tendons that help in bending the fingers.
What is the median nerve?
The median nerve is one of the main nerves that runs through the arm, passes through the carpal tunnel in the wrist and ends in the hand. The median nerve controls the movement and feeling of the thumb and all the fingers except the ‘pinky or last finger’.
What is the Carpal Tunnel Syndrome?
Carpal tunnel syndrome, commonly called the Median Nerve Syndrome occurs when the Median Nerve is compressed or ‘pinched’ in the wrist. It can create tingling, numbness and weakness in the hand and the arm. This syndrome can occur in either one or both of your hands.
Carpal tunnel syndrome can occur at any age. However, people between 30-60 years of age are most frequently diagnosed with it.
What are the symptoms of Carpal Tunnel Syndrome?
You will feel the following symptoms in the thumb and all fingers except the little finger. These include:
- Weakness in the hand
- Tingling, burning, itching, numbness in the palm, thumb, index and middle finger
- Tingling or ‘pins and needles’ feeling across the arm
- Pain in the arm and hand
What are the effects of this syndrome?
- Carpal tunnel syndrome can affect your activities of daily living. Usual hand and wrist movements can become difficult and painful.
- Over time, without appropriate treatment, the condition can worsen. You may find it difficult to grip and hold daily objects or maintain a particular hand position for long.
- You will experience immense pain and numbness in your affected hand and arm. Muscle fatigue will continue to increase, which means your hand will feel weaker.
- The strength, as well as coordination of the thumb and fingers, will be affected. You will find it difficult to perform certain activities like pinching, holding, etc. You may thus drop objects.
What causes Carpal Tunnel Syndrome?
Repetitive hand or wrist movements
Overextending or repetitive movements of the hand and wrist can create a lot of pressure on the wrist and the median nerve. It can cause the median nerve to compress and swell, creating a lot of pain and discomfort. The following situations can make one vulnerable to getting affected with the Carpal Tunnel Syndrome.
- Repeated finger and wrist movements while typing, playing instruments
- Overextending the wrist while using the mouse
- Continuous exposure to vibrations on the hand and wrist
Underlying medical conditions
Some medical conditions can cause nerve swelling and at times, also restrict the blood flow. The conditions often linked with the carpal tunnel syndrome are,
- Rheumatoid arthritis
- Hypothyroidism
- Diabetes
- Trauma, Wrist Fracture
- Pregnancy
- Menopause
What are the risk factors for developing this syndrome?
- Sex: Women are more likely to be affected by this than men. Hormones fluctuations during pregnancy and before or after menopause can cause fluid retention in different parts of the body. It can lead to compression of the nerves. Women also tend to do more household chores which can contribute to development of the carpal tunnel syndrome.
- Diabetes or other medical conditions: Diabetes inflames the nerve and tendons, making them more susceptible to compression.
- Some jobs: Jobs that require repetitive finger and wrist movements, awkward hand positions, vibrations or stress on the wrist. It can include bakers, cashiers, hair stylists, musicians, typists, assembly line workers, surgeons, homemakers, etc. Rigorous hand movements like pulling, pushing, tugging, twisting, etc. can also lead to this issue.
How is Carpal Tunnel Syndrome diagnosed?
If you experience any of the symptoms, you must consult a doctor immediately.
Your physiotherapist or orthopaedic doctor will first perform some physical tests on your wrist to confirm the syndrome. One such test is the Phalen’s test - the therapist will ask you to stretch out your hand, bend your wrist towards the floor and keep it intact for at least 30 seconds. If you start experiencing tingling sensations and numbness, then you may be having the carpal tunnel syndrome.
Other examinations like X-Ray, ultrasound and MRI will allow the doctor to see the bones, soft tissues and the muscles.
The doctor may also perform Electromyography (EMG) to study your nerves and muscle activity. The nerve conduction study is a diagnostic test to measure the strength and speed of the signals in the nerves.
What are the treatments for Carpal Tunnel Syndrome?
If carpal tunnel syndrome is diagnosed in the early stages, the recovery is quick and successful. But, if you ignore the symptoms and the condition is left untreated for long, it can become more severe and even lead to permanent muscle damage.
To avoid complications, visit a doctor as soon as you develop the symptoms of Carpal Tunnel Syndrome. You must diligently follow the necessary steps of treatment.
Non-surgical treatment methods - All of the below-mentioned methods alleviate the symptoms and promote rapid healing and recovery if followed sincerely.
Lifestyle changes
- Avoid activities involving repetitive movements of the hand and the wrist for a certain period to allow healing.
- Take regular breaks in between to provide relief to your hand and wrist.
- Modify the activities involving the affected hand and wrist.
Medication
Your doctor may prescribe certain medications for the inflammation and pain to subside.
- Anti-inflammatory drugs
- Pain killers
In some cases, the doctor may give steroid shots to reduce the swelling. It will also relieve the pressure on the median nerve.
Exercise
Exercise is one of the most important steps for recovery from this condition. If done regularly, it can even prevent it from occurring.
- Do strengthening exercises for the arm, forearm and wrist muscles. These exercises will help regain strength and control of the hand and wrist.
- Focus on stretching the muscles around the wrist joint to achieve an easy and comfortable range of movement.
- Perform various nerve gliding exercises to allow the nerve to move better in the carpal tunnel passage.
Immobilization
The doctor may also recommend you to wear wrist splints. A wrist splint looks like a fingerless glove and prevents unwanted movements of the wrist. It lessens the pressure on the median nerve and allows the wrist to rest.
Surgery
When none of the non-surgical methods of treatment provide relief, the doctor will suggest you opt for the carpal tunnel release surgery. The surgery will increase the size of the carpal tunnel to reduce the pressure on the median nerve.
Can Carpal Tunnel Syndrome occur again after treatment?
The people undergone the carpal tunnel release surgery will mostly not get the symptoms of carpal tunnel syndrome again.
People treated with non-surgical methods need to continue doing their exercises to strengthen their muscles. They should also take regular breaks in between their intense activities. Following the recommended lifestyle changes and hand exercises will minimize their chances of experiencing this condition.
What are the ways to prevent yourself from Carpal Tunnel Syndrome?
- Avoid repetitive movements of the wrist that causes stress.
- Take regular breaks between activities to give rest to your hand and wrist.
- Avoid extreme wrist movements like flexion or extension.
- While working, make sure your table is at the height of your elbows.
- While typing, maintain a straight neutral wrist. Avoid extending or bending the wrist too much.
- While using the mouse, use some form of padding or a small roll of towel as a cushion under the wrist. This provides added support and reduces the pressure on the joint.
- Regularly exercise to strengthen the muscles.
- Visit a therapist as soon as you feel pain and difficulty in hand movements.