Overview of Carpal Tunnel Syndrome:
It is a nerve disorder affecting the strength and sensations of the hand and wrist caused by pressure on the median nerve. This nerve supplies all 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.
Symptoms of Carpal Tunnel Syndrome:
Mostly, the symptoms develop gradually and have on-and-off characteristics. A more severe manifestation of the condition, i.e., in later stages, may include the following symptoms:
Tingling, numbness, pain, and burning sensation.
Radiating shock-like symptoms in the fingers.
Weak and clumsy hands 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.
The pain might have a different nature and intensity. However, few patients do not report pain at all.
What are the Risk Factors of Carpal Tunnel Syndrome?
Certain conditions make a person more susceptible to acquiring this condition, and they are as follows:
Familial or Hereditary: It could be due to genetics. This disease may run in families.
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 varying hormone levels. It might result in carpal tunnel syndrome.
Gender: Women are more likely to be affected. Reports from the World Health Organization (WHO) show that men are affected too, but in very few numbers.
Underlying Medical Condition: General health conditions like rheumatoid arthritis, diabetes, and an imbalance of thyroid hormones have been known to be associated with this condition.
What Are Diagnostic Tests?
The following diagnostic methods will be used on visiting the doctor, along with certain tests to conclude.
Physical Examination: A physical examination would be the best way to diagnose.
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 the 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: This 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 can 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.
Electromyogram: As the name suggests, this investigation measures the conduction of electricity in muscles and nerves. In medical terms, “myo” refers to muscles. The technology of electromyograms 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 of the soft and hard tissues. Hence, the patient may be advised to go for a wrist ultrasound.
X-ray: A hand-wrist radiograph showing the arrangement of 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, patients with this syndrome develop tingling or numbness in the fingers within 60 seconds: the earlier the symptom, the more severe the condition.
What Are the Treatment for Carpal Tunnel Syndrome?
It is always better to visit the 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, they can be worn.
Non-steroidal anti-inflammatory drugs are given to reduce pain, like Ibuprofen and Naproxen.
Change the activities that cause them pain or symptoms and give 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 it is called a carpal tunnel release.
This can be done either endoscopically or through conventional methods. After surgery, the patient will be asked to elevate the hand above the heart level and move fingers to avoid or reduce swelling and stiffness. There can be minor symptoms like pain and swelling for a few months, and it may take time to get the pinch and grip actions back entirely and effectively. The patient 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 the doctor to clear the doubts and get the necessary treatment as soon as possible.
Call a doctor online for further queries.
To conclude, people should not ignore any unusual symptoms like numbness or tingling sensation in their hands, as this could be a sign of carpal tunnel syndrome, a common condition. Although it can be treated; however, delay in treatment can affect the quality of life of the affected individual as this syndrome affects the hands.
Frequently Asked Questions