Have you ever noticed weakness, numbness, or tingling in your hands or wrist? These symptoms may be due to a common condition called carpal tunnel syndrome.
It is a nerve disorder affecting the strength and sensations in hand and wrist, caused by pressure on the median nerve. This nerve supplies all the four fingers except the small one (pinky finger) and a few muscles at the thumb’s base, which is due to the narrowing of the tunnel. According to studies, women and the elderly are more affected. If it is not treated correctly, then it might lead to various symptoms such as weakness and numbness of the muscles.
Mostly, the symptoms develop gradually and have on-off characteristics. Once, it develops into a more severe form, in later stages, the symptoms are frequent and can represent as follows:
Tingling, numbness, pain, and burning sensation.
Radiating shock-like symptoms in the fingers.
Weak and clumsy hands that make it challenging to perform small day to day activities.
Unable to hold things or often dropping them because of loss of proprioception or weakness.
Pain. The pain might have different nature and intensity. However, few patients do not report pain at all.
Certain conditions make a person more susceptible to acquire this condition, and they are as follows:
Familial or hereditary.
Repetitive movement of the hands: This may activate the tendons present in the wrist and cause swelling that leads to pressure on the nerve.
Pregnancy: Changes in the hormones may cause it. It is identified by some researchers that the pregnancy period is the most crucial one. An increase in the level of hormones might contribute to the unstable hormone levels. It might result in carpal tunnel syndrome.
Gender: Women are more likely to be affected. Reports from the World Health organization show that men are affected too but in very few numbers.
General health conditions like rheumatoid arthritis, diabetes, and imbalance of thyroid hormones have known to be associated with this condition.
Alcoholics. The habit of drinking alcohol might directly involve the median nerve. This might be very harmful to the patient. In the very few reported cases of carpal tunnel syndrome in males, the main reason was an addiction to alcohol.
Tumor in the tunnel region that causes compression of the nerve.
On visiting your doctor, the following diagnostic methods will be used, along with certain tests to conclude.
The physical examination would be the best way for diagnosis.
Gently tap or apply pressure in the median nerve area along with the inside region of the wrist and check for any numbness or tingling sensation.
Extend or flex your wrist and look for any numbness.
Checking the sensation in fingers with instruments and the patient’s eye closed.
Any weakness in muscles near the thumb.
Any weakness might indicate carpal tunnel syndrome. But for the confirmatory part, the doctors will proceed with the other tests. They are:
Electrophysiological Tests: This helps to identify the severity of the nerve damage or compression. It can diagnose any other nerve compression or condition if present.
Nerve Conduction Studies:
It helps to identify the nerve that is not conducting the signals and the severity, thus guiding the treatment as well. It also detects how fast the median nerve could transfer the impulse. While performing this procedure, many electrical node patches are attached to the skin. The nerve will be voluntarily stimulated for this study.
As the name suggests, this measures the conduction of electricity in muscles and nerves. In medical terms, “myo” refers to muscles. The technology of electromyogram records the electrical activity of the skeletal muscles.
Ultrasound: It is a non-invasive procedure and is the best diagnostic tool. This checks for nerve compression via imaging the soft and hard tissues. Hence, you may be advised to go for a wrist ultrasound.
X-ray: A hand-wrist radiograph showing the arrangement bone will further help in diagnosis. Also, it can be used to rule out other conditions of bone. This might not be helpful in mild cases of carpal tunnel syndrome.
MRI: Magnetic resonance imaging can be used to visualize the soft tissue in a more detailed way.
Wrist Flexion Test (Palen Test): In this, the patient is asked to rest elbows on the table and let the wrist fall freely for some time. Usually, the patients with this syndrome develop tingling or numbness in the fingers within 60 seconds: the earlier the symptom, the more severe the condition.
It is always better to visit your doctor in the initial stages of the symptom to get better treatment and outcome. The management can be either conservative or surgical.
Conservative or non-surgical management: When the symptoms are in the initial stages, the following might help and avoid any surgery needed. Lifestyle modification is needed. If the person is addicted to alcohol, they might refrain from the habit.
Bracing or Splinting: Wearing them helps to relax the nerves and thus reduces the symptoms. They are preferred at night, but even during the morning, this can be worn.
Non-steroidal anti-inflammatory drugs are given to reduce pain like Ibuprofen and Naproxen.
Change in the activities that cause them pain or symptoms and giving rest to severe wrist movements.
Exercises for Nerve Gliding: Certain exercises help relieve the nerve from the tunnel and can be followed under a doctor’s supervision and advice.
Steroid Injections: Injecting these in the carpal tunnel will help relieve the symptoms temporarily.
Surgical management: In case of severe symptoms of muscle weakness or damage, a surgical method is followed to relieve the nerve and is called a carpal tunnel release.
