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Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is a condition characterized by weakness and pain in the wrist and hand. The condition is attributed to issues in the median nerve, and not the muscles or tendons as some people believe. Symptoms of carpal tunnel syndrome can range from mild to debilitating.

Carpal Tunnel – The passageway that forms beneath the broad and strong transverse ligament is called the carpal tunnel. The floor of the tunnel is the bowl-shaped carpal bones.

Median Nerve and Flexor Tendons – Nine flexor tendons and the median nerve pass under the ligament bridge and through the carpal tunnel.

  • The fibrous cords that connect the muscles in the forearms to the fingers are called flexor tendons. They also make the clenching of the fist and the flexing of the fingers possible.
  • The median nerve serves two key roles—it provides motor and sensory function for the thenar muscle (found at the base of the thumb) and supplies sensation to the flexor tendons and the palm side of the index, thumb, and the middle and ring fingers.

Process

How the process that leads to carpal tunnel syndrome evolves is not completely known. In essence, the condition occurs when the tissues found around the median nerve inflames and presses on the nerve. The disorder is reversible in its early stage. However, over time, the nerve insulation may wear away and permanent nerve damage can occur.

Causes

Carpal tunnel syndrome is classified as an inflammatory disorder resulting from physical injury, repetitive stress, or other medical conditions like rheumatoid arthritis. Determining the precise cause of the condition however is very difficult as no tests to identify the specific cause is available. With the exception of patients with certain underlying conditions, the biological mechanisms that lead to the development of CTS is unknown.

While some studies indicate that more than half of the CTS cases are associated with workplace factors, no strong evidence of a cause-and-effect relationship is available. In fact, some recent studies strongly suggest that carpal tunnel syndrome is sometimes associated with medical conditions like diabetes, hypothyroidism, and osteoarthritis. People with certain environmental or genetic risk factors have also been observed to be more susceptible to developing carpal tunnel syndrome. It is also associated with golf, especially those who are just starting into the game. Risk factors include alcohol abuse, smoking, obesity, and significant mental stress. The condition has also been observed to run in families, suggesting that it has some type of genetic origin.

While some physical and medical conditions are considered initial culprits leading to the development of the condition, certain working conditions have been associated with nerve damage. Jobs that involve vibration or high force are considered particularly hazardous, as is repetitive wrist and hand work especially in cold temperatures.

Symptoms

Symptoms of the condition typically progress gradually over months, sometimes, even years. However, those who experience persistent or recurrent pain, tingling, numbness, and weakness in the hand should check with a doctor. Some of the most prevalent symptoms of CTS include:

  • Pain in the palm side of the hand and wrist.
  • Tingling, burning, numbness or a combination of those symptoms in the palm side of the ring, middle, and index fingers.
  • Over time, patient may lose the ability to feel cold or heat. A noticeable sense of weakness and a tendency to drop things may also be experienced.
  • Some patients may feel that their hands are swollen even when there is no visible signs of swelling.

Prevention

Depending on persistence, cause, and the patient’s individual characteristics, carpal tunnel syndrome can be a minor inconvenience or a disabling condition. For mild cases, symptoms will not last long and the condition will get resolved on its own. However, in severe cases that are untreated, loss of sensation may become permanent when the muscles found at the base of the thumb will wither. Since several factors are believed to contribute to the condition, there is no single way to prevent the condition from developing.

Below are some of the ways to prevent carpal tunnel syndrome:

  • Those whose jobs entail repetitive tasks should take multiple microbreaks (at least 3 minutes each time), begin each task with a warm-up, and when possible, avoid overexertion of the fingers and the hands.
  • Good posture is considered very important in preventing carpal tunnel syndrome, especially for computer users and typists. Use a wrist pad. Those who use a computer mouse and keyboard can help prevent the development of the condition by making sure the wrist and hand is in relaxed position at all times.
  • Wrist and hand exercises may also help minimize one’s risk for developing CTS. Stretching and isometric exercises can also strengthen the muscles of the hands and the wrist.
  • Keeping the head upright and the neck flexible can also help maintain the proper nerve function and blood circulation to the hands and arms.
  • During microbreaks, activities like stretching or shaking the limbs, squeezing the shoulder blades together, leaning back in the chair, and taking deep breaths should be performed in order to reduce discomfort and strain.
  • When possible, working at low temperatures should be avoided as it can significantly reduce sensation in the fingers and hands.
  • Wearing thick gloves whenever possible is also advisable as it can help lessen the shock that will be transmitted to the wrist and hands.

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