This can be done either endoscopically or through conventional methods. After surgery, you will be asked to elevate your hand above the heart level and move fingers to avoid or reduce swelling and stiffness. There can be minor symptoms like pain, swelling for a few months, and it may take time to get your pinch and grip actions back entirely and effectively. You may also have to wear a brace or splint for quite some time (weeks).
Though the symptoms may look initially not so bothersome, it is always advisable to consult your doctor to clear the doubts and get the necessary treatment as soon as possible. The availability of doctors online through some medical platforms has made consultations easy, and thus, you can get guided professionally.
Call a doctor online for further queries.
In the case of no treatment, carpal tunnel syndrome will lead to symptoms like numbness and weakness that could be mild, moderate, or even very severe. It might affect the routine activity of the affected individual. Adequate treatment and consultation with the physician are mandatory to prevent complications. Treating at an earlier stage is better.
The following job people have a higher risk of Carpal tunnel syndrome, which involves repetitive hand movements, strong gripping, and mechanical stress in the palm.
Assembly line worker.
Sewer or knitter.
The warning signs of carpal tunnel syndrome are a pain that radiates from the hand towards the shoulder. Secondly, a pain that is more severe on the thumb side of the hand. An untrue feeling of having shocked near the thumb and fingers near the thumb. Numbness, tingling, weakness can also be other presenting warning signs in a patient affected by carpal tunnel syndrome.
Carpal tunnel syndrome occurs due to the compression of the median nerve in the wrist. This would lead to ischemia of the wrist that can further lead to symptoms like numbness, weakness, and tingling sensation of the hand and wrist. It most commonly presents with pain in and around the wrist region. You should contact your doctor if you have severe discomfort and pain.
The surgery indicated for carpal tunnel syndrome is carpal tunnel release surgery. During the treatment of carpal tunnel syndrome, the transverse carpal ligament is cut, which was initially causing pressure on the median nerve, and this surgery would involve a cut or incision from the base of the palm.
Non-surgical treatment of carpal tunnel syndrome is possible at the initial stages of the syndrome that would include wrist splints that can be used to limit the movement of the hands, especially during sleeping. Non-steroidal anti-inflammatory drugs can be used to help with pain and inflammation. Corticosteroids can be used to treat patients with inflammation, and this group of drugs also aids in relieving pressure over the affected median nerve.
The ways to overcome carpal tunnel syndrome:
Rest to hands and wrist or restricting movements to the hand
Grip losing exercises.
Fetal position during sleeping has to be avoided in all means and ways. To avoid sleeping in a fetal position, one can choose a pillow hugging method of sleeping. Wrist splints can be worn during sleeping to avoid movements making sure the splint does not compress much. For more clarification on this, get help from our experts at icliniq.com.
Carpal tunnel syndrome initially presents as pain and swelling, mild numbness, weakness, and tingling, which confuses with many other disease presentations. However, on a thorough and focused physical examination, carpal tunnel syndrome can be elicited.
Over the counter pain medications, warm compress over the wrist and hand, wearing splints and attempting to perform mild wrist stretching exercises are the various methods to relieve pain from carpal tunnel syndrome.
On having the symptoms of weakness, numbness, pain, tingling sensation, and most importantly, considering your work nature and routine activities, we can conclude that it might be carpal tunnel syndrome. But if you need to confirm the condition, then you should consult your doctor.
The normal carpal tunnel syndrome is not a serious disorder to be feared off, especially if proper medical care is given there is no need for worrying. Complications occur only if it is left untreated. The tendons and ligaments start getting affected in the later stages.
Carpal tunnel syndrome rarely goes away by itself. You should consider taking proper treatment for this. With medical treatment, it does not usually recur. Also, the treatment does not leave behind any lifetime defects in the hand and wrist of the affected patient.
The patient should perform a series of physiotherapy exercises to heal naturally. It is possible to fix the syndrome naturally only if the effect or severity of the syndrome is way less. Once the median nerve is severely compromised, natural remedies do not usually help.
Many people may proceed to their usual workouts with prescribed medical braces, but however to be on the safer side, patients are instructed to avoid wrist gripping exercises like weight lifting and pull-ups and pushups. It would be better if exercises are avoided completely until full cure and recovery of the disease are achieved.
Adequate medical care and treatment is the only way to stop the progress of the disease. The other way of treating the disease from progressing is avoiding the activities that aggravate carpal tunnel syndrome. Do not involve in physical activities.
It is a procedure done under anesthesia. So, usually, it is not painful. However, the pain might be present post-surgically. The degree of pain is also related to the cause of the syndrome. If it is only due to repetitive movements, the pain is quite less, but if it is due to any trauma and associated other injuries, the pain could be worse and severe.
Yes, it is possible that you might get nerve damage. If left untreated carpal tunnel syndrome might lead to permanent injury to the nerve, it might cause ischemia that might lead to necrosis, so treatment is mandatory to prevent permanent damage to the median nerve.
Last reviewed at:
10 Aug 2020 - 4 min read
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